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Causes of Premenstrual Syndrome (PMS)

Dr Ananya Mandal, MD

Premenstrual syndrome or PMS is physical, emotional and hormonal disturbances just before the beginning of a woman’s menstrual periods that subsides after the beginning of the period.

Who does Premenstrual syndrome affect?

Women are more prone to PMS in their late 20s and early 40s. Symptoms usually worsen around puberty when menstruation begins or after birth of the first child.

Some women suffer the symptoms before menopause in late 30s and 40s. PMS usually goes away once menopause sets in. Pregnancy is also a time when PMS symptoms reduce.

What causes Premenstrual syndrome?

Although benign and harmless these may debilitate a woman and hamper her daily living activities. The exact cause of PMS has not been identified.

There are many theories that describe the causes of PMS. Some these include hormonal disturbances, chemical changes in the brain and so forth. (1-7)

Hormonal disturbances

It has been shown that women with PMS often respond differently to the fluctuations of the female hormones that occur during a menstrual cycle.

Researchers speculate that excessive estrogen, progesterone deficiency, elevated prolactin, increased aldosterone could be associated with PMS symptoms.

Chemical changes in the brain

Certain chemicals in the brain may also play a role in PMS. These include chemical messengers of the brain called serotonin. This chemical fluctuate during the menstrual cycle.

This chemical regulates moods and those with disturbances of serotonin may develop mood disturbances and depression associated with PMS. Low serotonin also leads to fatigue, food cravings and difficulty in sleeping.

Diet and Premenstrual syndrome

A diet rich in salt, caffeine, alcohol or fat may also aggravate PMS symptoms. Excessive salt in diet also leads to fluid retention.

Low levels of certain vitamins (like vitamin B6) and minerals are thought to influence PMS as well.

Obesity, exercise and other factors that may contribute to Premenstrual syndrome

Women who are obese or who take little or no exercise are also at a higher risk of PMS. Smokers are also at a higher risk. Those with thyroid disease and with low blood sugar may also develop symptoms of PMS.

Other causes of Premenstrual syndrome

Other causes of PMS include:

  • Social, cultural background also seems to play a role in risk of PMS.
  • Women with a family history of the condition, or with a certain biological or psychological factors
  • Around 75 to 80% women during their childbearing years suffer from PMS.
  • Women with family history of major depression or those with a previous history of depression after childbirth called postpartum depression or a mood disorder.
  • Those with severe PMS may also have a psychiatric disorder called premenstrual dysphoric disorder.
  • Excessive emotional stress, anxiety etc. may lead to aggravated symptoms of PMS.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Aug 1, 2012

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