PMS (premenstrual syndrome) encompasses various symptoms that can be traced back to the female menstrual cycle and occur about 4 to 14 days before the menstrual period begins. About 75 percent of sexually mature women are affected by PMS, with around 5 percent of women having serious impairments in everyday life as a result of PMS.
What is PMS?
PMS (premenstrual syndrome) is a series of different physical and/or psychological complaints that occur monthly in a certain period of time, in the second half of the menstrual cycle, and usually subside with the onset of menstrual bleeding.
While mild forms of PMS are not recognized as a disease, severe forms of PMS, especially premenstrual dysphoria, are considered a mental illness that can have a significant negative impact on the everyday life of the women affected. See AbbreviationFinder for abbreviations related to PMS.
Symptomatically, PMS manifests itself with varying, complex complaints that cover a wide spectrum from headaches and/or abdominal pain, hot flashes and water retention to serious psychological impairments such as mood swings, anxiety and depression.
Stress factors, an unbalanced diet with excessive nicotine, alcohol and caffeine consumption as well as a lack of exercise can increase the symptoms of PMS.
The underlying causes of PMS have not yet been conclusively clarified, which can partly be attributed to the fact that in most cases the women affected have a combination of causes.
On the one hand, hormonal imbalances, such as a disturbed presence of progesterone and estrogen, which could result from hormonal fluctuations during the menstrual cycle, are suspected. On the other hand, PMS can be caused by an underactive thyroid or a disturbed melatonin level.
In addition, some hormonal contraceptives (e.g. birth control pills) can trigger PMS or increase the symptoms associated with PMS. An unbalanced diet, lack of exercise, excessive alcohol and nicotine consumption and psychosocial stress factors (problems at work and/or in the family) also contribute to an increase in the symptoms typical of PMS.
Symptoms, Ailments & Signs
PMS can make the days leading up to menstruation very painful for affected women. However, the specific complaints can be perceived very differently. Many women experience PMS as a feeling in the lower abdomen that initially feels a little tight and then gets stronger. PMS can also be felt four or more days before menstruation, but the symptoms often come immediately before menstruation.
In addition to complaints, which are also described as cramps in the abdomen, PMS can also affect the complexion. Many sufferers suffer from pimples and oily skin in the days leading up to their period. The mind can also be affected by PMS. General malaise, lack of concentration and even depressive moods can be the result of PMS.
The altered interaction of hormones shortly before menstruation can make you feel irritable, tired and listless. Physical complaints such as a tight stomach can usually be relieved with painkillers. A gynecologist should always be consulted if symptoms are perceived as extremely severe. Before prescribing any special preparations, he must clarify whether another gynecological disease is causing the severe pain.
Diagnosis & History
To diagnose PMS, the affected woman is asked about her specific symptoms and when they occurred as part of an anamnesis. In addition, it is clarified whether the PMS could be due to hypothyroidism, endometriosis, depression, the onset of menopause or other possible causes.
The hormone level can also be checked to determine a possible hormonal imbalance. In some cases, especially if there are several complaints, a diary should be kept in which the different complaints are recorded with their respective degrees of severity.
As a rule, PMS disappears with the onset of the menopause. A premenstrual syndrome that is accompanied by severe symptoms that severely affects the everyday life of the affected woman should always be treated, also because severe, untreated PMS increases the risk of breast cancer.
PMS, the premenstrual syndrome, is a great burden for many women. However, seven percent of those affected can show such severe symptoms that even the entire social environment is severely affected. Then it is spoken of a premenstrual dysphoric disorder. Premenstrual dysphoric disorder is a real mental illness that can occur as part of premenstrual syndrome.
Affected women become difficult to irritate and sometimes highly aggressive. Even though they know it’s wrong, these women often engage in behavior at this stage that they would strongly dislike in normal times. So it can happen that they become violent, hit their child, get screaming fits or even throw objects.
Women affected by premenstrual dysphoric disorder experience a loss of control during this time. Therefore, the realization that their behavior is wrong is of no use to them. The biggest risk for these women is that they can destroy their social environment with their kind. This can lead to divorce or even the loss of children.
The professional perspective is often affected by this due to illness. In the long term, this can result in social isolation, which often leads to other chronic mental illnesses such as depression in addition to the premenstrual symptoms.
When should you go to the doctor?
Premenstrual syndrome is not actually a disease and does not need to be treated. In the case of mild to moderate symptoms, it is therefore not urgently necessary to consult a doctor. In the course of the annual gynecological check-up, those affected should nevertheless describe the symptoms.
However, there is a need for action if severe mental and physical symptoms occur repeatedly in nine out of twelve cycles. In these cases, it is advisable to consult a doctor, since the symptoms can rarely be caused by serious illnesses. The first point of contact is either the general practitioner or the gynecologist.
