Nearly every woman at some point has some symptoms related to fluctuating hormone levels as menstruation approaches. For about half of these women, symptoms are mild and do not affect normal daily life. The other half of women report symptoms severe enough to impact daily life and relationships. Between 3-5% of women report extremely severe symptoms.
In general, PMS is a set of physical, emotional and behavioral symptoms that occur during the last week of the luteal phase (a week before menstruation) in most cycles. The symptoms should typically resolve within four days after bleeding starts and not start until at least day 13 in the cycle. Women may begin to experience PMS symptoms at any time during the reproductive years. Once established, the symptoms remain fairly constant until menopause, although they can vary from cycle to cycle.
Symptoms may include: breast engorgement and tenderness, abdominal bloating, constipation or diarrhea, acne, headache, alcohol intolerance, fluid retention, weight gain, clumsiness, nausea and vomiting, heart palpitations, cyclical breast pain, depression, anxiety, insomnia, change in sexual desire, irritability, hostility and outbursts of anger. In severe cases, violence towards one's self or others can occur. PMDD (Pre-Menstrual Dysphoric Disorder) is a condition of marked severe depression, irritability and tension.
First line therapies include lifestyle modification, especially exercise. Over the counter pain relievers may be helpful. Vitamins B6 and calcium are recommended. In severe cases, SSRIs (Selective Serotonin Re-Uptake Inhibitors — a widely used group of anti-depressants) or other anti-depressive medications, birth control pills or diuretics can be used to treat symptoms.
Medical Disclaimer: The information provided on the Gynecology & Infertility Associates website should be relied upon for medical education purposes only. It is not intended to replace the independent judgment of a health care provider. The appropriateness of a course of treatment for a patient may vary from the medical information provided herein due to individual conditions and/or complications.