PMS and emotional changes

Premenstrual syndrome, or PMS as it is commonly known, is a medical disorder that is characterized by a set of hormonal changes and neurotransmitter sensitivity in the brain that trigger disruptive symptoms in a significant number of women for up to two weeks prior to menstruation.  Researchers estimate there are at least 40 million women who suffer from PMS and that 5 million require medical treatment for a marked mood and behavioral changes.  These 5 million women have a more severe case of the condition which is called premenstrual dysphoric disorder.

Over 150 symptoms have been attributed to premenstrual disorder and can vary from month to month.  Some women also find that they have months which are symptom-free.  Pre-menstrual syndrome is a condition that affects women of childbearing years, including those in their teens and who are premenopausal.

While there are definitive physical symptoms which include migraines, headache, fluid retention, constipation, painful joints, backache, abdominal cramping and heart palpitations women with premenstrual syndrome also suffer from the very specific emotional changes.  These emotional and behavioral changes can include depression, irritability, panic attacks, lack of coordination, anxiety, tension, altered libido or decreased work performance.

Thankfully there is no one woman who will present with all the symptoms of premenstrual syndrome.  This condition was originally described in 1931 by an American neurologist who identified certain elements to distinguish premenstrual syndrome from other disorders.  While a woman may believe she has premenstrual syndrome, it is important for her to obtain a definitive diagnosis from her physician since the symptoms of PMS also mimic other medical conditions which, if left untreated, can have disastrous results.

Premenstrual syndrome is thought to be triggered by hormonal changes but researchers have also found that this there is a sensitivity to the neurotransmitter serotonin which controls mood, anxiety and weight gain.  Because of the sensitivity to serotonin doctors have found good results using the antidepressant classification of the selective serotonin reuptake inhibitors.  To date there has been only one or two research studies which has used this drug in treatment during adolescence.

During the pre-menstrual phase it appears that a woman\’s brain has a reduced ability to utilize serotonin and therefore the selective serotonin reuptake inhibitors work by improving the ability to use serotonin and stabilize a woman\’s mood.

There also appeared to be some emotional symptoms which are worsened by the effects of the physical symptoms of premenstrual syndrome, namely pain and fatigue.  While exercise releases natural mood elevating and pain relieving chemicals called endorphins it may be perceptually more difficult for a woman to exercise during those two weeks prior to her menstrual cycle.

Women who become pregnant often find that the symptoms disappear especially in the second and third trimester.  It also appears that heredity may play a factor since sisters, mothers and daughters in the same family will often suffer from premenstrual syndrome although the specific symptoms may differ.

There are also times that women will experience increased activity and feelings of euphoria prior to the symptoms of premenstrual syndrome or migraines.  During this period of time a woman may clean the house, increase productivity at work, function with little sleep and feel euphoric.  During this time she may also have an increased libido which corresponds with ovulation.

Once the emotional changes of premenstrual syndrome are manifested a woman will typically feel \”out of control\” which can signal the beginning of the symptoms of depression.

In a study published in 2005, 79% of women in the study reported experiencing emotional changes such as mood swings, emotional lability and anger when they had premenstrual syndrome.  84% of men reported that women were close to experiencing premenstrual syndrome which indicated they were perceptive about the emotional changes their partners faced.  Women in this study believe that their personal relationships suffered and the study showed that 72% of women felt that PMS negatively affected their relationship with their partner and 62% felted negatively affected their relationship with their children.  (1)

The emotional changes that are associated with premenstrual syndrome are treatable with dietary changes, lifestyle choices and eliminating specific toxins such as tobacco, alcohol and caffeine.  Doctors are also able to prescribe other medications as well as an increase in the amount of exercise a woman receives each week in order to help her body regulate be sensitivity to hormones which fluctuate during the month and the brain\’s ability to handle the serotonin.

(1) Journal of Indian Academy of Forensic Medicine: Premenstrual Syndrome

RESORUCES

Dr Oz: PMDD: When PMS Interferes with Life and Living

British medical Journal: Premenstrual Syndrome

Everyday Health: Mood Swings: PMS and Your Emotional Health

WomensHealth.gov: Premenstrual Syndrome Fact Sheet