By Dr Ananya Mandal, MD
Premenstrual syndrome is a set of emotional, physical and behavioural disturbances that occur especially 5 to 10 days before the start of a period.
When do symptoms of PMS occur?
The symptoms usually begin at the second half of the menstrual cycle that is approximately 14 or more days after the first day of the last period.
The symptoms reduce or relieve after beginning of the period and usually within 4 to 7 days after the beginning of the period.
Patient is usually asked to keep a daily diary with all possible symptoms and the day of onset, duration and intensity of the symptoms for at least three months to help in diagnosis of PMS.
Types of symptoms of PMS
More than 150 different symptoms of PMS have been recorded however some are more common than others.
Symptoms are usually classified as physical, emotional and behavioural.
Symptoms vary from woman to woman depending on her cultural, social, familial, biological or psychological makeup. They may vary in intensity from mild to severely incapacitating. (1-7)
Physical symptoms of PMS
Physical symptoms of PMS include:
- Abdominal fullness and bloating. Patient feels accumulation of gas. There may be fluid retention as well.
- Breast tenderness
- Bowel upset manifested as constipation or diarrhea.
- Fatigue and easily tiring.
- Some women complain of dizziness, nausea or vomiting.
- Headache and backache. There may be muscle and joint pain as well. Migraine or asthma may be worsened with PMS.
- Increased sensitivity to noise and bright lights
- Some women suffer from palpitations and increased sweating
- There may be skin symptoms like acne and excessive oily skin. Hair may be dry or greasy.
- Weight gain by up to 1 kg due to fluid retention
- There may be discomfort within the pelvis and even pain
Behavioural and emotional symptoms of PMS
Behavioural and emotional symptoms may be seen commonly with PMS. Mood related and behavioural problems include:
- Strange food cravings and cravings for sweets and sugar
- Feelings of hopelessness and sadness
- Excessive tension, anxiety and edginess
- Mood swings with excessive teariness or crying. Irritability or aggressive behaviour with outbursts of anger
- There may be loss or increase in sexual drive
- There is usually poor judgement
- Many women suffer from poor self image and guilt. Some may suffer from irrational and increased fears. There may be decreased self esteem
- Sleep problems that may be sleeping difficulty, lack of sleep or excessive sleep
- There may be slow and sluggish movement with increased lethargy
Mental symptoms of PMS
Problems of mental processes include:
- Difficulty in concentrating and focussing
- Simple forgetfulness
- Poor judgement
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)