Premenstrual Syndrome (Tension)

What Is Premenstrual Syndrome (Tension)

Premenstrual syndrome (tension), or PMS, is a group of physical and emotional symptoms that start one to two weeks before a woman’s menstrual period. Most women have at least some symptoms of PMS which go away after their periods start. The symptoms may range from mild to severe. Over 90% of women report experiencing premenstrual symptoms like bloating, headaches, and moodiness.

Some women may have such severe symptoms that they need to miss work or school, while others may not be bothered by milder symptoms. Most women experiencing PMS are usually in their 30s.

How Common Is PMS?

Estimates for how common PMS is, vary. According to a 2017 study on premenopausal women, three out of four women reported experiencing PMS symptoms at some point in their lifetime. Although it’s common to have one or a few premenstrual symptoms, clinically significant PMS was seen in only 3% to 20% percent of premenopausal women. Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD)

What Is Premenstrual Dysphoric Disorder?

Premenstrual dysphoric disorder (PMDD) is a severe and potentially debilitating form of PMS. Around 2% of people who menstruate have PMDD. With PMDD, PMS symptoms can be significantly more intense, particularly in terms of emotional reactions and mood. Symptoms may include heightened anger, profound sadness, and increased anxiety.

What Are the Symptoms Of PMS?

PMS (premenstrual syndrome) can vary from woman to woman. Some may experience physical symptoms like bloating or gas, while others may have emotional symptoms like sadness. It’s also common for symptoms to change over time.

Physical symptoms of PMS can include:

• Swollen or tender breasts
• Constipation and diarrhea
• Cramping
• Headache or backache
• Clumsiness
• Lower tolerance for noise or light
• Thirst and appetite changes (food cravings)
• Breast tenderness
• Fatigue
• Skin problems

Emotional or mental symptoms of PMS include:

• Irritability or hostile behavior
• Sleep problems (sleeping too much or too little)
• The trouble with concentration or memory
• Depression, feelings of sadness, or crying spells
• Mood swings
• Changes in sex drive
• Diminished interest in activities
• Anxiety
• Confusion
• Social withdrawal

How Do PMS Symptoms Begin?

The menstrual cycle typically lasts around 28 days on average. In an average-length cycle, ovulation, the release of the egg from the ovaries, occurs around day 14, which is the midpoint of the cycle. PMS symptoms can start at any time after ovulation and persist for approximately five days after menstruation begins. Menstruation, or bleeding, begins on day 28 of the cycle.

What Are the Causes Of PMS?

The cause of PMS or why some people experience it more severely than others has not been identified by science. Nevertheless, researchers have proposed various explanations:
• Cyclical changes in hormones
Numerous medical professionals concur that PMS results from fluctuating amounts of the hormones progesterone and estrogen. These hormones naturally change throughout the menstrual cycle. During the luteal phase, which follows ovulation, hormones reach a peak and then decline rapidly, which may lead to anxiety, irritability, and other mood changes.
• Chemical changes in the brain
The neurotransmitters, serotonin and norepinephrine play many vital roles in the body, including regulating mood, emotions, and behavior. The symptoms of PMS may also be influenced by these chemical messengers. For instance, a decrease in estrogen may cause norepinephrine to be released, which then results in a decrease in the production of dopamine, acetylcholine, and serotonin. These adjustments may result in disturbed sleep and a melancholy or gloomy mood.
• Existing mental health conditions
Having a mental health condition, like depression or anxiety, can increase the likelihood of experiencing PMS or premenstrual dysphoric disorder (PMDD), which is a more severe form of PMS. The risk of developing these conditions can also be higher if there’s a family history of PMS, bipolar disorder, depression, or postpartum depression. Some women may also notice that their underlying mental health symptoms, such as bipolar disorder or depression, worsen just before their period starts. Experts haven’t fully explained the connection between mental health symptoms and mood changes during menstruation, but many believe it’s related to chemical changes in the brain as mentioned earlier.
• Lifestyle factors
Certain habits might affect the severity of your symptoms. Potential lifestyle factors that could worsen PMS symptoms include:

• Smoking
• Eating a lot of foods high in fat, sugar, and salt
• A lack of regular physical activity
• Regular alcohol Intake

PMS And Your Mental Load

PMS symptoms can make it more challenging to manage daily responsibilities, tasks, and commitments, adding to the mental load. Women may feel overwhelmed, stressed, and find it harder to cope with multiple demands on their time and energy. It can affect one’s ability to focus, make decisions, and handle emotional challenges effectively. PMS-related symptoms can contribute to increased mental and emotional burden, making it important for women to practice self-care and seek support when needed.

What Can I Do to Manage PMS?

• Increase physical activity, aim for 30 minutes a day, 5 times a week. Considering the challenges of multiple responsibilities and work, it might be difficult to find time for exercise, so incorporating physical activity into your schedule rather than treating it as an extra task can be helpful. Options such as brisk walks or cycling to work, taking walks during lunch breaks, joining exercise classes, or participating in team sports offer both physical activity and a social element. By prioritizing and integrating physical activity, you can improve your well-being despite a busy schedule.
• Eat healthy foods like whole grains, fruits, and vegetables.
• Try to get enough calcium from foods (think dairy, green leafy vegetables, and canned salmon).
• Avoid salt, caffeine, and alcohol.
• Don’t smoke.
• Get plenty of sleep.
• Work to lower stress.
• Track your moods and symptoms in a journal.
• Try over-the-counter pain relievers like ibuprofen, acetaminophen, or naproxen. Be sure to follow the dosing instructions exactly as it says on the label.

Some women take vitamins and minerals like folic acid, magnesium, vitamin B-6, vitamin E, and calcium with vitamin D. Others find that herbal remedies help. If you take any vitamins or supplements, check with your doctor first to make sure they are safe for you.

How Can My Doctor Help With PMS?

If you’ve tried various approaches but continue to experience severe PMS symptoms, it’s important to seek help by scheduling an appointment with a general practitioner or a gynaecologist. In cases of severe PMS symptoms, a doctor may recommend the use of hormonal birth control pills to alleviate these symptoms.
These medications work by influencing the levels of estrogen and progesterone in the body. Combined hormonal contraceptives and progesterone-only options are effective in reducing the hormonal fluctuations that contribute to PMS or PMDD. They provide contraception, making them a valuable treatment option.
However, it is crucial to have a detailed discussion with a healthcare professional, including medical and family history, to understand the benefits and risks associated with these options.

Also, Doctor may suggest other treatment plans including:

• Talk therapy, is a way to feel better and learn new skills to overcome challenges by talking with a mental health counsellor.
• Over-the-counter (OTC) medicines
• Prescription medications like diuretics, antidepressants, etc.