Written by Hormone Health Associate Ms. Annie Hawkins, Consultant in Obstetrics and Gynaecology
Premenstrual syndrome, Premenstrual tension and Premenstrual dysphoric disorder are all sub types of the group of disorders known as Premenstrual Syndromes.
They have different exact definitions, but all consist of a group of symptoms that occur in the luteal phase of the menstrual cycle, after ovulation and before menstruation. These symptoms either significantly improve or go away completely once menstruation occurs.
Many different symptoms have been reported at the premenstrual time and different women have different symptoms. They are broadly grouped into the Physical, the Psychological and the Behavioural types of symptoms.
The commonly known physical symptoms include breast tenderness, abdominal bloating and acne. In some cases, they can include worsening of physical illnesses such as asthma attacks, epileptic fits, or a change in diabetic control and women can end up hospitalised.
Psychological symptoms include feeling very low, or very anxious at this time, sometimes with feelings of self-loathing or suicidal thoughts, irritability and aggression.
Behavioural symptoms include planning life around the cycle, avoiding social interaction and having time off work.
Most women can recognise when their period is coming by experiencing these types of symptoms at a low level. However, we estimate that around 5% of women are so affected by their symptoms, that they produce a significant effect on their life. Symptoms can go through times in life when they are better and times when they are worse. In general, they seem to worsen with age, and can be particularly severe in the perimenopause. This means that sometimes it can be difficult to understand what is happening to you.
If you feel that this describes you, the first thing to do is to start keeping a daily symptom diary (See “What to include in a symptom diary”). This can really help your Hormone Health doctor understand what has been happening to you and when, to try and see how best to help you.
The National Association of Premenstrual Syndromes (NAPS), which is one of Hormone Health’s nominated charities, is a patient support group with a very helpful website at www.pms.org.uk, which we recommend that you also look at.
Treatment options include lifestyle modifications, alternative and complementary therapies, Non-hormonal and hormonal medical treatments. It appears to be the fluctuations in the hormone levels and their interaction with the brain that make symptoms worse.
Every woman is different, so depending on your age, other medical conditions and your hormone status, your doctor can decide with you what options might be best to try when you meet for your consultation.