Premenstrual syndrome presents itself with a combination of physical and emotional symptoms. These include:

• Headache
• Undue fatigue
• Muscle ache and joint pain
• Bloating
• Abdominal distention
• Constipation or diarrhea
• Muscle cramps
• Breast tenderness [6]
• Gain in weight
• Sleep problems
• Mood swings
• Depression [7]
• Crying spells
• Poor concentration
• Anxiety [8]
• Tension

Women with PMS do not experience all the above symptoms at the same time.

• Fatigue

  Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems. Depression. [mayoclinic.com]

  Depression, chronic fatigue, and premenstrual syndrome often coexist in women seeking treatment for premenstrual distress. [ncbi.nlm.nih.gov]

  The most common complaints are mood alteration and psychologic effects-irritability, nervousness, lack of control, agitation, anger, insomnia, difficulty in concentrating, lethargy, depression, and severe fatigue. [health.am]

  The most common complaints are mood alteration and psychologic effects--irritability, nervousness, lack of control, agitation, anger, insomnia, difficulty in concentrating, lethargy, depression, and severe fatigue. [web.archive.org]

• Weight Gain

  The lesions coincided with a premenstrual syndrome, characterized by fluid retention-related symptoms, such as leg swelling, breast tenderness, bloatedness with abdominal girth variation and weight gain. [ncbi.nlm.nih.gov]

  The most common physical and emotional signs and symptoms associated with premenstrual syndrome include: Weight gain from fluid retention Abdominal bloating Breast tenderness Tension or anxiety Depressed mood Crying spells Mood swings and irritability [web.archive.org]

  PMS Signs and Symptoms PMS has been characterized by more than 150 symptoms, ranging from mood swings to weight gain to acne. The symptoms vary from woman to woman and cycle to cycle. [healthcommunities.com]

  gain and bloating; individuals may experience mood changes Physiological, emotional, and mental stress related to the period of time immediately preceding menstruation 625.4 Excludes menstrual migraine ( 346.4 ) Applies To Menstrual molimen Premenstrual [icd9data.com]

• Ankle Swelling

  Diuretics (water tablets) Diuretics (water tablets) may give relief from ankle swelling. They will not relieve abdominal bloating, which is not caused by fluid retention but by relaxation and distension of the muscle in the wall of the bowel. [netdoctor.co.uk]

• Nausea

  Trichomonas vaginalis was significantly correlated with headache and Gardnerella vaginalis with nausea. [ncbi.nlm.nih.gov]

  Other nonspecific symptoms may include headache, vertigo, paresthesias of the extremities, syncope, palpitations, constipation, nausea, vomiting, and changes in appetite. Acne and neurodermatitis may also occur. [web.archive.org]

• Abdominal Pain

  The disorders can manifest with a wide variety of symptoms, including depression, mood lability, abdominal pain, breast tenderness, headache, and fatigue. [ncbi.nlm.nih.gov]

  Definition of premenstrual syndrome : a varying group of symptoms manifested by some women prior to menstruation that may include emotional instability, irritability, insomnia, fatigue, anxiety, depression, headache, edema, and abdominal pain — called [merriam-webster.com]

  pain/cramps Treatment guidelines full guidelines available from… National Association for Premenstrual Syndrome, 41 Old Road, East Peckham, Kent TN12 5AP ( – 0844 815 7311 ) The National Association for Premenstrual Syndrome (NAPS). [guidelines.co.uk]

  pain The cause of premenstrual syndrome is unclear, but seems to be related to fluctuations in estrogen and progesterone levels in the body. [chop.edu]

• Abdominal Fullness

  It features irritability, depression, fatigue, tension, headache, breast tenderness, a sense of abdominal fullness and pain, fluid retention and backache. Various treatments may have to be tried before relief is obtained. [medical-dictionary.thefreedictionary.com]

• Bruxism

  We concluded that the excessive water retention caused a little widespread swelling, present at cheeks level also, that associated with a temporary bruxism (perhaps related to psychological stress typical of premenstrual syndrome) was probably responsible [ncbi.nlm.nih.gov]

• Joint Stiffness

  stiffness Exacerbation of epilepsy, migraine, asthma, rhinitis or urticaria Abdominal pain/cramps Treatment guidelines full guidelines available from… National Association for Premenstrual Syndrome, 41 Old Road, East Peckham, Kent TN12 5AP ( – 0844 815 [guidelines.co.uk]

• Mastodynia

  Water retention in the breast increases during this second, luteal phase, which is one of the main causes for the painful swelling of tissue inside the breast (mastodynia). [amitamin.com]

