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PMS - Premenstrual Syndrome

Premenstrual syndrome (PMS) is a syndrome common to many women. The symptoms of PMS range from mild to severe and are both physical and psychological. As the name implies, symptoms appear during the week before your menstrual period and often improve with the onset of bleeding. While many symptoms can be distressing, there are treatments available to at least help alleviate them.

Symptoms of PMS

PMS symptoms can be extremely distressing and usually include irritability, anxiety or depression, diminished self-esteem, difficulty concentrating, sleep problems, appetite changes, low energy, bloating, headache and breast swelling and tenderness. The types and severity of symptoms vary from one woman to another, but research suggests that as many as 75% of menstruating women have some PMS symptoms.

Of these, most have emotional symptoms including being overly sensitive to things that would not otherwise upset you, episodes of crying, irritably, tension, and moodiness. Appetite changes are also very common and approximately 75% of women report sweet or salty craving during PMS. The majority of these symptoms is fairly mild and does not need treatment. A much smaller number of women (probably 3-8%) experience more severe symptoms that can be disabling.

Some have defined the term PMS as requiring that at least on psychological and one physical symptom be present every month during the premenstrual period. Women many want to seek treatment when their symptoms are so severe that they seriously interfere with their daily activities.

Treatments of PMS

Many treatments have been tried for alleviating the symptoms of PMS but no treatment has been found to be consistently effective. Treatments include lifestyle and stress management, dietary restrictions (salt or carbohydrate), diuretics, prostaglandin inhibitors (such as Motrin), progesterone (hormone treatment, ovulation inhibitors, vitamins (pyridoxine), lithium and antidepressants. One approach has been to use hormonal manipulation, including oral contraceptives, to stop ovulation from occurring.

There is some evidence to suggest that a brain chemical, serotonin, may play a role in severe forms of PMS. Antidepressants that alter the serotonin system have been shown to help many women with severe forms of PMS who failed other treatments. These have become the first line treatments at this time due to their low incidence of side effects and their high success rate.

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