Premenstrual syndrome

Premenstrual syndrome
Premenstrual syndrome
Specialty	Gynecology, psychiatry
Symptoms	Fatigue, irritability and other mood changes, tender breasts, abdominal bloating
Complications	Premenstrual dysphoric disorder
Usual onset	1–2 weeks before menstruation
Duration	6 days
Causes	Unknown
Risk factors	High-salt diet, alcohol, caffeine
Diagnostic method	Based on symptoms
Treatment	Lifestyle changes, medication
Medication	Calcium and vitamin D supplementation, NSAIDs, birth control pills
Frequency	~25% of women

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] Different women experience different symptoms.^[6] Premenstrual syndrome commonly produces 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] These symptoms are nonspecific and are seen in women without PMS. Often PMS-related symptoms are 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 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]

^ ^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.
^ ^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.
^ ^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.
^ ^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.
^ Cite error: The named reference :2 was invoked but never defined (see the help page).
^ ^a ^b "Premenstrual syndrome (PMS) | Office on Women's Health". www.womenshealth.gov. Retrieved 14 November 2022.
^ ^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.

[Women2014-1] ^ ^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.

[AFP2011-2] ^ ^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.

[AFP2003-3] 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.

[:1-4] 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.

[:2-5] Cite error: The named reference :2 was invoked but never defined (see the help page).

[Women2021-6] "Premenstrual syndrome (PMS) | Office on Women's Health". www.womenshealth.gov. Retrieved 14 November 2022.

[Tiranini-7] 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.

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