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Premenstrual Syndrome (PMS)

Facts and Definition of Premenstrual Syndrome (PMS)

Patient Comments
  • Premenstrual syndrome involves a variety of physical, mental, and behavioral symptoms tied to a woman's menstrual cycle.
  • The acronym PMS stands for "premenstrual syndrome."
  • By definition, PMS symptoms and signs occur during the two weeks before a woman's period starts, known as the luteal phase of the menstrual cycle.
  • Sometimes the signs and symptoms of early pregnancy are similar to those of PMS (premenstrual syndrome).
  • The signs and symptoms of PMS typically become more intense in the 2-3 days prior to the period and usually resolve after the first day or two of flow.
  • PMS is a complex health concern. A significant portion of menstruating women are believed to suffer from PMS.
  • PMS usually occurs in women in their fourth and fifth decades of life (aged 30-49 years). For a small number of women, it can be severely incapacitating. A woman who has had a hysterectomy (removal of the uterus) may still experience PMS if at least one ovary remains.
  • Because many different processes may contribute to PMS, methods of treatment vary widely and can include medical and alternative approaches. Surgery is a last resort.
  • Some women may have a more severe condition called premenstrual dysphoric disorder (PMDD). PMS and PMDD are not the same. Women with PMDD have more severe symptoms that have a significant impact upon their daily functions. The two may occur together, or a woman may have one and not the other.

When Does Premenstrual Syndrome (PMS) Start?

Premenstrual syndrome occurs during the luteal phase of the menstrual cycle. This phase occurs immediately after an egg is released from the ovary and lasts from day 14 through day 28 of a normal menstrual cycle (day one is the day a woman's period begins).

How Long Does Premenstrual Syndrome (PMS) Last?

The symptoms of premenstrual syndrome usually are gone within 3-4 days of the start of a woman's period.

What Causes Premenstrual Syndrome (PMS)?

During the luteal phase, hormones from the ovary cause the lining of the uterus to grow thick and spongy. At the same time, an egg is released from the ovary. If the egg meets sperm, it may implant in the lining of the uterus and grow. At this time, the level of a hormone called progesterone increases in the body, while the level of another hormone, estrogen, begins to decrease. The shift from estrogen to progesterone may cause some of the symptoms of PMS.

PMS and PMDD are thought to result from an interaction between the changing sex hormone levels during the luteal phase of the menstrual cycle and neurotransmitters in the brain, particularly the neurotransmitter serotonin, in susceptible women. While hormone levels are generally normal in women with PMS, the individual's response to the hormones and their changing levels may be different or abnormal.

Hormonal cycling affects the level of serotonin, a brain chemical that regulates many functions, including mood and sensitivity to pain. Compared to women who do not have PMS, some women who experience PMS have lower levels of serotonin in their brains prior to their periods. (Low serotonin levels are commonly associated with depression. Popular selective serotonin reuptake inhibitor (SSRI) antidepressant medicines such as fluoxetine [Prozac], sertraline [Zoloft], and paroxetine [Paxil] lift depression by raising levels of serotonin in parts of the brain.)

  • Bloating is a common symptom of PMS. This may occur because of cycling in hormones that affect the kidneys, the organs that control the balance of water and salt in the body. Fluid overload may cause some of the symptoms of PMS, especially swelling and weight gain, and may also aggravate some negative self-perceptions, and thus worsen emotional symptoms at this stage of the menstrual cycle.
  • Hormonal cycling also affects the level of serotonin, a brain chemical that regulates many functions, including mood and sensitivity to pain. Compared to women who do not have PMS, some women who experience PMS have lower levels of serotonin in their brains prior to their periods.
Medically Reviewed by a Doctor on 11/17/2016

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Patient Comments & Reviews

The eMedicineHealth doctors ask about Premenstrual Syndrome (PMS):

Premenstrual Syndrome (PMS) - Experience

Please share your experience with PMS.

Premenstrual Syndrome PMS - Symptoms

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Premenstrual Syndrome (PMS) - Effective Treatments

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What is PMDD? Severe PMS?

  • Premenstrual dysphoric disorder (PMDD) is a particularly severe form of the premenstrual syndrome (PMS).
  • Both PMS and PMDD cause disturbing symptoms during the second half, known as the luteal phase, of a woman's menstrual cycle.
  • PMDD can cause a number of different signs and symptoms, but fatigue, tiredness, mood changes, and bloating are common.
  • The symptoms of PMDD are severe enough to have a significant impact upon the woman's daily activities and functioning.

Read What Your Physician is Reading on Medscape

Premenstrual Syndrome »

Premenstrual syndrome (PMS) is a recurrent luteal phase condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in deterioration of interpersonal relationships and normal activity.

Read More on Medscape Reference »


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