Premenstrual Syndrome (PMS)

More than 150 symptoms have been reported in association with PMS. There are five basic categories:

Anxiety (includes nervousness, mood swings, irritability & impatience)
Depression (includes crying, confusion, social withdrawal & insomnia)
Pain (includes backache, cramps and breast pain)
Water retention (includes abdominal bloating, weight gain & swelling)
Hypoglycemia (includes headache, craving sweets, increased appetite & fatigue)

Classic PMS symptoms begin 7-10 days before menstruation, peak 2 days before the period starts, and then fade away on the last premenstrual day or first day of period. Though symptoms may vary, they will occur during a specific and relatively constant time of the menstrual cycle and have a clear beginning and end.
Up to 80% of women of reproductive age experience premenstrual emotional and physical changes. It's estimated that 20-40% of these women experience some difficulty as a result of these changes during the premenstrual interval, and 2.5-5% report a significant impact on work, life style, or relationships.
No clinical tests exist to document PMS. Diagnosis depends on use of a menstrual calendar to verify a cycle of symptoms.
Treatment of PMS should be targeted toward specific symptoms such as diuretic therapy for fluid retention and inhibition of prostaglandin synthesis for dysmenorrhea.

(Editor's note: some psychiatrists advocate use of the newer anti-depressant medications called SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft to treat symptoms of PMS. For more information on these drugs, go to:

http://www.mentalhealth.com/drug/p30-p05.html for Prozac and http://www.mentalhealth.com/drug/p30-z02.html for Zoloft.)

Some successful therapies include oral contraceptives and low-salt and refined sugar diets to reduce bloating and hypoglycemia-like symptoms. Vitamin supplementation has not been shown to consistently reduce PMS symptoms.
Premenstrual symptoms have been recognized for centuries, but the cycle disorder occurring prior to the menses was first described in 1931.

Sources: Shoupe, Donna, Management of Common Problems in Obstetrics and Gynecology, 3rd Edition, 1994.

The American College of Obstetricians and Gynecologists. Premenstrual Syndrome. Committee Opinion #155. Washington, DC: April 1995.

Editor's Note: For more information on PMS and a wide variety of other women's health issues, contact:

The American College of Obstetricians and Gynecologists
Department of Public Information
409 12th Street, S.W.
Washington, D.C. 20024-2188 USA
Telephone: (202) 484-3321
FAX: (202) 479-6826
Web: http://www.acog.org

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