Which doctor should be consulted depends on the symptoms present. In the case of psychological problems, it may also be advisable to consult an endocrinologist, psychiatrist or psychologist. If there are mainly physical symptoms, those affected should consult a gynecologist or naturopath. In principle, many general practitioners and specialists are not properly trained in relation to premenstrual syndrome. It can therefore be advisable in many cases to consult several doctors. Conventional medical therapy approaches are not effective for some women. In these cases, it is advisable to also consider alternative approaches.
Treatment & Therapy
The treatment of PMS depends to a large extent on the underlying symptoms and the level of suffering felt by each affected woman. Mild PMS does not need to be treated if the symptoms associated with it only slightly affect the everyday life of those affected.
In many cases, learning relaxation techniques such as autogenic training or progressive muscle relaxation to avoid or minimize the effects of stress factors is sufficient to treat mild PMS. Hormonal contraceptives with progestins are also used to treat PMS. Antiphlogistics (anti- inflammatories) are used against pain and a low-salt and easily digestible diet can help against water retention when avoiding alcohol, nicotine and caffeine and/or diuretics.
In some cases, herbal remedies (wolfweed, monk ‘s pepper) and/or an additional increase in magnesium and vitamin B intake provide relief. In individual cases, psychological support for the affected woman through behavioral or psychotherapy may be indicated, while antidepressants (such as amitriptyline) are used therapeutically in the presence of depression.
Outlook & Forecast
Premenstrual syndrome depends on many contributing factors. Girls and young women who suffer from PMS may notice a significant improvement in symptoms towards the end of puberty and into adulthood. At best, as adult women, they feel no or only mild symptoms. If an adult patient still suffers from PMS, then she will most likely experience the symptoms until the menopause.
There are factors that make the symptoms worse or that can also alleviate them. Nicotine and caffeine consumption can have an aggravating effect, while combinations of certain fatty acids in the diet can alleviate the symptoms. A change in diet can therefore have a positive effect on well-being. Lack of exercise can also be a reason why premenstrual symptoms are more severe than necessary. Sport and fitness can have a preventive effect.
Certain diseases such as thyroid disorders, fungal infections or sleep problems also increase the symptoms of PMS. Although there is no cure for premenstrual syndrome, the affected woman can still try to relieve the symptoms without taking medication. If the symptoms are severe, painkillers can be taken to relieve the symptoms enough to manage normal everyday life, so that the social consequences of PMS are not unnecessarily severe.
Due to the fact that the causes have not been finally clarified, PMS cannot be specifically prevented. However, the extent of the respective symptoms can be positively influenced by a balanced diet without excessive consumption of nicotine, alcohol and caffeine, physical activity and relaxation techniques to reduce stress. In addition, the risk of disease is increased in obesity (overweight). Accordingly, weight reduction can minimize the risk of developing PMS.
To speak of follow-up care in the area of PMS is not quite correct, since it is a symptom that usually repeats itself monthly. If the symptoms experienced by the woman are particularly severe, monthly follow-up care can be provided to support physical and mental regeneration.
This can be done with warm baths, gentle endurance training or massages and depends on individual well-being and taste. Drinking enough water, healthy nutrition and enough sleep can also be integrated into aftercare after the often very uncomfortable days of premenstrual syndrome.
Often women can treat PMS themselves with herbal remedies like chasteberry. If this is successful, it is part of the aftercare to reliably adhere to the dosage. Regular visits to the gynecologist are also included in the follow-up care to ensure, for example, that there is no other illness hiding behind the breast tenderness that is mistaken for PMS.
Learning relaxation techniques is also a means of making follow-up care meaningful. PMR (progressive muscle relaxation), AT (autogenic training), fantasy journeys and yoga are just a few of many examples. Follow-up care also includes the woman observing what is particularly good for her during the PMS period. By keeping a cycle calendar, these measures can be started early.
You can do that yourself
PMS (Premenstrual Syndrome) is a common and regularly occurring phenomenon. For affected women there is a whole range of possibilities to relieve the unpleasant symptoms through self-help in everyday life. This is often particularly reliable because PMS can be easily predicted due to its dependency on the woman’s menstrual cycle. In this context, self-help is possible for both the physical and mental complaints that PMS brings with it as a very individual symptom.
In the physical area, the unpleasant breast tenderness and skin blemishes are particularly noteworthy. Monk ‘s pepper preparations are often suitable for reducing feelings of tension in the chest. A well-supportive bra will help reduce the pain that often occurs with movement. The blemishes can often be alleviated with mild antiseptic cleansing products.
In the mental area, the range of possible complaints such as fears or depressive moods, but also tiredness, can be alleviated with physical activity. Exercise in the fresh air, such as walking or swimming, is particularly recommended. If you want to take it easy, you can find balance with yoga or progressive muscle relaxation. It often also helps to schedule stressful private or professional commitments in such a way that they do not fall into the PMS phase and do not put additional strain on those affected.