Premenstrual syndrome

Premenstrual syndrome (PMS) is characterized by irritability, anxiety, emotional lability, depression, edema, breast pain, and headaches, occurring during the 7 to 10 days before and usually ending a few hours after onset of menses. Diagnosis is clinical, often based on the patient's daily recording of symptoms. Treatment is symptomatic and includes diet, drugs, and counseling. The cause of PMS is unclear.
Risk factors for premenstrual syndrome include:
* History of depression or mood disorders, such as postpartum depression or bipolar disorder
* family history of PMS
* family history of depression
* Domestic violence
* Substance abuse
* Physical trauma
* Emotional trauma
Associated conditions include:
* Dysmenorrhea
* Major depressive disorder
* Seasonal affective disorder
* Generalized anxiety disorder
* Schizophrenia
Symptoms of PMS
A woman's menstrual cycle lasts an average of 28 days.  Ovulation, the period when an egg is released from the ovaries, occurs on day 14 of the cycle. Menstruation, or bleeding, occurs on day 28 of the cycle. PMS symptoms can begin around day 14 and last until seven days after the start of menstruation. The symptoms of PMS are usually mild or moderate. Nearly 80 percent of women report one or more symptom that does not substantially affect daily functioning, according to the journal American Family Physician.

The symptoms of PMS include:
* Abdominal bloating
* Abdominal pain
* Sore breasts
* Acne
* Food cravings, especially for sweets
* Constipation
* Diarrhea
* Headaches
* Sensitivity to light or sound
* Fatigue
* Irritability
* Changes in sleep patterns
* Anxiety
* Depression
* Sadness
* Emotional outbursts
Premenstrual dysphoric disorder (PMDD)
Some women have severe PMS symptoms that occur regularly and only during the 2nd half of the menstrual cycle; symptoms end with menses or shortly after. Mood is markedly depressed, and anxiety, irritability, and emotional lability are pronounced. Suicidal thoughts may be present. Interest in daily activities is greatly decreased.
In contrast to PMS, PMDD causes symptoms that are severe enough to interfere with routine daily activities or overall functioning. PMDD is severely distressing, disabling, and often under diagnosed.
When to see your doctor
See your doctor if physical pain, mood swings, and other symptoms start to affect your daily life, or if your symptoms don't go away.
The diagnosis is made when you have more than one recurrent symptom in the correct time frame that is severe enough to cause impairment and is absent between menses and ovulation. Your doctor must also rule out other causes, such as:
* Anemia
* Endometriosis
* Thyroid disease
* Irritable bowel syndrome (IBS)
* Chronic fatigue syndrome
* Connective tissue or rheumatologic diseases
Your doctor may ask about any history of depression or mood disorders in your family to determine whether your symptoms are the result of PMS or another condition. Some conditions, such as IBS, hypothyroidism, and pregnancy, have symptoms similar to PMS. Your may need to do a thyroid hormone test to ensure that your thyroid gland is working properly, a pregnancy test, and possibly a pelvic exam to check for any gynecological problems.
Keeping a diary of your symptoms is another way to determine if you have PMS. Use a calendar to keep track of your symptoms and menstruation every month. If your symptoms start around the same time each month, PMS is a likely cause.
Easing the symptoms of PMS
You can't cure PMS, but you can take steps to ease your symptoms. If you have a mild or moderate form of premenstrual syndrome, the treatment options include:
* Drinking plenty of fluids to ease abdominal bloating
* Eating a balanced diet to improve your overall health and energy level, which means eating plenty of fruits and vegetables and reducing your intake of sugar, salt, caffeine, and alcohol
* Taking supplements, such as folic acid, vitamin b-6, calcium, and magnesium to reduce cramps and mood swings
* Taking vitamin d to reduce symptoms
* Sleeping at least eight hours per night to reduce fatigue
* Exercising to decrease bloating and improve your mental health
* Reducing stress, such as through exercising and reading
* Going to cognitive behavioral therapy, which has been shown to be effective
You can take pain medication, such as ibuprofen or aspirin, to alleviate muscle aches, headaches, and stomach cramping. You can also try a diuretic to stop bloating and water weight gain.
Take medications and supplements only as directed by and after speaking with your doctor, eg-
* Folic acid supplements
* Vitamin B-6 supplements
* Calcium supplements
* Magnesium supplements
* Vitamin d supplements
* Ibuprofen
* Aspirin
Your doctor may also suggest cognitive behavioral therapy, which is a form of counseling that can help you understand your thoughts and feelings and change your behavior accordingly.