Article Medically Reviewed By:
Ellen W. Freeman, PhD
Research Professor Department of Obstetrics/Gynecology and Department of Psychiatry University of Pennsylvania School of Medicine Philadelphia, PA
Overview
What Is It?
Premenstrual syndrome (PMS) describes a wide range of severe, recurrent symptoms that occur from several days to two weeks before your period. Up to 40 percent of menstruating women have symptoms severe enough to disrupt their lives. The symptoms of PMS can appear any time between puberty and menopause, although the most common age for it to start to become a problem is during the late 20s to early 30s.
Symptoms of PMS may get worse with age and stress, although the underlying causes are not well understood. Even women who have had hysterectomies can have PMS if at least one functional ovary is left. Women who are vulnerable to depressive illness, panic disorder, other psychiatric disorders or chronic medical conditions may also be susceptible to PMS, although these conditions may occur in women without PMS as well. Heredity may also play a role: if your mother or sister suffers from PMS, you may find you experience it, too.
As many as 150 physical and behavioral symptoms have been assigned to PMS, but the number of PMS symptoms that most women experience is much more limited. The most common symptoms include irritability, bloating, mood swings, anxiety, depressed mood, fatigue, appetite changes, water retention and breast tenderness, among others. Menstrual cramps, or dysmenorrhea, are not considered a PMS symptom, although women with PMS may experience cramps.
PMS appears to be caused by rising and falling levels of the hormones estrogen and progesterone, which may influence brain chemicals, including serotonin, a substance that has a strong affect on mood. It's not clear why some women develop PMS or PMDD and others do not, but researchers suspect that some women are more sensitive than others to changes in hormone levels.
Calcium may play a role in PMS. In one study, women who took 600 mg of calcium twice a day experienced fewer PMS symptoms than women who took a placebo.
Dietary changes and exercise may also help relieve the discomfort of PMS symptoms. When symptoms are severe, serotonergic antidepressant medication may be prescribed. It is thought that increased serotonin reduces PMS symptoms.
One of the most important strategies for coping with premenstrual discomfort is to be aware of any pattern your symptoms follow. The more aware you are of your symptoms—when they start and stop and what works best to relieve them, for example—the better you can develop strategies to recognize and cope with them—whatever they may be.
Premenstrual Dysphoric Disorder (PMDD)
Approximately three to eight percent of women experience premenstrua...
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