Premenstrual syndrome (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 the etiology of PMS. Five to ten days prior to menses, plasma estrogens rise and progesterone levels decline. These changes are accompanied by an increase in follicle stimulating hormone (FSH) six to nine days prior to menstruation, and peak aldosterone levels two to eight days before menstruation. Prolactin levels are elevated in most PMS patients. Other biochemical pathways such as the insulin response, and uptake of vitamins and minerals are being studied as potential causative factors. One hypothesis suggests that PMS may be due to an aberration in blood viscosity and red blood cell hydration during the menstrual cycle.(1)
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. One brain chemical that may be especially important is serotonin, a neurotransmitter. The serotonin system has a close relationship to the female hormones, and imbalances of the serotonin system may play an important role in causing PMDD. Symptoms occur a week before menstruation and ends after bleeding starts. In order to be diagnosed with PMDD, you must have at least 5 of these symptoms.(2)
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