Premenstrual syndrome

"PMS" redirects here. For other uses, see PMS (disambiguation).
Premenstrual syndrome
SpecialtyGynecology, psychiatry
SymptomsFatigue, irritability and other mood changes, tender breasts, abdominal bloating[1]
ComplicationsPremenstrual dysphoric disorder[1][2]
Usual onset1–2 weeks before menstruation[1]
Duration6 days[2]
CausesUnknown[1]
Risk factorsHigh-salt diet, alcohol, caffeine[1]
Diagnostic methodBased on symptoms[3]
TreatmentLifestyle changes, medication[1]
MedicationCalcium 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]

  1. ^ a b c d e f g h i j k l m "Premenstrual syndrome (PMS) fact sheet". Office on Women's Health. December 23, 2014. Archived from the original on 28 June 2015. Retrieved 23 June 2015.
  2. ^ a b c d e f g h i j k Biggs, WS; Demuth, RH (15 October 2011). "Premenstrual syndrome and premenstrual dysphoric disorder". American Family Physician. 84 (8): 918–24. PMID 22010771.
  3. ^ a b c Dickerson, Lori M.; Mazyck, Pamela J.; Hunter, Melissa H. (2003). "Premenstrual Syndrome". American Family Physician. 67 (8): 1743–52. PMID 12725453. Archived from the original on 2008-05-13.
  4. ^ a b c d e Gudipally, Pratyusha R.; Sharma, Gyanendra K. (2022), "Premenstrual Syndrome", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 32809533, retrieved 2023-01-31, 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.
  5. ^ Cite error: The named reference :2 was invoked but never defined (see the help page).
  6. ^ a b "Premenstrual syndrome (PMS) | Office on Women's Health". www.womenshealth.gov. Retrieved 14 November 2022.
  7. ^ a b Tiranini L, Nappi RE (2022). "Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome". Fac Rev. 11: 11. doi:10.12703/r/11-11. PMC 9066446. PMID 35574174.