PREMENSTRUAL SYNDROME

(Premenstrual Tension; PMS)

 Basic information

description

Premenstrual syndrome (PMS) involves symptoms that begin 7 to 14 days prior to a menstrual period and usually stop when menstruation begins. About half of all women experience PMS at some time, some very frequently. It most often affects women ages 25 to 40.

FREQUENT SIGNS & SYMPTOMS

• Depressed mood.
• Nervousness and irritability.
• Dizziness or fainting.
• Fatigue.
• Emotional instability; mood swings.
• Increased or decreased sex drive.
• Headaches.
• Tender, swollen breasts.
• Bloating, constipation, or diarrhea.
• Other digestive disturbances.
• Fluid retention (edema) in ankles, hands, and face.
• Higher incidence of minor infections such as colds.
• Acne outbreaks.
• Decreased urination.
• Many other symptoms (over 150) have been attributed to PMS.

causes

Unknown, but may be due to changes in the level of hormones (especially estrogen and progesterone). These changes cause retention of sodium in the bloodstream, resulting in edema in body tissues including the brain. Increased levels of prostaglandin (a chemical) in the bloodstream may be a factor. More theories about the basis of PMS include emotional, diet, changes in brain chemicals, and other factors.

risk increases with

• Younger women (symptoms often begin in mid-20s).
• Family history of PMS.
• Personal history of depression or mood disorders.
• Other factors (e.g., stress, smoking, or painful periods) may increase PMS risk or worsen its symptoms.

PREVENTIVE MEASURES

Cannot be prevented. After diagnosis, you can plan ahead to reduce, control, and better cope with symptoms. Let people close to you know about the PMS.

expected outcomes

There is no cure. Different treatments can relieve the symptoms for different women. PMS symptoms often decrease after age 35 and stop with menopause.

possible complications

• Severe symptoms that disrupt a woman's life.
• Premenstrual dysphoric disorder.

 diagnosis & treatment

general measures

• Your health care provider may do a physical exam, pelvic exam, and blood tests to rule out other disorders. Diagnosis is usually based on the symptom history. Keep a menstrual diary for 2 months. Write down your symptoms, dates, and other details.
• Treatment can include lifestyle changes, drug therapy, psychotherapy, and alternative therapies. No single treatment works for everyone. Several may be needed.
• Healthy lifestyle changes can include regular exercise, diet changes, good sleep habits, and quitting smoking.
• Psychotherapy includes cognitive-behavioral therapy (CBT), learning relaxation techniques, or biofeedback.
• Alternative therapies include massage, acupuncture, chiropractic care, phototherapy, and others.
• Join a support group. Talking with others can help.
• To learn more, do an Internet search or visit a library.

medications

• These are used with varying degrees of success:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen for pain, cramping, and headaches.
  • Antidepressants or antianxiety drugs.
  • Diuretics to reduce fluid retention.
  • Vitamin B-6, vitamin E, magnesium, or calcium.
  • Hormones to suppress ovarian function.
  • Certain herbal products (e.g., evening primrose oil).
  • Oral contraceptives.

activity

Begin a regular, aerobic exercise program (such as walking or biking). Exercise can help relieve or reduce PMS symptoms. Try to maintain good sleep habits.

diet

Eat small, frequent, low-fat, low-salt, complex carbohydrate meals. Limit use of caffeine and alcohol. Drink plenty of fluids (e.g., water or juice; not soft drinks).

 notify our office if

• You or a family member has symptoms of PMS.
• Symptoms don't improve, despite treatment.

Special Notes: