Premenstrual syndrome (PMS) is an extremely common disorder of women that occurs previous to the menstrual cycle, producing a wide range of physical and emotional symptoms.  In fact, up to 75% of women experience some type of PMS. The symptoms typically start a week previous to the start of the monthly cycle and stop within the first 2 days of beginning the cycle.  The symptoms tend to re-appear monthly and may vary in intensity from month to month.  PMS tends to be most common from the late 20’s to the early 40’s.

Women who suffer from PMS exhibit a wide variety of symptoms that can interfere with their life and range from mild to severe.  The symptoms can be either mental/emotional or physical.  Some of the mental/emotional symptoms include: mood swings, fatigue, irritability, food cravings, depression, anxiety, difficult concentration, insomnia, feeling overwhelmed and anger.  Some physical symptoms include: tender breasts, cramping, fatigue, bloating, headaches, acne, changes in stool patterns, cramps, back pain, joint pain, swelling and weight gain.

Some women may suffer from a very severe form of PMS, called Premenstrual Dysphoric Disorder or PMDD.  As many as 50% of woman with severe PMS actually suffer from PMDD. This disorder includes severe mental/emotional symptoms of depression, hopelessness, irritability, anxiety, tension, low self-esteem, weepiness and anger, which all resolve at the onset of the menstrual cycle.  The symptoms of PMDD occur through most of the cycles of the year and cause a significant interference of these women’s lives.

The exact cause for all women who suffer from PMS is not known.  There are many theories about the causes of PMS; however, as every woman is different, it is more likely that PMS is a combination of different causes for each woman.  It is commonly thought that a fluctuation in hormone levels prior to the onset of menses play a major role.   Some hormones that are thought to be out of balance are also those that are out of balance in depression, such as serotonin.  Other triggers for PMS include: underlying mood disorders, stress and poor lifestyle and eating habits.

There are no tests or exams that diagnose PMS or PMDD; it is a clinical diagnosis.  However, in order to establish a baseline before treatment or a pattern to the symptoms, a symptom diary may be advised.  Women who see a doctor for the concern of PMS or PMDD may get a full physical including their yearly pap.  Some women with severe enough symptoms may get a psychiatric evaluation.