Premenstrual Syndrome - FAQs

What is Premenstrual Syndrome (PMS)?

PMS is a combination of physical, psychological and behavioural disturbances resulting in deterioration of interpersonal relationships and/or interference with normal activities that occurs after a woman's ovulation and normally ends with the onset of her menstrual flow, i.e., approximately 10-14 days before menses.

How Common is PMS?

About 85% of women experience some features of PMS. 2 - 10% of women have severe enough PMS symptoms which have an impact on their work, relationships or lifestyle in a significant way and thus require treatment.

What are the Symptoms of PMS?

The symptoms of PMS cause varying degrees of discomfort, but are largely harmless, and may be:

Physical Symptoms

  • Headache, backache, abdominal pain
  • Skin problems
  • Swollen joints (particularly ankles)
  • Water retention
  • Weakness
  • Weight gain, bloating
  • Breast tenderness (mastalgia)
  • Nausea

Behavioural Symptoms

  • Fatigue
  • Dizziness
  • Insomnia
  • Food and alcohol cravings
  • Overeating
  • Excessive sleep

Psychological Symptoms

  • Irritability
  • Tearfulness
  • Depression
  • Mood swings
  • Anger, anxiety
  • Forgetfulness

Premenstrual tension may appear up to 2 weeks before a period, and stops soon after bleeding starts.

What are the Causes of PMS?

The causes of PMS remain unknown but could be due to:

  • Deficiencies in prostaglandins (PGE1)
  • Increased sensitivity to progesterone
  • Serotonin deficiency
  • Genetic factors
  • Sodium and water retention

How Does PMS Affect a Woman?

PMS affects the woman's quality of life by affecting her:

  • Personal life
  • Family life
  • Social life
  • Career
  • Sexual life
  • Interpersonal relationships

How is PMS Diagnosed?

Diagnosis of PMS is done by excluding any other physical and psychiatric disorder. PMS also must be distinguished from simple premenstrual symptoms (e.g., bloating, breast tenderness) that do not interfere with daily functioning and are characteristic of normal ovulatory cycles.

The three key elements of the diagnosis are:

  • Symptoms consistent with PMS
  • Consistent occurrence of symptoms only 2 weeks before start of the menstrual cycle
  • Negative impact of symptoms on work and lifestyle

How is PMS Managed?

PMS can be managed by lifestyle modification and medications -

1) Lifestyle Modifications

  • Patient education - reassurance and explanation
  • Relaxation therapy - rest, yoga, meditation
  • Behavioural changes - by keeping a symptom diary
  • Dietary changes - multivitamins, evening primrose oil, calcium, magnesium, restriction of sodium, caffeine
  • Exercise - aerobics, walking

2) Medicines to Eliminate Symptoms of PMS and Make Daily Activities Easier.

For more details, kindly consult your doctor.

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