PMS - What should I know?

Are we all getting a little tired of the PMS jokes and all the horror stories associated with Premenstrual syndrome (PMS)? It is always good to keep a sense of humor about life, but it is also good to be knowledgeable and aware of things that affect so many women as does this syndrome. So, ignoring all of the usual adjectives associated with this condition, just exactly what is PMS?

In 1994, the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.) (DSM-IVR) included "premenstrual dysphoric disorder" among its catalog of disorders.(1) PMS is a cluster of physical and emotional symptoms associated with the menstrual cycle. Most women experience some degree of PMS at some point in their menstrual history, although symptoms vary significantly from woman to woman. Reproductive hormones and neurotransmitters are thought to play a central role in PMS. Five to ten days prior to menses, estrogen levels rise and progesterone levels decline. These changes are accompanied by an increase in something known as follicle stimulating hormone (FSH) six to nine days prior to menstruation. Then, around two to eight days before menstruation aldosterone levels peak. Prolactin levels are elevated in most PMS patients. So you can see that a lot of changes are occurring in a short period of time.

There are many theories around what causes these major changes to occur and why they are more dramatic in some women and less dramatic in others. One theory is that the way that the body uses vitamins and minerals may be a factor. Another hypothesis is that there is some deviation in the viscosity or thickness of the blood along with a change in the amount of water within the red blood cells during the menstrual cycle.(2)

1 The American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychological Association; 1994.
2 Simpson LO. The etiopathologies of premenstrual syndrome as a consequence of altered blood rheology: A new hypothesis. Med Hypothesis. 1988;25(4).

STATISTICS

Women's Health in the Department of Health and Human Services, 1999.

 

SIGNS and SYMPTOMS

For most women, PMS produces symptoms that are annoying but manageable. For some, PMS is debilitating, leaving the woman unable to carryout daily activities. Moderate to severe PMS can be divided into four subtypes.(1)

1 Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndromes. J Reprod Med. 1983;28(7):446-64.
2 The American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychological Association; 1994.

This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.

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