Premenstrual Syndrome describes

Overview

Premenstrual syndrome (PMS) describes a large vary of severe, perennial symptoms that occur from many days to 2 weeks before your amount. PMS affects up to seventy five p.c of girls in their childbearing years. The symptoms of PMS will seem any time between time of life and climacteric, although the most common age for it to start to become a problem is during the late 20s to early 30s.

Symptoms of PMS could go downhill with age and stress, although the underlying causes are not well understood. Even ladies UN agency have had hysterectomies will have PMS if a minimum of one purposeful ovary is left. Women UN agency square measure prone to depressive health problem, panic disorder, other psychiatric disorders orchronic medical conditions may also be susceptible to PMS, although these conditions may occur in women without PMS as well. Heredity may play a role: if your mother or sister suffers from PMS, you may find you experience it, too.

As several as one hundred fifty physical and behavioural symptoms are 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 andprogesterone, which may influence brain chemicals, including serotonin, a substance that has a strong affect on mood. It’s not clear why some ladies develop PMS or PMDD et al. don’t, 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, ladies UN agency took 600 mg of atomic number 20 doubly daily older fewer PMS symptoms than ladies UN agency took a placebo.

Dietary changes and exercise may facilitate relieve the discomfort of PMS symptoms. When symptoms square measure severe, serotonergic medicine medication is also prescribed. It is thought that inflated 5-hydroxytryptamine 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

Approximately 3 to eight p.c of girls expertise emission unhappy disorder (PMDD), a condition that, like PMS, is associated with the menstrual cycle. The symptoms of PMDD square measure constant as PMS symptoms, though ladies with PMDD could expertise additional unhappy (depressive) symptoms and additional severe symptoms. In fact, to be diagnosed with PMDD, symptoms must be severe enough to disrupt a woman’s daily function. Symptoms should conjointly meet diagnostic criteria specific to PMDD developed by the yank psychiatrical Association.

The most vital criteria for a PMDD diagnosing square measure mood symptoms. Physical symptoms may also be present but aren’t as critical to the diagnosis. The distinction between PMDD and delicate PMS is just like the distinction between a light cephalalgia and a head ache, consultants say.

Women UN agency have a history of depression square measure at higher risk for PMDD than alternative ladies. Treatment for PMDD includes serotonergic medicine medications and a selected whole of contraception pills, called Yaz. Yaz contains drospirenone (aprogestin) and ethinyl estradiol (a form of estrogen) and has been shown to be clinically effective at treating the emotional and physical symptoms of PMDD, but should solely be wont to treat PMDD if you select to use it for contraception as a result of alternative types of treatment do not carry constant risks as oral contraceptives. Another form of birth control pill containing drospirenone plus a daily dose of folic acid also is FDA-approved to treat PMDD. It is sold-out beneath the whole names Beyaz and Safyral.

Birth control pills containing drospirenone could cause some serious aspect effects in rare cases, including blood clots in the legs and lungs, so be sure and talk to your health care provider about your risks and benefits. Oral contraceptives don’t seem to be counseled for girls UN agency smoke due to inflated vas risks.

Diagnosis

Many premenstrual syndrome (PMS) symptoms improve with treatment. Treatment choices vary from medication medical care to contraception pills to diet modification, including vitamin and mineral supplementation, herbal medicines and exercise.

Antidepressant medication known as selective 5-hydroxytryptamine uptake inhibitors (SSRIs) square measure usually suggested to girls with severe mood-related symptoms like anxiety, depression or mood swings.

Overall, common treatment options include:

• • Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications are used to relieve premenstrual headache and other menstrual-cycle related pain. A variety of NSAIDs are available including over-the-counter ibuprofen products (Motrin) and others or naproxen sodium (Aleve). They usually cost less and have fewer side effects than other treatments. Prescription NSAIDs also are available.Note: NSAIDS carry some risks, such as an increased risk of serious cardiovascular (CV) events, including heart attack and stroke. As a result, the FDA has issued a “black box” warning highlighting this risk, as well as the risk of potentially life-threatening stomach bleeding. If you’ve recently had heart surgery, you shouldn’t take NSAIDS. All other women considering NSAIDS to ease PMS or any other condition should discuss these potential risks with their health care professional.
  • Contraceptive hormones. Some women with PMS or PMDD experience relief of their symptoms after they start taking birth control pills. (Other women, however, feel worse on birth control pills.) You can take the pill continuously to avoid having a menstrual period, thus preventing the hormonal changes that can lead to PMS/PMDD. The combination birth control pills Yaz (containing 3 mg of drospirenone, a progestin, and 20 mcg ethinyl estradiol, a form of estrogen) and Beyaz and Safyral (containing 3 mg of drospirenone, 20 mcg ethinyl estradiol and a daily dose of folic acid) are FDA approved for the treatment of PMDD. However, these contraceptives should only be used to treat PMDD if you choose to use them for birth control because other forms of treatment don’t carry the same risks as oral contraceptives. Birth control pills containing drospirenone may cause some serious side effects in rare cases, including blood clots in the legs and lungs, so be sure and talk to your health care provider about your risks and benefits. Oral contraceptives are not recommended for women who smoke because of increased cardiovascular risks.
  • GnRH agonists (gonadotropin-releasing hormone). These medications include leuprolide (Lupron), among others. They belong to a class of hormones used to temporarily shrink fibroids and relieve endometriosis. They also may be recommended to treat PMS because they “turn off” the menstrual cycle by blocking estrogen production. Side effects may include menopausal symptoms like hot flashes, vaginal dryness and bone loss. That’s why low-dose hormone therapy, a combination of estrogen and progestin hormones, is typically prescribed along with GnRH agonists. Some women may experience a return of their PMS symptoms with the additional hormone therapy. GnRH agonists are usually considered only as a short-term treatment option (given for no longer than six months) because of the increased health risks such as osteoporosis associated with low estrogen levels.
  • Antidepressant medications. Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are the preferred antidepressants for treating severe PMS and PMDD symptoms, including depression. SSRIs include sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluoxetine (Prozac). Other types of antidepressants may also be prescribed to treat PMS and PMDD, including venlafaxine (Effexor) and clomipramine (Anafranil). The U.S. Food and Drug Administration warns that girls taking antidepressants ought to monitor their symptoms closely, with the help of their health care professional, for signs that their condition is getting worse or that they’re turning into self-destructive, especially when they first start therapy or when their dose is increased or decreased.
  • Danazol. Danazol (Danocrine) is a medication that works similarly to GnRH agonists to prevent ovulation. Danocrine works to enhance PMS symptoms in some ladies, but it has some unpleasant side effects, such as acne and facial hair growth, so it is usually only used in ladies World Health Organization don’t reply to alternative treatments.
  • Anti-anxiety medications like benzodiazepine (Xanax) are typically prescribed once anxiety is that the main symptom related to PMS or PMDD. These drugs can be taken during the 14 days between ovulation and menstruation (the luteal phase) when symptoms occur (rather than daily). Dependence and serious withdrawal reactions can occur with Xanax, so its dosage and discontinuation should be carefully monitored.
  • Calcium supplements (1,200 mg daily). Additional calcium in any form may help relieve some PMS symptoms. Low-fat dairy products (milk, yogurt and cheese) are a primary source of calcium, but you can also gain calcium from the following:
    • Tofu and other soy products
    • Rice milk
    • Broccoli
    • Dark greens, like turnip greens
    • Green or red cabbage (raw)
    • Salmon and sardines

Taking an over-the-counter calcium supplement can also help. In one study, women who took 600 mg of calcium twice a day experienced fewer PMS symptoms than women who took a placebo. But be patient; it may take two to three months to relieve PMS symptoms with calcium supplementation. If symptoms persist, have your vitamin D levels checked or change the type of calcium supplement you’re using. Low levels of vitamin D can affect how the body absorbs calcium, and some generic supplements may not have enough calcium available for absorption.

• Exercise. Regular exercise can also help relieve and possibly prevent PMS symptoms. You will get the greatest benefits if you exercise for at least 30 minutes, at least five days a week. But even taking a 20- to 30-minute walk three times a week can improve your mood.
• Chasteberry. The extract of the fruit of the chasteberry tree is shown to be a safe and effective treatment for PMS. This therapy is used primarily outside the United States. It may be obtained over the counter, but the dose and purity may be uncertain.

In addition, there’s some evidence that some nutritional supplements such as vitamin E, magnesium and vitamin B-6 may help ease symptoms of PMS. Discuss these and other strategies with your health care professional before taking any dietary supplement.

There is no single treatment that works well for each lady World Health Organization experiences PMS. Typically, it’s wise to try the most conservative treatment options first, which include lifestyle changes such as modifying your diet and exercising more. Discuss your symptoms with your health care professional if strategies you’ve tried don’t work, so he or she can recommend other treatment options.