• Mood Swings

  PMDD signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension. [mayoclinic.com]

  Symptoms of mood swings, irritability, and anxiety occur in many women during the premenstrual phase of the menstrual cycle. Several promising treatment options now exist for women whose symptoms are severe and interfere with daily functioning. [ncbi.nlm.nih.gov]

  The most common physical and emotional signs and symptoms associated with premenstrual syndrome include: Weight gain from fluid retention Abdominal bloating Breast tenderness Tension or anxiety Depressed mood Crying spells Mood swings and irritability [web.archive.org]

  PMS Signs and Symptoms PMS has been characterized by more than 150 symptoms, ranging from mood swings to weight gain to acne. The symptoms vary from woman to woman and cycle to cycle. [healthcommunities.com]

• Loss of Libido

  ESTROGEN DOMINANCE AND PMS Progesterone deficiency (estrogen dominance) is much more likely since many of the symptoms correlate with estrogen dominance symptoms, most notably water retention, breast swelling, headaches, mood swings, loss of libido, and [johnleemd.com]

  The risk of perimenopausal and postnatal depression as well as anxiety disorders, appears to be higher amongst women with PMD. [ 3 ] Psychosexual problems, loss of libido and dyspareunia may be reported but usually have to be specifically asked about. [patient.info]

  It is suggested that avoidance of continuous use may reduce the risk of side effects of SSRIs, which can include anxiety, dizziness, insomnia, sedation, gastrointestinal disturbance, headache, loss of libido and anorgasmia (inability to achieve orgasm [doi.org]

• Emotional Outbursts

  Associated with verapamil therapy was a decreased severity in many symptoms of PMS, including agitation, depression, emotional outbursts, and irritability. A possible mechanism is discussed. [ncbi.nlm.nih.gov]

  outbursts See your doctor if physical pain, mood swings, and other symptoms start to affect your daily life, or if your symptoms don’t go away. [healthline.com]

• Auditory Hallucination

  hallucinations and delusion of reference, present only premenstrually; and (vi) remitted bipolar disorder presenting with premenstrual psychotic features. [ncbi.nlm.nih.gov]

• Delayed Menarche

  RESULTS: Intensive physical exercise delayed menarche. PMDD was diagnosed in 8% and PMS in 42.4% of all respondents. The prevalence of PMDD did not differ significantly between the groups (9.33% versus 6.00%). [ncbi.nlm.nih.gov]

• Irritability

  Tranquilizers (eg, a benzodiazepine) may be used for irritability, nervousness, and lack of control, especially if patients cannot alter their stressful environments. [health.am]

  PMDD is a severe form of premenstrual syndrome with symptoms including severe depression, feelings of hopelessness, anger, anxiety, low self-esteem, difficulty concentrating, irritability and tension. [web.archive.org]

  Tension and irritability were the most severe symptoms. Headache, irritability, self-deprecating thoughts, and depressed mood were the symptoms that were subjectively rated as the most burdensome. [ncbi.nlm.nih.gov]

• Headache

  Trichomonas vaginalis was significantly correlated with headache and Gardnerella vaginalis with nausea. [ncbi.nlm.nih.gov]

  The disorders can manifest with a wide variety of symptoms, including depression, mood lability, abdominal pain, breast tenderness, headache, and fatigue. [aafp.org]

There are no particular diagnostic tools for diagnosing PMS. Women need to consult their gynecologist when they begin experiencing unusual symptoms prior to menstrual cycle. It is also advised that women maintain a record diary wherein they would keep track of all the symptoms experienced during the week before the menstrual cycle begins. It is also necessary that women also make note of the date of initiation of period and the date when it ends.

• Hyponatremia

  A small number of volunteers presented hypocalemia (1,4%), hyponatremia (4,22%) and hypernatremia (7,04%). However, the higher number of the volunteers presented lower calcium level (83,09%). The frequency of anemic women was high (24%). [ncbi.nlm.nih.gov]

• Human Papillomavirus

  The following infectious agents were investigated: human papillomavirus, Chlamydia trachomatis, Neisseria gonorrheae, Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis. [ncbi.nlm.nih.gov]

• Chlamydia Trachomatis

  The following infectious agents were investigated: human papillomavirus, Chlamydia trachomatis, Neisseria gonorrheae, Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis. [ncbi.nlm.nih.gov]

Medications form the preliminary and most important part of treatment regime [9]. The following is the list of medications that are prescribed for treating PMS:

• Antidepressants belonging to the class of serotonin reuptake inhibitors have a positive impact on PMS symptoms. These drugs help to deal with problems of food cravings, mood swings, depression, sleep problems and fatigue.
• Non–steroidal anti-inflammatory drugs such as Advil, Aleve and Motrin are taken on the day of menstrual cycle. These drugs help relieve pain and discomfort.
• Diuretics can help reduce the fluid retention by shedding off the excess fluid through the kidneys.
• Oral contraceptives are prescribed which help stabilize the hormonal shifts and relieve the PMS symptoms.

