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premenstrual syndrome (PMS)

Premenstrual Syndrome (PMS) is a menstrual cycle disorder that affects women in the reproductive age group. It consists of a set of physical and emotional symptoms that severely impact the quality of life. PMS occurs during the luteal phase of the menstrual cycle (two to three weeks before the periods) when the estrogen and progesterone levels are high and are working hard to prepare the uterine lining for fertilization.

The cause of PMS is poorly understood, but the cyclical changes in estrogen and progesterone levels during this phase trigger the symptoms. Mood changes are attributable to the effects the hormones have on the serotonin and dopamine systems. Each woman has her own unique experience of PMS. Some may not experience it at all, some may experience only the physical symptoms, and some may experience a combination of both types of symptoms.

The physical symptoms of PMS are:

  • Headache, Backache, muscle and joint pain

  • Tiredness and fatigue

  • Sore and painful breasts (mastalgia)

  • Bloating and weight gain

  • Food cravings

  • Acne

The emotional symptoms of PMS are:

  • Irritability, angry outbursts

  • Sadness, anxiety

  • Forgetfulness, difficulty concentrating

  • Social withdrawal, lack of motivation

How to Manage PMS symptoms

The most crucial thing is to be aware of the

changes that your body goes through. Do not ignore the sudden shift in emotions, the increase in emotional sensitivity; getting out of the wrong side of the bed is not always the reason for every negative emotion you feel. Be mindful of every change in your behavior. Keeping track of your menstrual cycle will also guide you in identifying any symptoms of PMS. Recording your symptoms and recognizing when you experience them will help in effective

management during the next menstrual cycle.

Manage a healthy diet and exercise regularly;

this will decrease your risk and reduce the

severity of symptoms. Getting a goodnight's

sleep and maintaining sleep hygiene will ensure

that your mind and body are well-rested. Studies

have found that women who experience PMS symptoms

have particular vitamin and mineral deficiencies

such as Vitamin D, Vitamin B6, Calcium, and

Magnesium. Supplementing with these vitamins

are known to reduce the severity of PMS symptoms.

Premenstrual Dysphoric Disorder (PMDD) occurs when the behavioral symptoms of PMS become severe and unmanageable that it starts disrupting one's quality of life. If PMDD occurs, it is vital to seek professional help as antidepressants may be helpful. Birth control pills may be useful for some women experiencing PMDD.

An alternative to birth control pills is the more natural bioidentical hormones. Bioidentical hormones are derived from plant estrogens that are chemically identical to the hormones a human body produces. Intake of bioidentical hormones is also known to lessen the symptoms of PMS. They assist in the restoration of hormonal balance and maintain the regularity of the menstrual cycle. By preventing the sudden shift in hormonal levels, bioidentical hormones reduce the occurrence of PMS symptoms.

Personally, my extreme cravings for chocolate is a harbinger of my menstrual cycle. Along with the intense desire for chocolatey goodness, I also experience subtle mood changes. It took me some time to recognize these elusive yet significant changes. And once I became well-acquainted with my body, I was able to deal with it. Despite our shared biology, each one of us will experience PMS differently. It is crucial to be cognizant and to be able to identify the changes our mind and body go through before every menstrual cycle.


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2) Hantsoo L, Epperson CN. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Curr Psychiatry Rep. 2015 Nov;17(11):87. DOI: 10.1007/s11920-015-0628-3. PMID: 26377947; PMCID: PMC4890701.

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4) Del Mar Fernández M, Regueira-Méndez C, Takkouche B. Psychological factors and premenstrual syndrome: A Spanish case-control study. PLoS One. 2019 Mar 6;14(3):e0212557. doi: 10.1371/journal.pone.0212557. PMID: 30840651; PMCID: PMC6402625.

5) Bhuvaneswari K, Rabindran P, Bharadwaj B. Prevalence of premenstrual syndrome and its impact on quality of life among selected college students in Puducherry. Natl Med J India. 2019 Jan-Feb;32(1):17-19. DOI: 10.4103/0970-258X.272109. PMID: 31823933.

6) Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. PMID: 22069417; PMCID: PMC3208934.

7) Saeedian Kia A, Amani R, Cheraghian B. The Association between the Risk of Premenstrual Syndrome and Vitamin D, Calcium, and Magnesium Status among University Students: A Case Control Study. Health Promot Perspect. 2015 Oct 25;5(3):225-30. doi: 10.15171/hpp.2015.027. Erratum in: Health Promot Perspect. 2016;6(1):54. PMID: 26634201; PMCID: PMC4667262.


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