Home Diseases Premenstrual Syndrome (PMS) : Symptoms & Therapy

Premenstrual Syndrome (PMS) : Symptoms & Therapy

by Josephine Andrews
Published: Last Updated on 178 views

Premenstrual Syndrome (PMS) refers to physical symptoms such as pain in the lower abdomen and psychological impairments through to depressive moods that occur before menstrual bleeding begins. The reasons for this have not yet been fully explored. Read everything you need to know about the symptoms, causes and treatment of PMS here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

N93 N94

quick overview

  • Symptoms: Physical complaints such as lower abdominal pain, nausea, headaches; mental symptoms such as sadness, mood swings, depressive moods
  • Treatment: Sufficient sleep and exercise, balanced diet, relaxation and meditation exercises, hot-water bottles; in severe cases medication such as painkillers, antidepressants, diuretics, sometimes homeopathic remedies or natural remedies
  • Causes and risk factors: Not fully understood; Cycle-related fluctuations in the blood levels of female hormones (estrogen, progesterone ) presumably play a central role; Risk factors are stress, partnership problems, unbalanced diet, family history
  • Diagnostics: anamnesis interview, physical examination, blood test
  • Course and prognosis: Symptoms subside with the onset of menstrual bleeding. After the menopause, the symptoms usually disappear.
  • Prevention: Hardly possible; possible improvement through sport, healthy nutrition, sufficient sleep

What is Premenstrual Syndrome?

The premenstrual syndrome (abbreviated: PMS) describes a series of physical and psychological complaints that occur a few days before the start of the menstrual period. With the onset of the period, the symptoms disappear again.

PMS: what are the symptoms?

In women with premenstrual syndrome, various physical and/or psychological symptoms appear in the second half of the cycle, about two weeks to three days before the start of the menstrual period. How severe the PMS symptoms are pronounced varies from person to person and also varies from month to month.

Physical PMS Symptoms

Possible physical PMS symptoms include:

  • abdominal pain
  • Feeling of pressure in the lower abdomen
  • diarrhea or constipation
  • circulatory problems, dizziness
  • Hot flashes, sweats
  • back pain
  • Impure skin, pimples

PMS also changes the appetite of some women: some suffer from food cravings , while others complain of loss of appetite and a feeling of fullness . Nausea before your period and bloating are also possible. Some women also report weight gain before their period. This is based less on increased food intake than on water retention in the tissue.

Breast tenderness and breast pain before your period are also possible signs of PMS. Doctors speak of mastodynia. Stinging or pulling pains are characteristic. The breasts are also often enlarged because the hormonal imbalance before the period causes water to be stored in the breast tissue. With the onset of menstrual bleeding, these accumulations of water (edema) recede.

Mastalgia is to be distinguished from mastodynia. This is chest pain independent of the menstrual period. They are caused, for example, by cysts , a breast infection or breast cancer.

Headaches before the period are also not uncommon in premenstrual syndrome. Before menstruation, many suffer from pressure pain in the middle of the head. In some sufferers, the headache expands into a migraine .

Before menstruation, some people react much more sensitively to stimuli such as bright light, noise, smells or touch, which are then often perceived as extremely unpleasant. In addition, the tolerance for stress or time pressure is reduced in some PMS sufferers.

Mental PMS Symptoms

In most cases, premenstrual syndrome is not only accompanied by physical, but also by psychological problems. Affected people are often irritated in the time before the menstrual period . They also get tired more quickly , need more breaks and more sleep than usual. Other mental PMS symptoms that are commonly observed include:

  • Sudden tantrums
  • Depressive moods
  • Increased anxiety
  • paint of interest
  • listlessness
  • Inner rest
  • Difficulty concentrating
  • sleep disorders
  • hyperactivity

Many sufferers feel overwhelmed more quickly in the period before the menstrual period. They worry more and feel out of control . Some are also sad or depressed . Self-esteem is often impaired as a result. This fuels the negative overall feeling, which in turn increases other PMS symptoms such as anxiety, concentration and sleep disorders in some cases. Those affected often get trapped in a cycle of negative emotions .

The sadness or depressive mood before the period often have no objective reason. It usually disappears suddenly. These inexplicable mood swings often lead to problems with partners, family or friends.

If you suffer from mental PMS symptoms, it does not mean that you have a mental illness. The mental changes – just like the physical ones – are caused, among other things, by the altered hormone levels. Just like the physical PMS symptoms, the psychological symptoms usually disappear with the menstrual bleeding.

Common symptoms of PMS
Many women suffer from premenstrual syndrome, but symptoms can vary from woman to woman.

PMS or pregnant?

Some PMS symptoms such as mood swings, lower abdominal pain, nausea and food cravings also indicate a possible pregnancy . However, especially at the beginning of a pregnancy, other symptoms that can be clearly distinguished from PMS also occur. These include morning sickness, a permanently slightly elevated temperature and extreme exhaustion. And at the latest when the next menstrual bleeding does not occur, the question is answered: PMS or pregnant?

Premenstrual Dysphoric Disorder (PMDD)

For some women, the burden of premenstrual syndrome is so great that it interferes with normal daily, work, and family life. These particularly severe cases are referred to as premenstrual dysphoric disorder (PMDD).

The symptoms of premenstrual dysphoric disorder are similar to those of premenstrual syndrome, only much more pronounced and distressing. Typical of premenstrual dysphoric disorder are strong mood swings that make those affected feel depressed, tearful, anxious or even hopeless.

