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Gynaecologic Problems: Pre-menstrual syndrome


Pre-menstrual syndrome (PMS) is characterised by a combination of physical and psychological symptoms that occur in a cyclic pattern, appearing during the week before the menstrual period and often improving with the onset of bleeding. Research suggests that as many as 75% of menstruating women have some pre-menstrual syndrome symptoms. A much smaller number, (probably 3 -8 % of women) have a more severe syndrome which can be disabling.

Symptoms and Signs

The symptoms of PMS can be extremely distressing and usually include:

  • Irritability
  • Anxiety or depression
  • Diminished self-esteem
  • Difficulty concentrating
  • Sleep problems
  • Appetite changes
  • Low energy
  • Bloating, headache and breast swelling and tenderness.

Diagnosis and Treatment

The types and severity of symptoms vary from one woman to another. Some have defined the term PMS as requiring that at least 1 psychological and 1 physical symptom be present monthly during the pre-menstrual period. Women may want to seek treatment when their symptoms are so severe that they seriously interfere with their daily activities.
Many treatments have been tried for alleviating the symptoms of PMS but no treatment has been found that is consistently effective. Treatments include:

  • Lifestyle and stress management.
  • Dietary restrictions (salt or carbohydrate).
  • Diuretics.
  • Prostaglandin inhibitors.
  • Progesterone treatment.
  • Ovulation inhibitors.
  • Vitamins.
  • Lithium and antidepressants. There is some evidence to suggest that a brain chemical, serotonin, may play a role in severe forms of PMS. Antidepressants that alter the serotonin system have been shown to help many women with severe forms of PMS who failed other treatments. These have become the first line treatments at this time due to their low incidence of side effects and their good success rate.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The National Women's Health Information Center (NWHIC) FAQs:

Other HON resources 
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Pre-menstrual syndrome
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Contact Last modified: Jun 25 2002