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PMS, or premenstrual syndrome, is a very common condition. Know your symptoms and treatment

PMS, or premenstrual syndrome, is a physical condition known to affect a woman's emotional, physical, and behavioral state during certain days of the menstrual cycle, usually just before menstruation.

• What is the menstrual cycle?

PMS is a very common condition. Its symptoms affect up to 85% of women.

PMS symptoms start between five and eleven days before your period and usually go away when your period starts. The cause of PMS is unknown. However, many researchers believe it is related to a change in the levels of sex hormones and serotonin at the beginning of the menstrual cycle.

Estrogen and progesterone levels increase during certain times of the month. An increase in these hormones can cause mood swings, anxiety and irritability. Ovarian steroids also modulate activity in parts of the brain associated with premenstrual symptoms.

Serotonin is a chemical in the brain and intestine that can affect mood, emotions and thoughts. Therefore, changes in the levels of this hormone during the PMS period can significantly affect the person's condition.

Risk factors for TPM include:

• History of depression or mood disorders such as postpartum depression or bipolar disorder;
• Family history of PMS;
• Family history of depression;
• Domestic violence;
• Substance abuse;
• Physical trauma;
• Emotional trauma;

Associated conditions include:

• Dysmenorrhea;
• Major depressive disorder;
• Seasonal affective disorder;
• Generalized Anxiety Disorder;
• Schizophrenia;

PMS symptoms

A woman's menstrual cycle lasts an average of 28 days. Ovulation, the period in which an egg is released from the ovaries, occurs on the 14th day of the cycle. Menstruation, or bleeding, occurs on day 28 of the cycle. PMS symptoms can start around day 14 and last for up to seven days after menstruation begins.

PMS symptoms are usually mild or moderate. Nearly 80% of women report one or more symptoms that do not substantially affect routine, according to the journal American Family Physician.

Between 20 and 32% of women report moderate to severe symptoms that affect some aspect of life. From 3 to 8% report having premenstrual dysphoric disorder. The severity of symptoms can vary by person and by month. Symptoms of PMS include:

• Abdominal swelling;
• Abdominal pain;
• Sore breasts;
• Acne;
• Cravings for food, especially sweets;
• Constipation;
• Diarrhea;
• Headaches;
• Sensitivity to light or sound;
• Fatigue;
• Irritability;
• Changes in sleep patterns;
• Anxiety;
• Depression;
• Sadness;
• Emotional outbursts.

When to seek medical help

Seek medical help if physical pain, mood swings, and other symptoms begin to affect your daily life or if symptoms do not go away. The diagnosis is made when you have more than one recurring symptom at the correct time that is severe enough to be compromised and absent between menstruation and ovulation. Your doctor should also rule out other causes, such as:

• Anemia;
• Endometriosis;
• Thyroid disease;
• Irritable bowel syndrome (IBS);
• Chronic fatigue syndrome;
• Connective tissue problem or rheumatologic diseases.

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Your doctor may ask about a family history of depression or mood disorders to determine if your symptoms are a result of PMS or another condition. Some conditions, such as IBS, hypothyroidism, and pregnancy, have symptoms similar to PMS. Your doctor may do a thyroid hormone test to make sure your thyroid gland is working properly, a pregnancy test, and possibly a pelvic exam to check for any gynecological problems.

Keeping a diary of your symptoms is another way to know if you have PMS. Use a calendar to keep track of your symptoms and your period each month. If your symptoms start around the same time each month, PMS is a likely cause.

How to relieve PMS symptoms

PMS has no cure, but it is possible to adopt some habits to alleviate its symptoms. If you have a mild or moderate form of premenstrual syndrome, treatment options include:

• Drink plenty of fluids to relieve abdominal bloating;
• Have a balanced diet to improve your overall health and energy level, which means eating lots of fruit and vegetables and reducing your intake of sugar, salt, refined foods, gluten, caffeine and alcohol;
• Take supplements such as folic acid, vitamin B-6, calcium and magnesium to reduce colic and mood swings;
• Take vitamin D to reduce symptoms;
• Sleep at least eight hours a night to reduce fatigue;
• Exercise moderately to reduce swelling and improve mental health;
• Reduce stress, such as through exercise and reading;
• Do cognitive behavioral therapy, which has been shown to be effective.

You can take pain medication, such as ibuprofen or aspirin, to relieve muscle pain, headaches, and stomach cramps. You can also try a diuretic to reduce swelling. But take medications and supplements only after seeking medical help.

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Severe PMS: premenstrual dysphoric disorder

Severe PMS symptoms are rare. A small percentage of women who have severe symptoms have premenstrual dysphoric disorder (PMDD), which affects between 3 and 8% of women.

Symptoms of premenstrual dysphoric disorder may include:

• Depression;
• Suicide thoughts;
• Panic attacks;
• extreme anxiety;
• Intense anger;
• Crying fits;
• Lack of interest in daily activities;
• Insomnia;
• Difficulty thinking or focusing;
• Binge eating;
• Intense pain;
• Swelling.

Symptoms of premenstrual dysphoric disorder can occur due to changes in estrogen and progesterone levels. But there is also a relationship between low serotonin levels and premenstrual dysphoric disorder.

Your doctor can do the following to rule out other medical conditions:

• Physical exam;
• Gynecological examination;
• Complete blood count;
• Liver function test;

They may also recommend a psychiatric evaluation. A personal or family history of severe depression, substance abuse, trauma, or stress can trigger or worsen the symptoms of premenstrual dysphoric disorder.

Treatment varies. Your doctor may recommend:

• Daily exercise;
• Vitamin supplements such as calcium, magnesium and vitamin B-6;
• Caffeine-free diet;
• Individual or group counseling;
• Stress management classes;
• Drospirenone and ethinylestradiol tablet, which is the only contraceptive pill approved by Food and Drug Administration to treat symptoms of premenstrual dysphoric disorder.

If PMDD symptoms do not improve, your doctor may prescribe a selective serotonin reuptake inhibitor antidepressant. This drug increases serotonin levels in the brain and has many roles in regulating brain chemistry that are not limited to depression. Your doctor may also suggest cognitive-behavioral therapy, which is a form of counseling that can help you understand your thoughts and feelings and change your behavior.

You cannot prevent PMS or PMDD, but the treatments described above can help reduce the severity and duration of your symptoms.

Symptoms of PMS and PMDD may recur but usually disappear after menstruation begins. A healthy lifestyle and a comprehensive treatment plan can reduce or eliminate symptoms for most women. To learn about natural remedies for PMS, take a look at the article: "PMS Natural Remedy Recipes".