Prevention

1. An estimated 75 percent of women of childbearing age suffer from PMS in some form.
2. Approximately 3 to 8 percent of women experience premenstrual symptoms severe enough to disrupt their daily function and meet criteria for premenstrual dysphoric disorder (PMDD)––a severe form of PMS.
3. Taking additional calcium in any form may help improve or even prevent PMS symptoms. Ideally, increase daily amounts of low-fat dairy products and other calcium-containing foods to reach the 1,200 mg of calcium daily health care professionals recommend. If you have trouble reaching this goal from your diet alone, consider using over-the counter calcium supplements.
4. Symptoms of PMS may get worse with age.
5. If you experience PMS, you may experience an increased sensitivity to alcohol at certain points in your menstrual cycle.
6. Some evidence suggests that women who are vulnerable to depressive illness, panic disorder or other psychiatric or chronic medical disorders may be particularly susceptible to PMS.
7. Strategies for PMS symptom relief include medication, dietary changes, exercise and stress management.
8. Dietary changes to relieve PMS symptoms include increasing daily amounts of dietary or supplemental calcium, drinking more water and adding more complex carbohydrates (fruits, vegetables and grains) to your meals. Decreasing foods in your diet that contain refined sugar, limiting or avoiding caffeine and nicotine, decreasing alcohol consumption, decreasing salt intake and avoiding sodas may also help.
9. Some of the PMS symptoms you may experience, such as mood swings, irritability, bloating, hunger, carbohydrate cravings and fatigue, may lead you to consume high-fat foods and/or foods high in refined sugar, which actually aggravate these symptoms. Try to avoid them.
10. Even women who have had hysterectomies can have symptoms of PMS if at least one functional ovary is left intact following the hysterectomy.

Key Q&A

1. What exactly is premenstrual syndrome (PMS)?There are more than 150 documented symptoms of PMS, but the number of symptoms seen in the vast majority of patients is much more limited. Some of the most common PMS symptoms include bloating, fatigue, sudden mood swings, irritability,anxiety, depression, weight gain, headaches, joint and muscle aches, food cravings and fluid retention. To be considered PMS symptoms, they must occur exclusively in the last 14 days of your menstrual cycle (usually about five to seven days before your period begins). True PMS symptoms tend to increase in severity as the cycle progresses, are relieved within a few days after the start of the menstrual flow and are present for at least two to three consecutive menstrual cycles. Cramps are not considered a symptom of PMS, but they can occur in women with PMS.
2. What causes PMS?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.
3. How is PMS diagnosed?There is no single laboratory test for PMS, but one of the most common ways to diagnosis PMS is by keeping a daily checklist, chart or “menstrual cycle diary” that tracks when your premenstrual symptoms occurs for at least three months. Your health care professional should rule out other disorders or diseases that mimic or are identical to the symptoms caused by PMS before diagnosing you with the condition. These conditions include thyroid disorders, depression, endocrine abnormalities, menopause, heart problems, allergies and low blood sugar, among other conditions. Laboratory tests, personal and family medical histories and a physical exam are also part of the diagnostic process.
4. Is PMS treatable?Yes! Many women experience some relief from PMS symptoms if they make diet and lifestyle changes, particularly increasing consumption of calcium, complex carbohydrates (fruits, vegetables, grains and beans) and water, and decreasing caffeine, alcohol, salt and refined sugar intake. Regular exercise and sleep may also help relieve symptoms. Certain medications can provide relief.
5. When does PMS typically appear?PMS symptoms can appear any time between puberty and menopause, though the most common age for PMS to start to become a problem is during your late 20s to mid-30s.
6. Will my PMS symptoms get better as I age?Probably not until you reach menopause. In some women, symptoms of PMS worsen with age and stress. Even women who have had hysterectomies can have PMS if at least one functional ovary is left intact following the hysterectomy. Once you reach menopause, your PMS symptoms will end with the end of menstruation.
7. If I regularly take the recommended steps to relieve my PMS symptoms, how long before I may see results?It may take two to three months to experience relief from PMS symptoms. If you don’t see any improvements by then, check with your health care professional for a new action plan.
8. Are menstrual cramps a symptom of PMS?Cramps are not considered a symptom of PMS, although they may occur in women who have PMS. Called dysmenorrhea, cramps typically begin just before (24 to 48 hours) the onset of menstruation and disappear by the end of flow.