Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the 1-2 weeks before a woman’s period.
- Linked to the luteal phase
More than 200 different symptoms have been associated with PMS
Common emotional and non-specific symptoms:
- Stress, anxiety, difficulty with sleep, headache, malaise, mood swings, increased emotional sensitivity, and changes in libido
Common physical symptoms:
- Bloating, lower back pain, abdominal cramps, constipation/diarrhoea, swelling/tenderness in the breasts, cyclic acne, and joint/muscle pain, and food cravings
No laboratory tests or unique physical findings to verify the diagnosis of PMS
3 key features:
- Chief complaint is ≥ 1 of the emotional symptoms associated with PMS (most typically irritability, tension, or unhappiness).
- The woman does not have PMS if she only has physical symptoms, such as cramps or bloating.
- Symptoms appear predictably during the luteal (premenstrual) phase, reduce or disappear predictably shortly before or during menstruation, and remain absent during the follicular (preovulatory) phase.
- Symptoms are severe enough to interfere with everyday life
- Lifestyle changes (reducing salt, caffeine, and exercise)
- Nutritional supplementation (calcium and vitamin D)
- Anti-inflammatories (naproxen)
- Hormonal contraception:
- Combined oral contraceptive pill
- Contraceptive patch
- SSRIs (fluoxetine, sertraline)