Premenstrual syndrome (PMS) is a collection of somatic and psychological symptoms that occur in the days leading up to menstruation. PMS symptoms such as headaches, bloating, breast tenderness, irritability, sadness and concentration problems, among others, can be so severe that they interfere with normal functioning. Characteristically, these discomforts subside with menstruation. What are the causes of premenstrual syndrome? How do we diagnose and treat PMS? Answers to these questions can be found in the following article.

What is PMS?

PMS has been included in the ICD-10 International Classification of Diseases since 1982, and is a real disorder with which more than 80% of women of reproductive age struggle. Some undergo PMS more mildly, but in extreme cases the symptoms can be so severe that they severely hamper patients’ lives, leading to disorganization of work life and social relationships.

Causes of premenstrual syndrome

The exact causes of premenstrual syndrome are not fully understood, but it is known to be related to fluctuations in sex hormones during the menstrual cycle. PMS is characterized by elevated progesterone levels during the second phase of the cycle, the luteal phase. PMS is also known to accompany ovulatory cycles, and inhibiting ovulation, such as by giving the patient birth control pills, suppresses the annoying PMS symptoms.

In addition, factors that increase the risk of PMS include:

  1. high BMI,
  2. stress,
  3. vitamin and mineral deficiencies,
  4. traumatic experiences,
  5. poor quality of life.

Symptoms of premenstrual syndrome

Premenstrual syndrome includes nearly 300 different symptoms. Each woman may experience different complaints. Their intensity and duration may also vary. Moreover, the symptoms experienced may change from cycle to cycle. PMS symptoms are divided into psychological and somatic (physical).

Mental symptoms of PMS include:

  1. lowered mood,
  2. irritability,
  3. excitability,
  4. a sense of hopelessness,
  5. anger,
  6. emotional lability,
  7. sensitivity,
  8. sadness,
  9. difficulty concentrating,
  10. loss of interest in activities that previously gave pleasure,
  11. deterioration of interpersonal contacts.

Physical symptoms of PMS include:

  1. breast tenderness and enlargement,
  2. headaches,
  3. muscle, bone and joint pains,
  4. abdominal pain,
  5. nausea,
  6. bloating,
  7. uncontrollable appetite,
  8. a sense of weight gain.

Diagnosis of premenstrual syndrome

Diagnosis of PMS requires the presence of at least one psychological and somatic symptom that seriously affect daily functioning. These symptoms must occur cyclically, in phase II of the cycle, for at least two cycles.

It is also important to rule out other conditions with PMS-like symptoms, such as:

  1. depression,
  2. anxiety disorders,
  3. bipolar affective disorder,
  4. thyroid disease,
  5. endometriosis.

Treatment of PMS

More than half of patients experiencing bothersome PMS symptoms do not see a doctor. This is probably due to the common belief that it is normal to feel worse a few days before menstruation. Meanwhile, the unpleasant symptoms of premenstrual syndrome can and should be effectively alleviated.

Treatment of PMS often requires a multispecialty approach, including the cooperation of a gynecologist, psychiatrist and endocrinologist.

In some women, annoying PMS symptoms subside with magnesium and omega 3 supplementation.

Beneficial changes can also be seen after lifestyle changes, i.e.: introducing regular physical activity and following a healthy diet with limits on alcohol, coffee and sugar.

Also helpful in relieving PMS symptoms will be:

  1. losing excess body weight,
  2. reducing exposure to stress,
  3. improving sleep quality,
  4. relaxation techniques (massage, meditation),
  5. cognitive-behavioral therapy.

In more severe cases, it is worth considering the inclusion of hormonal contraception.

If that doesn’t help, relief may come from treatment with drugs from the selective serotonin reuptake inhibitor (SSRI) group, used continuously or cyclically in phase II of the cycle

Home remedies for PMS

Home remedies can be helpful during PMS. Beneficial effects to relieve PMS symptoms are natural plant preparations, such as:

  1. evening primrose oil,
  2. peppermint,
  3. curcumin,
  4. immaculate monkshood.