In addition to medications, women are also advised to exercise regularly and stay physically active. Diet rich in vitamins and minerals and low in salt is also advised to avoid water retention during PMS.

Symptoms of PMS tend to get better with appropriate treatment. Medications and changes in life style have shown to play major role in improvement of PMS symptoms. However, a small percentage of women continue to suffer from severe symptoms until menopause.

Complications

The following are the complications associated with PMS:

• Women with PMS can suffer from major depressive disorders.
• Research has pointed towards the fact that women with PMS significantly indulge in alcohol and other substance abuse as compared to their counterparts.
• PMS also greatly increases the risk of other medical illnesses such as asthma and migraines. Certain other conditions can also get aggravated during PMS; these include irritable bowel syndrome, inflammatory bowel disease, seizures, epilepsy and multiple sclerosis.

The exact cause of premenstrual syndrome is unknown. However, several factors that are known to play a significant role in development of PMS have been listed below:

• Hormonal changes contribute significantly to PMS. The symptoms associated with hormonal fluctuations tend to go away during pregnancy and menopause [2].
• Changes in the levels of serotonin in the brain are known to trigger several symptoms of PMS. Low production of this neurotransmitter is thought to give rise to depression, sleep problems, food cravings and mood swings before the onset of menstrual cycle.
• Stress is one of the significant factors that can aggravate symptoms of premenstrual syndrome.
• Faulty eating habits are also identified as one of the potential factors that can give rise to PMS. A diet low in vitamins and minerals, high in sodium and caffeine can pave way for development of PMS in many women.
• Current researches has unearthed evidence that alterations in the endorphin release, gamma aminobutyric sytem, and production of prolactin may influence the occurrence of PMS [3].

PMS is a very common condition and it has been estimated that 3 out of every 4 women are affected with this condition. In the United States, about 90% of women suffer from PMS at least once in their lifetime. Women who smokes has twice the propensity to develop severe PMS than non-smokers [4].

Changes in the hormonal levels during the ovulation period are known to trigger premenstrual syndrome. A significant shift in the hormonal levels can cause drastic mood changes and can trigger symptoms of PMS. A diet that is low in magnesium and calcium can also trigger PMS. When nutritional supplements were given to menstruating women suffering from PMS, a significant improvement in the symptoms was noticed. Research has also found a strong link between deficiency of serotonin – brain chemical and PMS. PMS become totally non-existent beyond menopausal [5].

An active lifestyle and a healthy diet can go a long way in preventing PMS. Staying physically active and exercising regularly can help keep several symptoms of PMS at bay [10]. A proper diet combined with regular exercise helps relieve stress, improves the energy levels and has a positive impact on the mood of the individual.

Premenstrual syndrome (PMS) refers to group of symptoms experienced at least a week before the menstrual period. Women in their late 20s and early 30s tend to experience these symptoms than their younger counterparts.

Emotional and physical symptoms are experienced during this period. However, the degree of intensity of these symptoms varies from one cycle to another. The symptoms begin approximately ten days before the commencement of the cycle and fade off either before the day or on the first day of the menstrual cycle. In some cases, women tend to experience severe symptoms prior to their menstrual cycle; such condition is referred to as premenstrual dysphoric disorder (PMDD) [1].

Definition

Premenstrual syndrome (PMS) is defined as group of symptoms that begins a week or two before the onset of menstrual cycle. The symptoms generally fade away with the commencement of menstruation. It is a common problem and is known to affect about 75% of women worldwide.

Cause

The exact cause that triggers PMS is not known. However, hormonal changes, poor dietary habits and lifestyle factors are known to play foul.

Symptoms

Women with PMS experience both emotional as well as physical symptoms which include breast tenderness, bloating, constipation or diarrhea, weight gain due to fluid retention, mood swings, depression, crying spells, fatigue, sleep problems, headache, joint aches, acne break outs and food cravings.

Diagnosis

There are no specialized diagnostic procedures to detect PMS. However, women are advised to visit their gynecologist once they experience some unusual symptoms prior to their regular periods.

Treatment

Medications form the basis of treatment regime. Antidepressants, NSAIDs, oral contraceptives and diuretics are prescribed to relieve the symptoms caused due to PMS. Adopting good dietary habits and following an active lifestyle also has a positive impact on PMS.

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