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Premenstrual Syndrome

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What is Premenstrual Syndrome?

Premenstrual syndrome (PMS) refers to the regular monthly experience of physical and emotional distress in women of reproductive age, usually several days preceding menses. The symptoms are usually noticed in women between the ages of 25 and 35 years with up to 85% of women being affected by the condition. It may either cause mild discomfort or may result in severe symptoms that may affect the daily routines.1

What are the  Signs and Symptoms of PMS?

Premenstrual syndrome is usually characterized by a wide variety of signs and symptoms, which become prominent during the menstrual periods.

Some of the numerous clinical features include

What are the Causes and Risk Factors of PMS?

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The exact cause of PMS is not known. However, factors such as disturbances in the levels of hormones such as progesterone, estrogen and prolactin during menstruation, vitamin B6 deficiency and hypoglycemia (decrease in blood sugar) have been attributed to cause the syndrome. Social and personal issues relating to menstruation and womanhood may affect the psychological status of women thereby resulting in the symptoms of stress and depression in some. Daughters of women who were themselves PMS sufferers tend to suffer from PMS more commonly. 2

How is it Diagnosed?

The diagnosis is based on a detailed history of the symptoms observed and a careful exclusion of any underlying conditions or associated disorders. The affected woman may be asked to maintain a PMS calendar in which she marks the presence or absence of any PMS symptoms each day. The doctor may advise certain blood tests and other investigations to rule out the presence of any other underlying illnesses.2

What is the Treatment?

The doctor may counsel the affected woman about the condition and the causative factors of PMS. Certain modifications in lifestyle (such as joining aerobic exercises) and diet patterns resolve the symptoms in mild cases. Reducing the intake of caffeine and sodium has also been found to be effective in such cases. Vitamin, calcium and magnesium supplements may be advised at times for a short duration. If unresolved, the doctor may advise the woman to take certain medications to relieve the symptoms. Alternative approaches such as aromatherapy, massage, relaxation and yoga may be beneficial in mild cases of PMS.

Premenstrual syndrome can be prevented by practicing a healthy lifestyle that includes regular exercise (at least 3–5 times a week), a well-balanced diet, decreased intake of salt, sugar, caffeine, and adequate sleep and rest.1,2

What are the Complications?

The symptoms may at times become severe disturbing the woman’s regular personal, social and occupational life. It may also lead to depression.

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1.Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. Am Fam Physician. 2003; 67(8): 1743–1752.

2.Moline ML, Zendell SM. Evaluating and managing premenstrual syndrome. Medscape Womens Health. 2000; 5(2): 1.

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