Premenstrual Syndrome

Premenstrual syndrome (PMS) or premenstrual dysphonic disorder (PMDD) is an association of distressing physical, psychological and / or behavioral symptoms, which occur in the luteal phase (second half) of the menstrual cycle of sufficient severity. They also interfere with the normal activities and personal relationships of many women.

Symptoms Of PMS Or PMT
Studies have revealed that women consume more refined carbohydrates, dairy products and less fiber, B-complex, vitamins and minerals. However, the women who suffer from PMS or PMT often show symptoms such as:

Anxiety
Nervous tension
Weight gain
Depression governed by various hormonal changes

Although various symptoms of PMS could be experienced during the late luteal phase but occasionally the symptoms might occur as early as ovulation.

Risk Factors
There are several risk factors of PMS that have been identified. These include:

Age
Parity
Menstrual disorders
Gestational complications and
Heredity

- Age:
Commonly PMS is reported among the women who are in their thirties or more but the younger women are also no exception.

- Parity:
A positive correlation between symptom frequency and parity has been observed and progressively worse symptoms were reported after childbirth.

- Menstrual disorders:
Dysmenorrhea has been constantly reported among women with PMS. Menstrual flow longer than 8 days has been constantly associated with the severity of PMS symptoms.

- Oral contraceptives:
Long-term use of oral contraceptives has been cited as a possible cause of PMS.

- Gestational complications:
Prevalence of PMS was reported to be very high (90%) among women with a history of toxemia during pregnancy.

- Heredity:
Familial incidence of PMS is very high. 70 % daughters of PMS mothers suffer from the condition (Johnson S, 1987)

SYMPTOMS OF PMS

Psychological: Irritability, short temper, lethargy, fatigue, loss of concentration, depression disorders, crying spells and sadness, hostility and aggression, impatience, suicidal tendencies, tension and a change in libido.

Dermatological: Acne, herpes outbreaks, purities, dryness, changes in the scalp.

Neurological: Headache (especially migraine), dizziness, fainting, palpitations, increase in seizures in epileptics, asthma, rhinitis and vertigo.
Musculoskeletal: Joint pains, arthritis like symptoms, backache and swelling of fingers and legs.

Gastrointestinal: Constipation often followed by loose motions, abdominal cramps, food cravings, thirst, anorexia and nausea.
Renal: Less frequent urination

Mammary: Breast tenderness and swelling.

CLASSIFICATION OF PMS
PMS has been classified in many different ways on the basis of the symptoms. It was Abraham who developed the most useful classification in 1980, using the term Premenstrual Tension (PMT).

Abraham's Classification Of PMS

Gonadal hormone imbalance: High oestrogen to progesterone ratio in the luteal phase leads to the fluid retention, breast tenderness, changes in carbohydrate metabolism, mood changes etc

Angiotensin: High angiotensin secretion leads to fluid and electrolyte imbalance.

Aldosterone: Elevated secretion of aldosterone causes sodium and water retention in the body.

Prolactin: Fluctuation in prolactin levels causes sodium, potassium and water retention as well as breast tenderness.

Thyroid stimulating hormone: Thyroid dysfunction has been reported during PMS among women.

Opioids, peptides and endorphins: These substances are found in brain and nervous tissue. Deficiency of these has been associated with PMS. Especially beta-endorphin deficiency leads to cramping, craving for carbohydrates, insomnia, irritability and nausea.