Premenstrual Symptoms The recurrence of symptoms in the same phase of the cycle for at least three consecutive cycles and the presence, during the follicular phase (first half of the cycle), of a symptom-free period of at least seven days, are essential conditions for making the diagnosis of premenstrual syndrome.
About 80% of women will complain of more or less unpleasant symptoms near the menstrual flow. You will get more ideas after reading refeeding syndrome symptoms and its causes.
Approximately, in 10-40% of women, these disorders will have some repercussions on their working activity and their lifestyle, while only in 5% of women of reproductive age can the typical picture of PMS be configured.
The most important role in diagnosing PMS is played by the severity of the symptoms that occur in the premenstrual phase and the extent of their remission after menstrual flow.
Table of Contents
Symptoms
The symptoms, which usually appear 7 to 10 days before the start of the flow, are extremely variable and difficult to assess in their extent.
They range from depression to breast tenderness, from headache to abdominal swelling, from edema (swelling) of the extremities (legs and less frequently arms) to instability in behavior.
In some patients, they progressively worsen while in others they reach peaks of considerable intensity interspersed with periods of well-being.
Premenstrual syndrome can occur at any time in a woman’s reproductive life; it most commonly appears in later years, and in those patients who report a history of long periods of natural menstrual cycles, ie without the use of oral contraceptives.
Mostly it does not manifest acutely, but the symptoms gradually worsen over the years.
Complications
PMS can have social and marital repercussions. In fact, in the most serious cases, there may be a poor performance in work up to absenteeism, alterations in sexual desire, social isolation.
Exceptionally, women affected by this syndrome are responsible for psychotic behavior (suicide, etc.) or even for criminal acts. Precisely for this eventuality, PMS is recognized by the legislation of some countries (England, France) as a mitigating condition.
Is it serious?
Usually, the syndrome does not go away on its own but by changing one’s lifestyle or using some form of therapy.
There is no data on the behavior of the syndrome at the time of the transition to menopause, but it seems that the approaching end of menstruation can positively influence it.
There is no evidence that PMS begins or worsens after pregnancy, nor that its frequency increase after tubal ligation. Little information exists about the influence of heredity on the syndrome, although some data would seem to prove the existence of genetic factors.
Causes
Although numerous hypotheses have been advanced, the factors involved in the origin of the various disorders related to the premenstrual syndrome are not known with certainty.
Among the various theories proposed, they received the greatest consensus:
The hormonal one, consisting of an altered estrogen-progesterone ratio due to a progesterone deficiency in the luteal phase (the second half of the cycle);
That of an altered hydro-saline exchange (water-salts) determined by the excess or defect of various hormones that have an action on the hydro electrolytic balance: estrogen and progesterone, antidiuretic hormone (ADH or vasopressin), prolactin, aldosterone;
That of thyroid dysfunction, based on the observation that some women with premenstrual syndrome show evident or subclinical signs of hypothyroidism and that in these patients the administration of thyroid hormones determines an improvement of the premenstrual syndrome;
That of vitamin B6 deficiency, based on the relationship between the levels of this vitamin and some endocrine functions;
That of hypoglycemia, based on the similarities existing between the classic picture of PMS and that of the hypoglycemic condition, and on the demonstration that sex hormones are able to influence glucose metabolism;
That of prostaglandin E1 deficiency, which are substances involved in the perception of pain;
The psychosomatic one, which is based on psychological, behavioral and social considerations, and on the finding of an association, even if not frequent, of the premenstrual syndrome with real psychiatric pathologies.
Conclusion
However, it is important to bear in mind that up to now it has not been possible to demonstrate differences in the circulating levels of various hormones (including estrogen, progesterone, testosterone, FSH, LH, prolactin) during the menstrual cycle between women with PMS and those without.
The same applies to substances involved in the regulation of hydroelectric metabolism such as aldosterone. No differences were recorded even with respect to weight gain.
