PMS (Premenstrual Syndrome) and PMDD (Premenstrual Dysphoric Disorder)

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What is PMS?

Many women experience changes in their body or mood before their menstrual flow begins. Premenstrual Syndrome (PMS) is the name given to a collection of physical and emotional symptoms that can occur in the two weeks before a woman’s period. About 20–40% [1] of women experience symptoms of PMS, while 2–10% [2] report disruption of their daily activities.

What are the symptoms of PMS?

Each woman’s symptoms are different; they may be mainly physical, psychological, or both. Common physical symptoms include tender breasts, headache, fluid retention and a feeling of being bloated. Common psychological symptoms include fatigue, mild mood swings, irritability, anxiety and depression.

The severity of PMS varies, some women experience severe psychological symptoms that impact on daily functioning in the weeks before their period. Severe cases of PMS are sometimes recognised as Premenstrual Dysphoric Disorder (PMDD), and usually show severe symptoms of depression, anxiety, and irritability before menstruation begins. Approximately 2–10% of menstruating women experience PMDD.

Who gets PMS?

Symptoms can begin at any age after a woman begins to menstruate. However, symptoms do not occur when a woman is pregnant, or after menopause.

How is PMS diagnosed?

PMS shares many symptoms with a range of mood disorders, making diagnosis difficult. What distinguishes the syndrome is the characteristic pattern of its symptoms; appearing mid-cycle (after ovulation), worsening in the weeks before a period, and disappearing during menstruation. Before PMS/PMDD is diagnosed a woman may be asked to keep a diary or a chart of their symptoms.

What causes PMS?

There has recently been much research into the biological basis and treatment of PMS; however, the exact causes of PMS remain unclear. It is thought that some women may be more sensitive to the changes in hormonal levels that occur in the second half of the menstrual cycle.

What are the treatment options for PMS?

Various treatment options have been advocated for PMS. Some women are able to self-manage their symptoms. Making lifestyle changes (exercising regularly, eating a healthy diet, reducing caffeine and alcohol intake prior to a period) may help to alleviate the symptoms of PMS. Understanding the problem is important; allowing women to anticipate the onset of symptoms and plan a coping strategy. For example, avoiding stress or doing relaxation exercises prior to a period.

Your doctor may recommend taking antidepressant or anti-anxiety medication, hormone treatment (such as the oral contraceptive pill, oestrogen patches etc.), ibuprofen, or talking therapy such as Cognitive Behaviour Therapy (CBT).

Further help and information

National Association for Premenstrual Syndrome

References

  1. Ginsburg, K.A., Dinsay, R. Premenstrual syndrome. In: Practical Strategies in Obstetrics and Gynecology. Ransom SB (Ed.). WB Saunders Company, PA, USA, 684-694 (2000).
  2. Bhatia, S.C. and Bhatia, S.K. (2002) Diagnosis and treatment of premenstrual dysphoric disorder. American Family Physician 66(7), 1239-1248.

 

Last updated: February 2012


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