PMS: what is it?

PMS is the combination of symptoms that women experience from a week or two before their period. Once the period has occurred, the symptoms usually improve.

The symptoms may not be too troublesome, but for many women they can be physically and psychologically distressing affecting their ability to function in their personal relationships, socially and professionally.

Studies show that up to 30% of women may experience significant symptoms of PMS. A term that is being increasing used is Premenstrual Dysphoric Disorder (PMDD) – this is one particular type of severe and debilitating premenstrual condition.

PMS: the link with menopause!

PMS symptoms are linked to the activity of the ovaries, so occur during the fertile years of a woman’s life. This means that when the menopause occurs, PMS will cease, along with the monthly period. However, during the perimenopause symptoms usually deteriorate due to fluctuating hormones. Thus, both PMS and menopause symptoms can affect a woman’s wellbeing and quality of life at this time. The symptoms of PMS can in fact be similar to those experienced during the menopause. However, it is possible to differentiate between the two as PMS symptoms will stop or improve once a period has finished, whereas they can usually continuous during the menopause.

PMS: what causes it?

Every month, the hormones in a woman’s body fluctuate during the menstrual cycle, with the week or two before the period causing some or all of the symptoms noted below.  These changes have a natural rhythm that can be disrupted by lifestyle factors such as lack of exercise, increased stress levels and poor diet leading to an increased risk of PMS. However, recent studies have discovered that women with severe PMS have a particular gene (PMDD gene) or genetic make up which makes them more vulnerable to the hormonal changes which occur in every woman. These women are often more susceptible to menopause symptoms later in life.

PMS: what are the symptoms?

Many different symptoms have been reported, so again, keeping a personal diary will help you and your healthcare professional decide on the best way to manage your PMS.

Here are a few of the symptoms that you may experience:

Physical symptoms:

Irregular periods, heavier periods, breast tenderness, bloating, headaches, cramps (period pains).

Psychological:

Mood swings, depression, anxiety, irritability, aggression, anger, sleep disturbance, feeling out of control, tiredness, fatigue or lethargy

Unfortunately, the number and type of symptoms and severity may differ from one cycle to another. Consequently, keeping a symptom diary for at least 2 months is important to understand these potential variations.

PMS: what treatments are available?

Lifestyle changes:
  • Reducing stress, diet, exercise, limiting alcohol and smoking
Complementary therapies
  • There is some evidence that Agnus Castus, a traditional herbal remedy, and magnesium may be of help.
Medical treatments:
  • Hormone treatments such as
    • certain types of oral contraceptive pill (not all are beneficial and some may make the symptoms worse)
    • hormone patches, gels and implants delivering natural estrogen together with natural progesterone and possibly testosterone
    • occasionally the cycle may need to be suppressed with a nasal spray or an injection which mimicks the effect of menopause
  • SSRIs – Selective Serotonin Reuptake Inhibitors (modern anti-depressants used during the symptom phase of the cycle)
Surgical treatments:
  • Hysterectomy – for some women seeking a permanent cure for whom fertility is not an issue, removal of the uterus and ovaries may be appropriate. Adequate HRT must be ensured post surgery so that PMS symptoms are not replaced by menopause problems!

As with the menopause, PMS treatments need to be tailored to each woman’s needs and wishes.

If you want to know more about PMS or have concerns about the symptoms you are experiencing, you can contact your GP or regular healthcare provider in the first instance, but if you want more time to discuss your concerns and the options available to you in more detail, please get in touch with us at Hormone Health to arrange an appointment at our clinic at 92 Harley Street in London.