Are we all getting a little tired of the PMS jokes and all the horror stories associated with Premenstrual syndrome (PMS)? It is always good to keep a sense of humor about life, but it is also good to be knowledgeable and aware of things that affect so many women as does this syndrome. So, ignoring all of the usual adjectives associated with this condition, just exactly what is PMS?

In 1994, the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.) (DSM-IVR) included "premenstrual dysphoric disorder" among its catalog of disorders.(1) PMS is a cluster of physical and emotional symptoms associated with the menstrual cycle. Most women experience some degree of PMS at some point in their menstrual history, although symptoms vary significantly from woman to woman. Reproductive hormones and neurotransmitters are thought to play a central role in PMS. Five to ten days prior to menses, estrogen levels rise and progesterone levels decline. These changes are accompanied by an increase in something known as follicle stimulating hormone (FSH) six to nine days prior to menstruation. Then, around two to eight days before menstruation aldosterone levels peak. Prolactin levels are elevated in most PMS patients. So you can see that a lot of changes are occurring in a short period of time.

There are many theories around what causes these major changes to occur and why they are more dramatic in some women and less dramatic in others. One theory is that the way that the body uses vitamins and minerals may be a factor. Another hypothesis is that there is some deviation in the viscosity or thickness of the blood along with a change in the amount of water within the red blood cells during the menstrual cycle.(2)

Premenstrual dysphoric disorder (PMDD) is a condition associated with severe emotional and physical problems that are linked closely to the menstrual cycle and is considered a very severe form of PMS. Researchers have found that a brain chemical called serotonin could play an important role in PMDD. In order to be diagnosed with PMDD, you must have at least 5 of these symptoms.(3)

• feelings of sadness or despair, or possibly suicidal thoughts
• feelings of tension or anxiety
• panic attacks
• mood swings, crying
• lasting irritability or anger that affects other people
• disinterest in daily activities and relationships
• trouble thinking or focusing
• tiredness or low energy
• food cravings or binge eating
• having trouble sleeping
• feeling out of control
• physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain