3 out of 4 women report symptoms such as anxiety, headache, acne, fatigue or sadness, among others, when menstruation approaches; these cases are known as premenstrual syndrome .

In this article we will discuss the causes and symptoms of premenstrual syndrome, including its most severe form, premenstrual dysphoric disorder . We will also detail the treatments and home remedies by which these disorders can be combated.

Premenstrual syndrome and premenstrual dysphoric disorder

Premenstrual syndrome is defined as a varied set of physical, emotional, and behavioral symptoms that appear after ovulation , one to two weeks before menstruation. They usually stop after the start of the period.

It is estimated that approximately 80% of women have experienced PMS symptoms at some point in their lives. It is more common to occur after the age of 30 , in women who have had children or have a history of depression, both personal and family. The symptoms tend to worsen as menopause approaches.

Premenstrual dysphoric disorder is a severe variant of premenstrual syndrome that affects about 3-8% of women of childbearing age . Unlike PMS, PMS is considered pathological in that it interferes with the normal functioning of those who suffer from it.

In 2013, premenstrual dysphoric disorder was included in the DSM-5. This conception of the disorder has been criticized by many people who believe that it can have negative consequences for women at a socio-economic level and that it was invented by pharmacists to sell medicines. On the contrary, there are those who think that the existence of this diagnosis will increase awareness of the biological basis of this type of symptoms.

Symptoms and signs

Among the most frequent physical signs and symptoms are the appearance of acne breakouts, fatigue, abdominal distension and cramps, colic, constipation, diarrhea, headache, backache, muscles and joints, swelling and tenderness in the breasts, food cravings and weight gain due to fluid retention.

The psychological symptoms of premenstrual syndrome include difficulty concentrating, decreased mood, anxiety, tension, insomnia, irritability, aggressiveness, mood swings, crying, social withdrawal and variations in sexual desire.

Most women who feel symptoms of PMS say that they only suffer from some of the disorders we have mentioned. In general, the pattern of occurrence of symptoms is predictable.

In cases of premenstrual dysphoric disorder the psychological and emotional symptoms are often particularly intense ; for example, feelings of sadness may become hopeless, and irritability and anger may facilitate the emergence of conflicts with other people.

Causes of premenstrual syndrome

PMS-related changes are related to the luteal phase of the menstrual cycle, also called ‘post-ovulation’. During this period the unfertilized egg disintegrates and is later expelled in the bleeding.

In the luteal phase, eggs secrete progesterone, a hormone involved in pregnancy, sex drive, regeneration of skin tissue, blood clotting, breast growth and breast cancer.

It is believed that the deregulation in the production of progesterone and other hormones , which variably affects different women, influences the development of PMS. In addition, fluctuations in the neurotransmitter serotonin may partly explain symptoms such as fatigue, emotional lability, insomnia, and cravings.

Emotional symptoms would be intensified by the presence of stress or depression, while alterations in sodium, mineral or vitamin levels would increase some of the physical signs, such as fluid retention and resulting abdominal bloating.

There are also hypotheses that socio-cultural factors may also contribute to the development of PMS and PSD.

Treatment and remedies

Various medical and psychological treatments, as well as home remedies , are used to reduce the symptoms of premenstrual syndrome. There is no proper treatment for this syndrome, as the effects of the hormonal changes are temporary.

Below you can see the most common and effective treatments to relieve the symptoms of PMS.

1. Changes in diet

Limiting salt intake and large meals can reduce fluid retention, bloating, and the feeling of a full stomach. In contrast, eating foods rich in calcium and complex carbohydrates is recommended. Avoiding coffee and alcohol may also relieve some symptoms.

2. Physical exercise

Doing moderate aerobic exercise , such as swimming, cycling or brisk walking, is useful for treating fatigue, depressed mood and weight gain. Sport is recommended for half an hour a day at least 5 days a week.

3. Stress reduction

To relieve stress and related symptoms, such as anxiety, insomnia, irritability and headache, it is effective to sleep between 7 and 9 hours every night and do relaxation exercises . Progressive muscle relaxation, slow and deep breathing, yoga and massage are some options supported by research.

4. Non-steroidal anti-inflammatory drugs (NSAIDs)

Taking nonsteroidal anti-inflammatory drugs can be effective in relieving cramps, colic, and head, back, and breast pain. Ibuprofen, naproxen, and diclofenac fall into this category of pain relievers.

5. Diuretics

Diuretics such as spironolactone may be recommended to reduce swelling and weight gain caused by fluid retention in cases where exercise and limiting salt intake are insufficient.

6. Antidepressants

Research has found that selective serotonin reuptake inhibitors, such as fluoxetine, sertraline or paroxetine, are effective in treating the emotional symptoms of PMS, although they can cause side effects such as nausea and vomiting .

Although the effect of antidepressants is stronger if they are taken daily, for moderate cases of PMS it is usually sufficient to take them during the days before menstruation, when symptoms are expected to occur. However, it is essential to have a medical indication to use these products.

7. Hormonal contraceptives

Birth control pills are prescribed in cases of premenstrual syndrome and premenstrual dysphoric disorder where the physical symptoms are severe. However, taking these drugs may increase the risk of developing cardiovascular disease and cancer . Similarly, it is necessary to have the corresponding medical indication.

8. Nutritional supplements

Supplements of calcium, magnesium, vitamin E, and vitamin B6 may help reduce the symptoms of PMS, especially breast tenderness, cramping, and fluid retention.

9. Herbal remedies

Among the most commonly used herbal remedies to treat PMS are ginger, ginkgo, soybean, St. John’s wort, chasteberry and evening primrose oil.

It should be noted that scientific studies have not supported this type of therapy at this time, so its effectiveness, side effects and interactions with other drugs are not clear.

Bibliographic references:

  • Dickerson, Lori M.; Mazyck, Pamela J.; Hunter, Melissa H. (2003). “Premenstrual syndrome. American Family Physician.
  • Ford, O; Lethaby, A; Roberts, H; Mol, BW (2012). “Progesterone for premenstrual syndrome.”The Cochrane Database of Systematic Reviews
  • Markens, Susan (1996). “The Problematic of ‘Experience’: A Political and Cultural Critique of PMS”. Gender & Society.