Hormones & Cycles

PMS - Meaning, Symptoms and Treatment

PMS is the abbreviation for Premenstrual Syndrome. "Premenstrual" means that this "syndrome" occurs before menstruation - i.e. before your period starts.

It’s characterized by physical as well as emotional complaints, which can occur up to 14 days before your menstruation. Depending on the cycle, even directly after your ovulation. It could be that you notice changes in your body, such as water retention, skin changes, fatigue, headaches and much more. Plus your emotional side can come out - mood swings, depressive mood, indolence and anxiety...but don't panic! Firstly, you may not be affected by PMS at all and secondly, you may not get all your symptoms at once. Every woman has her own individual mix of complaints. And emotionality can also be beautiful and positive, just think of tears of joy!

What is PMS?

Premenstrual Syndrome (PMS) comprises a variety of physical and psychological complaints. These often torture women enormously in the days before menstruation. Both the number and the severity of the symptoms vary from woman to woman. In some women, the symptoms are so severe that they noticeably affect everyday life. This applies to about 20 to 40 percent of all girls and women. Doctors call a particularly severe premenstrual syndrome, in which the psyche suffers considerably and the quality of life decreases decisively, premenstrual dysphoric disorder (PMDD). It is recognised as an independent clinical picture. It is estimated that PMDD affects three to eight percent of all women.

Watch how Dr. Debra Kenward, Obstetrician and Gynecologist explains what is PMS: video about pms

What causes PMS?

As always in connection with menstruation, hormones are suspected to be the cause - in this case the corpus luteum- hormone progesterone. After ovulation, the estrogen level drops and the female body releases more and more progesterone - this applies to all women, whether with or without PMS. However, every woman reacts individually to this change in hormonal balance - particularly 'hormone-sensitive' women can then experience discomfort. It is also suspected that the prolactin level additionally favours PMS or triggers it in some women, because the hormone prolactin mixes up the hormone balance properly. The result: the balance between estrogen and progesterone is upset and PMS symptoms occur. By the way: the prolactin level also increases through stress.

The causes of premenstrual syndrome are still largely unknown, although PMS affects so many women. Because there are so many different conditions in PMS, researchers now rule out that PMS has only a single cause. There are several causes of premenstrual syndrome that can be found in hormones, the psyche and the nervous system.

The following PMS causes are being discussed by researchers:

- The hormonal ups and downs of estrogen and progesterone during the female menstrual cycle are considered a major cause of premenstrual syndrome. The hormone level itself is not necessarily altered in PMS, but some women may be particularly sensitive to degradation products of the corpus luteum hormone progesterone. Especially in the second half of the cycle its concentration increases and the amount of estrogen decreases. And it is precisely here - 14 to a few days before menstruation begins - that the symptoms of PMS are extremely noticeable.

- Progesterone could interact with messenger substances in the brain- especially with the "happiness hormone" serotonin. After ovulation, the concentration of serotonin in the body decreases continuously and shortly before the onset of menstruation, its amount drops abruptly.

- A reduced level of the sleep hormone melatonin is also discussed by researchers as a cause of premenstrual syndrome.

- The genes probably also play a role in the development of PMS. Examples include a history of mental illness in the family or one's own mental illness such as depression or anxiety disorder. A link between premenstrual syndrome and psyche therefore appears probable.

- Environmental factors, such as stress and overload at work and in everyday life.

- For PMDD, researchers have already discovered a biological cause: women have a genetic hypersensitivity to sex hormones.

- It seems that lifestyle also plays a role as a risk factor for PMS, above all diet and exercise. People who consume too much sugar, caffeine, alcohol or nicotine and do too little exercise have a greater risk of PMS. It is known that women with a higher weight suffer from PMS significantly more frequently than women with normal weight.

Premenstrual syndrome does not affect the possibility of pregnancy, unlike endometriosis. During the menopause, many women report that PMS symptoms intensify. The good news is that premenstrual syndrome disappears with the last menstrual period in menopause at the latest.

Typical PMS Symptoms

The symptoms differ from woman to woman and are mostly not experienced all at once.

Physical symptoms include:

- Feelings of tension in the breasts (tender breasts)

- Painful breasts that are particularly sensitive to touch (chest pain)

- Abdominal pain, tension in the abdomen

- Water retention in the tissue (edema), body weight increases and many feel "bloated"; the water is preferentially stored in the breasts (the breasts suddenly become larger), in the face (eyelids) and on the hands, feet and legs.

- Head, back, muscle and joint pain

- Premenstrual syndrome can cause nausea, digestive problems such as flatulence, constipation or bloating.

- Sleep disorders: increased need for sleep, insomnia

- Premenstrual syndrome can cause increased sweating and hot flashes.

- Impure skin (pimples) up to acne hunger pangs, e.g. unrestrained craving for sweets, or the opposite: loss of appetite

Premenstrual syndrome also causes psychological symptoms, for example:

- Fatigue, exhaustion, loss of performance dejectedness, insecurity, reduced self-esteem

- Listlessness, lack of energy, lack of drive mood swings, anxiety, tension, depressive moods

- Premenstrual syndrome can also lead to depression

- Irritated mood, aggressiveness, outbursts of anger

- Concentration difficulties

- Feeling of loss of control over the body and feelings

As long as this list of symptoms may seem, not every woman with premenstrual syndrome necessarily develops all symptoms, and not to the same degree. There can be two, but also a dozen symptoms. What is clear is that PMS significantly affects everyday life and reduces the quality of life.

In up to five percent of women, the symptoms of premenstrual syndrome are so severe that normal everyday life or work is no longer possible. This severe form of PMS, which is associated with mental complaints, has its own name: Premenstrual Dysphoric Disorder (PMDD).

PMS or pregnancy?

Some women ask themselves this question because some PMS symptoms can be similar to those of early signs and symptoms of pregnancy. Signs of pregnancy can include the following:

- Cravings

- Mood swings

- Stomach pains

- Nausea and vomiting which, in contrast to PMS, usually occurs in the morning (typical "morning sickness").

If you are pregnant, your body temperature is also slightly elevated. A pregnancy test helps to be on the safe side. If you do not menstruate, always consult your gynaecologist as a precaution. He will perform another pregnancy test, which will either confirm or exclude your pregnancy.

How can I treat PMS symptoms?

Premenstrual syndrome - what helps? Doctors know several ways to treat premenstrual syndrome. For example, it can be treated with medication. However, measures aimed at your lifestyle are also known to help and should be considered before taking medication.

A positive influence on premenstrual syndrome can for example be achieved through your diet: Avoid stimulants such as alcohol, nicotine or caffeine and don’t eat too many sweets such as chocolate, cookies, or cakes. It’s recommended to eat according to a healthy diet with plenty of fresh fruit and vegetables containing vitamins (B6, D and E) and minerals (calcium, magnesium). Increase your intake of whole grain products and healthy unsaturated fatty acids (e.g. omega-3 fatty acids) instead of animal fats. Also pay attention to your salt intake - if you get too much of it, water retention will increase.

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