PMS- Premenstrual syndrome

We often are mistaken between Period Cramps and PMS. Premenstrual syndrome (PMS) is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation and normally end with the onset of her menstrual flow.

May 24, 2022

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Menstrual cramps usually start the day a woman’s menstrual period starts, and may last for the entire period. PMS has a wide variety of signs and symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It’s estimated that as many as 80% menstruating women have experienced some form of premenstrual syndrome.

What causes PMS?

Scientific research hasn’t led to a conclusive cause of PMS, or an explanation for why some people experience it more severely than others. That said, researchers have suggested a few different theories:

1. Cyclical changes in hormones

Many experts believe PMS happens in response to changing levels of the hormones estrogen and progesterone.

These hormones naturally fluctuate throughout your menstrual cycle. During the luteal phase, which follows ovulation, hormones reach a peak and then decline rapidly, which may lead to anxiety, irritability, and other changes in mood.

2. Chemical changes in the brain

The neurotransmitters serotonin and norepinephrine have several important functions in the body, including helping regulate mood, emotions, and behavior.

These chemical messengers may also factor into symptoms of PMS.

For example, a drop in estrogen may prompt the release of norepinephrine, which leads to declining production of dopamine, acetylcholine, and serotonin. These changes can trigger sleep problems and lead to a low or depressed mood.

What are the Symptoms?

The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.

Emotional and behavioural symptoms include tension or anxiety, depressed mood, crying spells, mood swings and irritability or anger, appetite changes and food cravings, insomnia,social withdrawal, poor concentrationand change in libido

Physical signs and symptoms include joint or muscle pain, headache, fatigue, weight gain related to fluid retention, abdominal bloating, breast tenderness, acne flare-ups, constipation or diarrhoea and alcohol intolerance

Does PMS change with age?

Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause.11

This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse.

PMS stops after menopause when you no longer get a period.

How is PMS diagnosed?

There is no single test for PMS. Your doctor will talk with you about your symptoms, including when they happen and how much they affect your life.

You probably have PMS if you have symptoms that:12

  • Happen in the five days before your period for at least three menstrual cycles in a row
  • End within four days after your period starts
  • Keep you from enjoying or doing some of your normal activities

Keep track of which PMS symptoms you have and how severe they are for a few months. Write down your symptoms each day on a calendar or with an app on your phone. Take this information with you when you see your doctor.

Tips on controlling PMS

  • Eat complex carbohydrates (such as whole grains and whole-grain breads, pasta, and cereals), fiber, and protein. Cut back on sugar and fat.
  • Avoid salt for the last few days before your period to reduce bloating and fluid retention.
  • Cut back on caffeine to feel less tense and irritable and to ease breast soreness.
  • Cut out alcohol. Drinking it before your period can make you feel more depressed.
  • Try eating up to 6 small meals a day instead of 3 larger ones.
  • Get aerobic exercise. Work out up to 30 minutes, 4 to 6 times a week.
  • Get plenty of sleep—about 8 hours a night.
  • Keep to a regular schedule of meals, bedtime, and exercise.
  • Try to schedule stressful events for the week after your period.

PMS or Pregnancy?

It’s a cruel reality that PMS and the early signs of pregnancy are nearly identical. The reason? You produce more progesterone the week after ovulation, whether or not you’re pregnant. Progesterone is the hormone responsible for many PMS symptoms, like bloating, breast tenderness, and mood swings. 

If you’re not pregnant, you’ll stop releasing the hormone about 10 days after ovulation. (As levels wear off, your symptoms subside, the uterine lining sloughs off, and you get your period.) If you are pregnant, you’ll continue producing progesterone (and experiencing PMS-like symptoms). 

Luvleen Chugh

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