Premenstrual syndrome is commonly abbreviated to PMS, and is also known as premenstrual tension, or PMT. These terms however are often misused, and appropriated to cover a broad range of unrelated symptoms. Whereas all women suffer some form of discomfort at points in the menstrual cycle, only around 10% experience Premenstrual Syndrome.
PMS relates to a particular collection of physical and emotional ailments which occur in women during the luteal phase of the menstrual cycle. To be rightly classified as PMS symptoms, they must recur to some degree at the same stage each month, and subside during and beyond menstruation. They must also be of sufficient severity so as to interfere with some aspects of life.
Premenstrual dysphoric disorder, or PMDD, is a severe form of PMS. Mood-related elements of PMS are exacerbated to the degree that PMDD is sometimes classified as a form of depression, and antidepressants are often administered to alleviate the symptoms.
It's not clear exactly what causes PMS, though many believe it relates to the activity of neurotransmitters in the brain. Studies have shown a spike in the excitotoxin glutamate during the luteal phase of themenstrual cycle. High glutamate levels have been closely linked to mood and emotional disorders.
The neurotransmitter serotonin is also affected at this stage. Serotonin manages various brain functions such as memory, sleep, contentment, and anxiety. Meanwhile, monozygotic twins (born of the same egg) show a strong correlation of PMS, with 50% more chance of these twins sharing PMS symptoms than those born from separate eggs. This would suggest a genetic element to the condition.
There are many risk factors which exacerbate the effects of PMS and PMDD. These include a high caffeine intake, a stressful lifestyle, a diet low in particular vitamins and minerals, and a history of depression. As with many conditions, age is also an important factor.
The clinical definition of PMS requires the presence of emotional symptoms. Without them, PMS will not be diagnosed. Although there may be physical symptoms, such as cramps and bloating, these alone do not constitute PMS.
The most common signs are irritability, anxiety, and depressive tendencies. Further symptoms may include fatigue, headaches, mood swings, and a decreased libido.
It's important to recognise that the exact grouping of symptoms, and their intensity, will be particular to each person. There is no rigid set of elements which together make up PMS. That said, each woman will experience roughly the same set of symptoms every month. The regular absence or instability of one element may suggest another issue rather than PMS.
Both lifestyle alterations and medical interventions can help alleviate the suffering caused by PMS. A reduction in caffeine, sodium, and sugar, plus an increase in aerobic exercise can offer a positive impact. A diet rich in vitamin E, vitamin D, vitamin B6, magnesium, and zinc is also highly recommended.
Drug treatment may include the use of Selective Serotonin Re-uptake Inhibitors (SSRIs) or hormone therapy. Drugs like clonidine and phenylalanine have also proven effective in some cases.
Finally, one of the most important aspects of managing PMS is understanding. You and those around you must appreciate that it is a medical condition, and it's important to treat it as such. As with many emotional disorders, the support of family and friends is an integral part to managing the situation.
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