Pre-Menstrual Syndrome and Pre-Menstrual Dysphoric Disorder


Symptoms of PMS and PMDD can be debilitating for some women.

Around 40% of women experience symptoms of PMS and around 5-8% suffer with severe symptoms. They are made worse at times due to the lack of understanding in the general community regarding these disorders and the tendency for people around you to perhaps shrug it off as ‘women’s issues’ or just ‘being hormonal’.

The exact cause of PMS remains controversial and not well studied but it is thought that hormonal fluctuations do play a part in PMS, as we know that oestrogen starts to fall in the second part of the cycle while progesterone rises mid-cycle and then goes on to fall just before menses. It is probably not due to the hormonal changes themselves but to the effects of changing hormone levels on receptors in the brain and the rest of the body.  It is likely that it is the sensitivity of the receptors that causes symptoms.  This may explain why some women have no PMS symptoms and others have severe symptoms.  We also know that women who have pre-existing depression or anxiety tend to suffer more with PMS and PMDD which may be due to lower serotonin levels in the brain.

Oestrogen boosts serotonin levels in the brain, which is why a fall in oestrogen may affect some women who perhaps have lower serotonin levels to start with.  In a normal cycle when progesterone is released from the ovary after ovulation, it should counterbalance the effects of falling oestrogen.  Progesterone converts into a neuro-steroid called allopregnanolone, which acts like a calming neurotransmitter called GABA.  It has a calming, soothing effect.  Women who have troubling symptoms may have shorter or lower progesterone peaks.  Inflammation and or pre-existing stress may make symptoms worse.

We know that PMS symptoms occur in the 5-10 days before menses and are relieved within 4 days of the onset of your period.  Symptoms must be present over at least 3 cycles.  Symptoms can be both physical and mental and include:

  • Breast tenderness
  • Bloating and abdominal pain
  • Swelling of hands and feet
  • Headache
  • Depression
  • Anxiety
  • Irritability
  • Angry outbursts
  • Social withdrawal
  • Brain fog

The good news is that there are many effective treatment options for PMS and PMDD.

It is important to seek help from someone who understands the menstrual cycle and the complicated way in which hormones can affect many parts of the body and mind.  There are natural and medical treatments that can help, as well as lifestyle changes, diet and nutritional supplements that can also make a big difference. Some women may have such severe symptoms that they may consider hormonal therapy.

At Eve Health we have many effective treatment options for PMS or PMDD and you definitely don’t need to suffer needlessly!  The Eve Health gynaecologists have an in-depth knowledge of the intricate way in which the hormones dance with one another during the menstrual cycle and the way they interact with the other parts of our body. We will guide you through the treatment options and improve your quality of life.

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