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Premenstrual syndrome (PMS) is a combination of emotional, physical, and psychological symptoms that many women experience after ovulation and before the onset of the menstrual period. Estrogen and progesterone levels begin to drop dramatically if you are not pregnant. The symptoms of the premenstrual syndrome disappear within a few days after the onset of menstruation, and the hormone levels begin to rise again.

Some women have very mild symptoms during menstruation, but for others, the symptoms of the premenstrual syndrome can be severe. The premenstrual syndrome disappears after menopause. After pregnancy, the premenstrual syndrome may recur.

CAUSES OF PREMENSTRUAL SYNDROME

Researchers do not know exactly what causes premenstrual syndrome, but several factors may contribute to this condition:

  • Hormone changes: Hormonal fluctuations influence the symptoms of premenstrual syndrome. During pregnancy and menopause, the premenstrual syndrome will go away.
  • Brain changes: Serotonin fluctuations can trigger the symptoms of premenstrual syndrome. Insufficient amounts of serotonin can lead to depression, fatigue, cravings, and sleep disorders.
  • Depression: Some women with severe premenstrual syndrome suffer from undiagnosed depression.

Some women may be more affected by these changes than others.

SYMPTOMS OF PREMENSTRUAL SYNDROME

The symptoms of premenstrual syndrome are different for every woman. Also, the symptoms can change throughout life.

Emotional and psychological symptoms:

  • Tension or anxiety
  • Depression, feelings of sadness, or crying
  • Mood swings
  • Anger, irritability, or hostile behavior
  • Excessive sensitivity
  • Changes in appetite or cravings
  • Sleep problems (too much or too little)
  • Social withdrawal
  • Decreased ability to concentrate
  • Confusion
  • Low libido

Physical symptoms:

  • Joint or muscle pain
  • Headache or back pain
  • Swelling of the hands or feet
  • Fatigue
  • Weight gain
  • Bloating
  • Constipation or diarrhea
  • Painful breasts
  • Sensitivity to noise or light
  • Acne
  • Alcohol intolerance

Symptoms usually go away within four days of starting menstruation for most women.

The symptoms of the premenstrual syndrome can worsen as you reach the age of 30 or 40 and approach menopause. Premenstrual syndrome stops after menopause when you no longer menstruate.

Symptoms of other conditions may worsen just before menstruation, such as seizures, migraines, asthma, and allergies.

DIAGNOSIS OF PREMENSTRUAL SYNDROME

There are no physical examinations or laboratory tests to diagnose premenstrual syndrome. Laboratory tests are performed to rule out other conditions that may mimic the premenstrual syndrome. Your doctor will ask you about your symptoms and how much they affect your daily activities.

You most likely suffer from premenstrual syndrome if you have symptoms that:

  • Occur in the five days before menstruation for at least three menstrual cycles in a row
  • End in four days from the start of menstruation
  • Make difficult some normal activities

TREATMENT FOR PREMENSTRUAL SYNDROME

If your symptoms are mild to moderate, they can often be alleviated by changes in lifestyle or diet. If your symptoms start to affect your daily activities, you can opt for medical treatment.

Your doctor may prescribe one or more medicines for the premenstrual syndrome, such as:

  • Nonsteroidal anti-inflammatory drugs: Ibuprofen, naproxen, and aspirin (for cramps, headaches, and pelvic discomfort).
  • Antidepressants: Fluoxetine, paroxetine, sertraline (for mood swings).
  • Diuretics: Spironolactone (for weight gain and bloating).
  • Oral contraceptives: They stop ovulation and relieve symptoms.

Lifestyle and home remedies

  • Smaller and thicker meals to reduce bloating and fullness.
  • Reducing the intake of fats, salt, and sugar.
  • Consumption of foods rich in complex carbohydrates: Whole wheat bread, pasta, cereals, barley, brown rice, beans, and lentils.
  • Consumption of calcium-rich foods: Yogurt and leafy green vegetables.
  • Avoiding caffeine and alcohol.
  • Regular aerobic physical activity throughout the month: Brisk walking, cycling, swimming, or other aerobic activities.
  • Sufficient rest: About eight hours each night.
  • Reducing stress by doing yoga or meditation.
  • Taking vitamin supplements: Calcium, magnesium, vitamin E, and vitamin B6.
  • Acupuncture: Some women experience relief from symptoms after acupuncture treatment.

If you want to find out about menstruation, check out our article on this topic: All about menstruation.

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