Premenstrual syndrome | |
---|---|
Specialty | Gynecology, psychiatry |
Symptoms | Fatigue, irritability and other mood changes, tender breasts, abdominal bloating[1] |
Complications | Premenstrual dysphoric disorder[1][2] |
Usual onset | 1–2 weeks before menstruation[1] |
Duration | 6 days[2] |
Causes | Unknown[1] |
Risk factors | High-salt diet, alcohol, caffeine[1] |
Diagnostic method | Based on symptoms[3] |
Treatment | Lifestyle changes, medication[1] |
Medication | Calcium and vitamin D supplementation, NSAIDs, birth control pills[1][2] |
Frequency | ~25% of women[2] |
Premenstrual syndrome (PMS) is a disruptive set of emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period.[4][5] Symptoms resolve around the time menstrual bleeding begins.[4] Symptoms vary,[6] though commonly include one or more physical, emotional, or behavioral symptoms, that resolve with menses.[7] The range of symptoms is wide, and most commonly are breast tenderness, bloating, headache, mood swings, depression, anxiety, anger, and irritability. To be diagnosed as PMS, rather than a normal discomfort of the menstrual cycle, these symptoms must interfere with daily living, during two menstrual cycles of prospective recording.[7] PMS-related symptoms are often present for about six days.[2] An individual's pattern of symptoms may change over time.[2] PMS does not produce symptoms during pregnancy or following menopause.[1]
Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life.[3] Emotional symptoms must not be present during the initial part of the menstrual cycle.[3] A daily list of symptoms over a few months may help in diagnosis.[2] Other disorders that cause similar symptoms need to be excluded before a diagnosis is made.[2]
The cause of PMS is unknown, but the underlying mechanism is believed to involve changes in hormone levels during the course of the whole menstrual cycle.[1] Reducing salt, alcohol, caffeine, and stress, along with increasing exercise is typically all that is recommended for the management of mild symptoms.[1] Calcium and vitamin D supplementation may be useful in some.[2] Anti-inflammatory drugs such as ibuprofen or naproxen may help with physical symptoms.[1] In those with more significant symptoms, birth control pills or the diuretic spironolactone may be useful.[1][2]
Over 90% of women report having some premenstrual symptoms, such as bloating, headaches, and moodiness.[6] Premenstrual symptoms generally do not cause substantial disruption, and qualify as PMS in approximately 20% of pre-menopausal women.[4] Antidepressants of the selective serotonin reuptake inhibitors (SSRI) class may be used to treat the emotional symptoms of PMS.[4]
Premenstrual dysphoric disorder (PMDD) is a more severe condition that has greater psychological symptoms.[2][1] PMDD affects about 3% of women of child-bearing age.[4]
Premenstrual syndrome (PMS) encompasses clinically significant somatic and psychological manifestations during the luteal phase of the menstrual cycle, leading to substantial distress and impairment in functional capacity.
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was invoked but never defined (see the help page).