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Home :: Premenstrual Syndrome
Premenstrual Syndrome (PMS or PMT) 
Premenstrual syndrome (PMS) is defined as a recurrent, cyclical set of varying physical and behavioral symptoms that appear 7 to 14 days before menses and usually subside with onset. Depending on the symptoms and their severity, they usually interfere with some aspect of a woman's life. The effects of PMS range from minimal discomfort to severe, disruptive symptoms and can include nervousness, irritability, depression, and multiple somatic complaints.
Researchers believe that 70% to 90% of women experience PMS at some time during their childbearing years, usually between ages 25 and 45. According to the DSM-IV-TR, a more severe form of PMS is referred to as premenstrual dysphoric disorder (PMDD). PMDD includes the psychological manifestations of PMS.
Causes of Premenstrual Syndrome
| The list of biological theories offered to explain the cause of PMS is impressive. It includes such conditions as progesterone deficiency in the luteal phase of the menstrual cycle and vitamin deficiencies. Although there's no evidence that PMS is hormonally mediated, failure to identify a specific disorder with a specific mechanism suggests that PMS represents a variety of manifestations triggered by normal physiologic hormonal changes. |
| Hormone levels |
| Measuring hormone levels is of no help in understanding PMS because there are no differences between women who get PMS and those who don't. |
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Signs and symptoms of Premenstrual Syndrome
Clinical effects vary widely among patients and may include behavioral symptoms, somatic symptoms, or both. These symptoms include:
- behavioral- mild to severe personality changes, mood changes, anxiety, nervousness, hostility, irritability, agitation, sleep disturbances (either insomnia or hypersomnia), fatigue, lethargy, and depression as well as overeating, food cravings, and increased appetite.
- somatic - breast tenderness or swelling, abdominal tenderness or bloating, weight gain, joint pain, headache, edema, diarrhea or constipation, and exacerbations of skin problems (such as acne or rashes), respiratory problems (such as asthma), or neurologic problems (such as seizures).
Diagnosis of Premenstrual Syndrome includes:
The patient history shows typical symptoms related to the menstrual cycle. To help ensure an accurate history, the patient may be asked to record menstrual symptoms and body temperature on a calendar for 2 to 3 months prior to diagnosis. Estrogen and progesterone blood levels may be evaluated to help rule out hormonal imbalance. A psychological evaluation is also recommended to rule out or detect any underlying psychiatric disorders.
Premenstrual Syndrome treatment
Educating and reassuring patients that PMS is a real physiologic syndrome are important parts of treatment. Because treatment is predominantly symptomatic, each patient must learn to cope with her own individual set of symptoms. Treatment may include antidepressants, vitamins such as B6 (pyridoxine), hormonal contraceptives, selective serotonin reuptake inhibitors, prostaglandin inhibitors, diuretics, and nonsteroidal anti-inflammatory drugs.
Herbal remedies for PMS
- Calcium carbonate intake to reduce craming and moodiness.
- Kava Kava will treats anxiety and improves mood.
- Buchu treats bloating and excess water weight.
- Magnesium oxide to reduce headache, fuild retention and moodiness.
Special considerations
- Inform the patient that self-help groups exist for women with PMS; if appropriate, help her contact such a group.
- Obtain a complete patient history to help identify any emotional problems that may contribute to PMS. lf necessary, refer the patient for psychological counseling.
- Suggest that the patient seek further medical consultation if symptoms are severe and interfere with her normal lifestyle.
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