Savvy womens Magazine


Women and PMS



Premenstrual syndrome (PMS) is a term commonly used to describe a wide range of severe, recurrent symptoms you may experience 7 to 10 days before your period begins. The condition affects roughly 30% to 40% of all women of childbearing age. PMS symptoms can appear at any time between puberty and menopause, though the most common age for PMS to become a problem is during your late 20s to mid-30s.

Symptoms of PMS may worsen with age, with stress and increase in severity after each pregnancy. Even women who have had hysterectomies can have PMS, if at least one functional ovary is left intact following the hysterectomy. Women who are vulnerable to depressive illness, panic disorders and eating disorders may also be susceptible to PMS, although these conditions may occur in women with PMS, as well. Heredity may play a role: if your mother or sister suffers from PMS, you may find that you experience it, too.

As many as 150 physical and behavioral symptoms have been assigned to PMS. These symptoms can include mood swings, anxiety, depressed mood, fatigue, appetite changes, water retention and breast tenderness, among others. Menstrual cramps, or dysmenorrhea, are not considered a PMS symptom, though women with PMS can experience menstrual cramps. For some women, symptoms can be severe and disrupt their lives and relationships.

No one knows exactly what causes PMS. Researchers now know, however, that PMS is not just an imbalance of estrogen and progesterone - commonly referred to as "female hormones" - or any other single hormone. A number of studies have found nothing abnormal in the levels or ratios of these hormones in women who experience PMS. Estrogen excesses, progesterone deficiencies, Vitamin B6 deficiencies, an excess of prolactin (a protein hormone that triggers production of breast milk) and altered glucose metabolism are among the many different theories that attempt to explain PMS, but none has been proven.

A complex interaction of neurohormones such as endorphins and serotonin and other brain chemicals may trigger PMS. Exactly how these brain chemicals change with or affect the menstrual cycle remains unclear. However, treatment studies are becoming more focused and may lead to a better understanding of the menstrual cycle and the effects of hormones on human behavior.

Three recent studies have pointed to calcium as playing a role in PMS. In one study, researchers found that women who received 1,200 mg of calcium carbonate each day for three menstrual cycles had a 50 percent reduction in PMS symptoms--particularly mood swings or depression, pain, cravings and water retention.

Thankfully, some PMS symptoms improve with treatment. Dietary changes and exercise may help to relieve the discomfort of PMS symptoms. When symptoms are severe, antidepressant medication may also be helpful. One of the most important strategies for coping with premenstrual discomfort is to be aware of any pattern your symptoms follow. The more aware you are of your symptoms - when they start and stop and what works best to relieve them, for example - the better able you will be to develop strategies to recognize and cope with them - whatever they may be.

What's Premenstrual Dysphoric Disorder (PMDD)?

While as many as 75 percent of women may experience some degree of premenstrual discomfort, approximately five to seven percent experience symptoms severe enough to disrupt their daily function and meet stringent diagnostic criteria, according to guidelines issued by the American College of Obstetricians and Gynecologists (ACOG) in April 2000. This more severe condition is called premenstrual dysphoric disorder (PMDD). Under the PMDD classification, which applies only to women who experience symptoms at the most severe end of the spectrum, dysphoric or depressive mood symptoms are the most important criteria for diagnosis. Physical symptoms may also be present, but they are not as critical to the diagnosis. The difference between PMDD and PMS is like the difference between a mild tension headache and a migraine, experts say.

Women who have a history of depression are at higher risk for PMDD than other women. Treatment for PMDD includes medication known as selective serotonin re-uptake inhibitors (SSRIs), a type of antidepressant medication.

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