Premenstrual Syndrome
The combination of symptoms that many women experience a week or two before their period.
While 90% of woman develop premenstrual symptoms, the physical and emotional changes you experience may vary from just slightly noticeable all the way to intense.
- 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.
- PMS symptoms may get worse as you reach your late 30s or 40s.
- Symptoms may worsen during the years leading up to menopause (called the perimenopause)
- In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause
- This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle.
- PMS stops after menopause when you no longer get a period.
What Causes premenstrual symptoms?
The development of premenstrual symptoms is a complex phenomenon, and there isn’t a single agreed-upon theory to explain it. More than likely, there are multiple factors which contribute to the development of premenstrual symptoms.
Disruptions in the balance between the nervous and hormonal systems may contribute to mood and physical symptoms.
Hormonal Fluctuations:
- Fluctuations in estrogen and progesterone levels during the menstrual cycle can impact the brain’s chemistry, leading to mood swings and irritability.
- The hormonal changes may affect neurotransmitters and neurochemicals in the brain, leading to mood swings, irritability, and other symptoms.
- PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant.
- PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin rising again.
- Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
Serotonin Levels:
- Some researchers propose that premenstrual symptoms are linked to changes in serotonin levels.
- Serotonin is a neurotransmitter that influences mood and emotions.
- Changes in serotonin, a mood-influencing neurotransmitter, may occur due to hormonal shifts, contributing to mood changes and anxiety.
- Fluctuations in estrogen and progesterone may impact serotonin function, contributing to mood disturbances, anxiety, and irritability.
- Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.
Inflammatory Responses:
- Some studies suggest that elevated levels of inflammatory markers during the menstrual cycle may contribute to symptoms such as bloating, pain, and mood changes.
Genetic Factors:
- Genetic factors could influence how individuals respond to hormonal changes and stress.
- Women with a family history of premenstrual syndrome (PMS) may be more likely to experience similar symptoms.
Stress and Lifestyle Factors:
- Stress can influence hormonal balance and contribute to the severity of symptoms.
- Lifestyle factors, such as poor diet, lack of exercise, and inadequate sleep, may exacerbate premenstrual symptoms.
- Psychological stress, relationships, and cultural influences may also play a role in the development and intensity of premenstrual symptoms.
- Emotional stressors can amplify the impact of hormonal changes on mood and behavior.
PMS Symptoms
Physical
- Joint or muscle pain
- Headache
- Fatigue
- Weight gain related to fluid retention
- Abdominal bloating
- Breast tenderness
- Acne flare-ups
- Constipation or diarrhea
Emotional and Behavioral
- Tension or anxiety
- Depressed mood
- Crying spells
- Mood swings and irritability or anger
- Appetite changes and food cravings
- Trouble falling asleep (insomnia)
- Social withdrawal
- Poor concentration
- Change in libido
What can you do to help the symptoms of PMS?
These tips will help you be healthier in general and may relieve some of your PMS symptoms.
Exercise
- Get regular aerobic physical activity throughout the month.
- Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week.
- Exercise can help with symptoms such as depression, difficulty concentrating, and fatigue.
- Physical activity triggers a release of:
- dopamine and serotonin, which can improve mood
- feel-good endorphins which are natural brain chemicals that can improve your sense of well-being.
Diet
- Choose foods high in complex carbohydrates, such as fruits, vegetables, and whole grains.
- Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.
Avoiding these foods and drinks the two weeks prior to your period may lessen many PMS symptoms.
Avoid food with:
- Caffeine
- Alcohol
- Salt
- Limit salt and salty foods to reduce bloating and fluid retention.
- Sugar
Get enough sleep.
- Try to get about eight hours of sleep each night.
- Lack of sleep is linked to depression and anxiety and can make PMS symptoms such as moodiness worse.
Don’t smoke.
- In one large study, women who smoked reported more PMS symptoms and worse PMS symptoms than women who did not smoke.
Self-care
- Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).
- Try yoga or massage to relax and relieve stress.
Over the counter (OTC) medication:
Some women find that taking an over-the-counter pain reliever right before their period starts may help lessen amount of pain and bleeding as well as some of the physical symptoms like headaches, backaches, and breast tenderness experienced during their period.
Over-the-counter pain relievers include:
- Ibuprofen
- Naproxen
- Aspirin
Vitamins
Calcium
- can help reduce some PMS symptoms, such as fatigue, cravings, and depression.
Vitamin B6
- can help reduce some PMS symptoms, including moodiness, irritability, forgetfulness, bloating, and anxiety.
Magnesium
- may help relieve some PMS symptoms, including migraines.
Polyunsaturated fatty acids (omega-3 and omega-6)
- Studies show that taking a supplement with 1 to 2 grams of polyunsaturated fatty acids may help reduce cramps and other PMS symptoms.
Prescription Medication
Hormonal Birth Control
Diuretics (“water pills”)
- may reduce symptoms of bloating and breast tenderness.
- Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.
Antidepressants
- Anti-anxiety medicine may help reduce feelings of anxiousness.
- Selective serotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. selective serotonin reuptake inhibitors (SSRIs) are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD).
- These medications are generally taken daily or only taken the two weeks before menstruation begins.
For more information on the symptoms and treatment options for Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD), call the office of County Obstetrics & Gynecology to schedule a consultation.
Treatments for can be tailored to each individual woman depending on the severity of your symptoms, age, and overall health.