Endocrinologist, journalist and popularizer of science Evdokia Tsvetkova explained what PMS is and laid out all the available information about premenstrual syndrome. Yes, it really exists!
What is PMS?
Premenstrual syndrome (PMS) is a set of physical and psycho-emotional symptoms that regularly occur in women one to two weeks before the onset of menstruation .
Premenstrual changes in the body cause concern in 12-20% of women from the onset of menstruation until menopause. According to other data, in every third woman.
Typical symptoms of premenstrual syndrome:
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irritability,
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anger,
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mood swings,
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depression,
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anxiety or worry,
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bloating,
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chest pain,
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fatigue.
At the same time, they can vary greatly depending on the individual characteristics of the organism. At the level of emotional and behavioral changes, tension or anxiety, depression, a tendency to cry, mood swings and irritability, changes in appetite, insomnia, difficulty concentrating, changes in libido may occur.
At the level of physical symptoms: joint or muscle pain, headache, fatigue, weight gain associated with fluid retention, bloating, breast tenderness, acne, constipation or diarrhea, changes in alcohol tolerance.
Physical and psychological manifestations can be combined.
In some women, these symptoms recur monthly and last an average of 6 days per month during most of their reproductive years.
Premenstrual dysphoric disorder, or PMDD, is a more severe form of PMS that occurs in 3–6% of women of reproductive age. With PMDD, all symptoms are significantly expressed, and panic attacks and suicidal thoughts may also bother.
Is PMS physiological or psychological?
There is a lively debate about whether premenstrual syndrome is a disease (i.e. a physiological feature of the body) or whether it is associated with psychological and social aspects. Sometimes even the fact of its existence is questioned.
There is no consensus yet on what exactly causes PMS, but the following factors may influence this condition:
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Cyclic changes in the ratio of sex hormones. When they gradually stop being produced and menopause sets in, PMS also disappears.
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Fluctuations in the neurotransmitter serotonin. It is believed that insufficient serotonin may cause premenstrual low mood, as well as fatigue, increased appetite, and sleep problems.
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Family history – PMS in mother and grandmother.
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The woman’s personal history of depression (seasonal affective disorder, postpartum depression, anxiety and panic disorders, history of clinical depression, undiagnosed depression).
Psychological factors also include stress levels, neuroticism, and coping strategies (what a person does to cope with stress).
There is evidence of a possible connection between PMS and PMDD and calcium-phosphorus metabolism, but its mechanisms are still unclear.
How do I know if I have PMS?
There is no single test to diagnose PMS. It is a diagnosis that is made based on your discussions with your doctor. However, there are some strategies your doctor can use to diagnose PMS.
PMS Symptom Diary
Your doctor may ask you to keep a diary to assess the frequency and severity of your symptoms. By doing this, you can see if there is a connection between your menstrual cycle and your symptoms. It usually takes several months of diary keeping to make any clear conclusions.
Sometimes women are surprised to find that their symptoms do not change with the phase of their cycle. This may be a sign of undiagnosed depression and/or anxiety. In this case, getting a proper diagnosis is an important first step to feeling better.
Thyroid testing
Some PMS symptoms overlap with those of thyroid disease, so your doctor may order a blood test to evaluate your thyroid function.
How is PMS treated?
A specialist who understands the subject and is familiar with modern research, after passing the necessary tests, can offer the following treatment options:
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antidepressants;
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oral contraceptives containing drospirenone (they even help with PMDD);
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cognitive behavioral therapy;
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calcium preparations.
There are also drugs that “turn off” ovulation and menstruation at the pituitary level, but taking them can cause serious side effects: absence of menstruation, hot flashes, increased frequency of urinary infections, mood swings, breast tenderness, depression, problems with concentration.
Important: combined oral contraceptives containing estrogen and progestin (for example, Lindynette) are not effective for PMS and PMDD. Correction of vitamin D deficiency, taking vitamin B6, magnesium, L-tryptophan are also not effective.
What you can do yourself:
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maintain regular physical activity;
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eat healthy and balanced meals;
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get enough sleep (for most people this is 7 to 8 hours);
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try to reduce stress levels by doing yoga or meditation;
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if you have pain, take painkillers (for example, ibuprofen or paracetamol);
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keep a diary of your symptoms for at least two or three menstrual cycles (as we wrote above, you can take it to a doctor’s appointment if necessary, plus it helps you track the situation yourself).