Are You Living with PMS?

As a practicing OB/GYN physician, I’m frequently asked by my female patients about Premenstrual syndrome (PMS).  PMS refers to a group of physical and behavioral symptoms that occur in a cyclic pattern during the second of the menstrual cycle (days 15 through 28).  Premenstrual dysphoric disorder (PMDD) is the rare and severe form of PMS.

Many patients will experience a mix of symptoms, both physical and psychological.  Some will have more issues in one area versus the other.  Common symptoms include anger, irritability, and internal tension that are severe enough to interfere with daily activities.  In its most severe case, it can be debilitating.

Mild PMS is common, affecting up to 75 percent of women who have regular menstrual cycles.  Severe PMS (or PMDD) only affects a small portion of women (3 to 8 percent).  The PMS condition can affect women of any socioeconomic, cultural or ethnic background.  Its severity can vary from month to month.  However, PMDD is usually a chronic condition that can have serious impact on a woman’s quality of life.  Fortunately, a variety of treatments and self-care measures can effectively control the symptoms in most women.

What Causes PMS?  

The exact cause of PMS is unknown.  It is not clear why some women develop PMS or PMDD and others do not.  However, it is known that a women’s body is sensitive to hormone levels that change throughout the menstrual cycle.  Studies suggest that rising and falling hormones are to blame for PMS.  These hormones can influence chemicals in both the brain and body, including substances that affect mood.

Symptoms 

Common symptoms of PMS include fatigue, bloating, irritability, and anxiety. Other mood symptoms are sadness, tension, anxiety, lack of concentration, fatigue and lack of energy. Physical symptoms can include headache, breast tenderness, breast swelling, weight gain, muscle pain, and joint pain.  Diagnosis is usually made by your health care provider with a simple history.

Effective Treatment      

Treatment from PMS can range from conservative to medical treatment. Usually, conservative treatments are recommended first. These consist of regular exercise, relaxation techniques, herbal supplements, vitamin and mineral supplementation. These can relieve symptoms in some women and have vertically no side effects. If these fail, medical therapy may be indicated.  These include medications that control mood symptoms or hormone levels (antidepressants or birth control pills).  The good news is that there are lots of methods and choices for patients who desire treatment.

Written by: Jeff Jacobs, MD

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