Premenstrual Syndrome (PMS)

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

1. Anxiety (includes nervousness, mood swings, irritability & impatience)
2. Depression (includes crying, confusion, social withdrawal & insomnia)
3. Pain (includes backache, cramps and breast pain)
4. Water retention (includes abdominal bloating, weight gain & swelling)
5. 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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