Premenstrual stress syndrome

Menstrual Cycle

PMS

Lining of Uterine Wall

Premenstrual Stress Syndrome (PMS), sometimes referred to as Premenstrual Tension Syndrome (PMT), Periodic Mood Swing, or simply Premenstrual Syndrome, represents a collection of physical and emotional symptoms that arise before the onset of menstruation.

Overview

PMS is distinguished from dysmenorrhea, which specifically relates to the pain or cramps experienced during the menstrual period. Estimates suggest that up to 75% of women of reproductive age may experience PMS at some point in their lives. A severe variant of PMS, known as premenstrual dysphoric disorder (PMDD), affects around 5% of women and is characterized by more intense mood disturbances, including depression and severe irritability.

Symptoms

The manifestation of PMS can vary among individuals but commonly includes:

• Mood swings
• Depression
• Anxiety
• Irritability
• Physical discomfort, such as bloating and cramps

These symptoms typically emerge in the two-week window between ovulation and menstruation.

Diagnosis and Treatment

Diagnosis

Differentiating PMDD from conditions like clinical depression and anxiety disorders is crucial for an accurate diagnosis.

Treatment

Management of PMS often begins with lifestyle changes:

• Reducing intake of caffeine, sugar, and sodium
• Increasing intake of vitamin B6 and calcium carbonate (typically 1200 milligrams a day)
• Regular exercise
• Maintaining a symptom diary for better understanding and management

For those with more severe symptoms, prescription medications like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) might be recommended.

Traditional herbal remedies include:

• Vitex (Chasteberry)
• Evening primrose (Oenothera Biennis)
• Red clover
• Black cohosh

These treatments may operate by stimulating the pituitary gland or influencing dopamine or opioid receptors.

Controversial Views

Some scholars and commentators have suggested that PMS may be, to some extent, a socially constructed disorder. This viewpoint gained attention in 1989 when Cathy McFarland observed discrepancies between study participants' recollection of their moods and daily mood records. Others have pointed out that placebos can sometimes provide relief similar to actual medications, adding complexity to our understanding of the syndrome.

However, the "mere social construct" hypothesis remains contentious. Evidence showcasing the significant role of neurotransmitters, especially serotonin levels, in the development and treatment of PMS symptoms challenges this view. Recent studies employing Positron emission tomography (PET) scans have demonstrated a correlation between self-reported emotional distress and serotonin precursor levels in the brain, supporting the neurochemical basis of PMS and PMDD.

See Also

• Menstrual Cycle
• Dysmenorrhea
• Serotonin
• Neurotransmitters

Premenstrual stress syndrome Resources
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