How is premenstrual syndrome treated?

PMS treatment depends on how intense the symptoms are. In mild cases, sufficient sleep and regular exercise usually help . A balanced diet is also recommended: make sure you eat a diet that is high in carbohydrates, low in salt and easily digestible. Avoid coffee, alcohol and nicotine, as these may aggravate the PMS symptoms.

Lower abdominal pain can be relieved with a hot water bottle or hot tea . Targeted relaxation exercises or meditation also help many .

In severe cases, when the symptoms interfere with everyday life, such symptomatic therapy is not sufficient. Then PMS is treated with medication. Painkillers such as ibuprofen , hormone preparations such as the birth control pill and mood-enhancing drugs (antidepressants) are available for this purpose. Massive water retention (edema) can be treated with diuretics . In the case of severe psychological symptoms, psychiatric treatment may be useful.

Sometimes dietary supplements, for example with magnesium, B vitamins or iron, also relieve the symptoms. Discuss the use of such preparations with your doctor.

PMS: homeopathy and medicinal plants

Many people rely on complementary therapies for PMS. Even if their effectiveness has often not been scientifically proven, many sufferers report an improvement in their symptoms.

Homeopathy knows various remedies that can be used for PMS. Depending on the type of complaint, these include, for example, Calcium carbonicum for water retention, especially with swollen breasts, Pulsatilla for sadness with frequent crying, Natrum muriaticum for irritability, sensitivity and crying, and Cyclamen for painfully swollen breasts and migraine-like headaches.

It is best to seek advice from an experienced therapist when choosing suitable homeopathic remedies.

The concept of homeopathy and its specific effectiveness are controversial and not clearly proven by studies.

Medicinal plants know preparations that treat PMS symptoms naturally. For example, the effectiveness of herbal preparations with chaste tree has been scientifically well researched. Such preparations are used, for example, when an increased prolactin level causes pain and tension in the breasts. Preparations containing St. John’s wort help with mild depressive moods . Valerian and lemon balm are recommended for sleep problems and nervous restlessness.

Medicinal plants have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

What Causes Premenstrual Syndrome?

The causes of premenstrual syndrome are not clearly understood. Doctors suspect that several factors trigger the symptoms. They then speak of a multifactorial development or a multifactorial genesis .

The role of hormones

Hormones appear to be the main cause of PMS. The female sex hormones estrogen and progesterone are particularly relevant for menstrual bleeding. Estrogen levels in the blood are highest during ovulation. Many feel ovulation through a painful pulling in the lower abdomen. In addition, more prolactin is produced during this time . This hormone causes the mammary glands to swell, sometimes causing tenderness in the breasts.

The hormonal changes during the cycle also cause electrolyte and fluid shifts in the body. This is believed to be responsible for at least some PMS symptoms. The substances that are produced when the hormone progesterone is broken down are also suspected of triggering PMS symptoms. In addition, PMS sufferers may be more sensitive to the interactions between progesterone and certain brain messengers such as serotonin .

Other possible PMS causes

Other factors that may contribute to the development of premenstrual syndrome are:

  • Low melatonin levels
  • Underactive thyroid (hypothyroidism)
  • Disorders of the autonomic nervous system
  • stress
  • problems in the partnership
  • unbalanced diet
  • nicotine consumption
  • Little movement
  • Some hormonal contraceptives

A family history of mental illnesses, such as depression, is also considered a risk factor.

Researchers have now proven a biological cause for premenstrual dysphoric disorder: according to their findings, PMDD is caused by a genetic hypersensitivity to sex hormones.

How is PMS diagnosed?

If you suspect that you are suffering from PMS, it is best to discuss this with your gynecologist. The doctor will first ask you about your medical history ( anamnesis ) in order to get an exact picture. Questions like these are possible:

  • How long before the menstrual period do the symptoms appear?
  • Do you have pain and if so, where exactly?
  • Do the symptoms always appear before the start of your period?
  • Do you only have physical problems or do you also feel mentally impaired?

PMS diary helps to prepare for the interview, in which you note down which symptoms occur over several cycles. This detailed information is helpful in ruling out other causes of the symptoms.

After the medical history, a physical examination follows. With a gynecological palpation examination and an ultrasound examination of the uterus and neighboring organs, the doctor is able to rule out organic diseases such as a tumor as the cause of the symptoms.

The doctor (possibly together with other specialists) will also examine whether the symptoms are possibly caused by an underactive thyroid , endometriosis or depression . The onset of menopause must also be ruled out, since PMS-like symptoms often occur during this time.

A blood test provides additional information . The expert uses various blood values ​​​​to determine whether the symptoms have hormonal causes. In general, increased inflammation values ​​​​​​appear during the symptoms.

How does premenstrual syndrome progress?

An accurate prognosis for PMS is not possible. Symptoms vary in intensity between cycles. Various treatment measures alleviate the symptoms in many of those affected, so that they live better in the “days before the days” and are less restricted. The good news is that the PMS problem will go away on its own at the latest when menopause occurs.

How can PMS be prevented?

It is not possible to prevent PMS. However, there are ways to counteract the suffering that occurs every month due to premenstrual syndrome. Doctors generally recommend a healthy lifestyle with plenty of sleep, regular exercise and relaxation exercises. A healthy diet may also alleviate the monthly symptoms: little salt, chocolate, alcohol and caffeine , but more whole grain products, fruit, vegetables, protein-rich foods and omega-3 fatty acids .

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