PMS: The Latest Insights

PMS: The Latest Insights on its Causes and How to Reduce Symptoms
© 2011 Health Realizations, Inc.

To the medical community, PMS (or premenstrual syndrome) is still a largely mysterious phenomenon that affects women during the one or two weeks before menstruation.

But for the women who face PMS each month (estimates of exactly how many menstruating women get PMS vary widely and go as high as 80 percent, but the American College of Obstetricians says it's up to 40 percent), the physical, emotional and psychological symptoms are all too familiar.


Fatigue and irritability are two of the most common symptoms reported by women with PMS.

Each woman's symptoms vary, and they vary for each woman from month to month, but can include any of 180 symptoms that have been identified to date including some of the common ones below:

Some Common PMS Symptoms

  • Breast swelling and tenderness
  • Fatigue
  • Trouble sleeping
  • Upset stomach, bloating, constipation or diarrhea
  • Headache
  • Food cravings (especially for sweet and salty foods) and changes in appetite
  • Joint or muscle pain
  • Tension, irritability or mood swings
  • Uncontrollable crying
  • Anxiety
  • Depression
  • Backache
  • Trouble concentrating
  • Acne breakouts
  • Aggressiveness
  • Changes in libido
  • Uterine cramps
  • Weight gain
  • Fluid retention
  • Swelling of feet and ankles
  • Forgetfullness

What Causes PMS?

There has been no single cause of PMS identified or accepted by the medical community. But because the changes that happen during PMS coincide with changes in hormone levels during the menstrual cycle, the most widespread theory about PMS is that it's related to changes in female sex hormones like estrogen and progesterone (though how it's related isn't clear).

Other theories have been suggested including that PMS could:

  • Be related to hypoglycemia (abnormally low blood sugar levels) or hypothyroidism (abnormally low levels of thyroid hormones).

  • Be related to pituitary hormones, prostaglandins and neurotransmitters in the brain.

  • Be due to a diet lacking in B vitamins, calcium or magnesium.

If there were to be a consensus among experts, however, it's likely to be that PMS is due to a variety of factors, including the physiological ones listed above, but also because of genetics, environment and lifestyle factors like nutrition and stress.

What About PMDD?

There's a lot of controversy about premenstrual dysphoric disorder (PMDD) and whether it's a real "disorder." PMDD includes all of the symptoms of PMS but to the extreme-where a woman who has PMS may feel sad, a woman with PMDD may feel suicidal. It's said to affect anywhere from 3 percent to 9 percent of women.

"It's a real biological condition for which women seek treatment--and for which effective treatment is available," says Jean Endicott, PhD, director of the premenstrual evaluation unit at Columbia Presbyterian Medical Center.

However, for each expert who believes in PMDD, there's another who says it isn't real, and that it could drive women to take a medication when what they really need is to get at the underlying issues.

As Joan Chrisler, PhD, a psychology professor at Connecticut College and president of the Society for Menstrual Cycle Research, said, "We're conditioned to want a pill. Instead of something you might need more, like a nap or a divorce, or the ERA."

And according to Paula Caplan, PhD, author of "They Say You're Crazy," "There is no evidence [that PMDD exists], though people have to find such evidence ... It is really appalling that using PMDD for women who want recognition for discomfort is a very clear message that goes something like: 'OK, OK, we'll believe you are feeling bad if we get to call you mentally ill for feeling bad.'"

Seven Ways to Help Reduce PMS Symptoms

Though PMDD symptoms may be so severe as to require medical or psychological help, the symptoms of PMS can usually be dealt with on your own. Here's what can help:

  • Exercise: According to Carol Watkins, MD, "Women who exercise regularly have fewer PMS symptoms." Regular exercise is typically considered to be at least three to five times a week.

  • Eat Better: Nutrient deficiencies and poor nutrition could make PMS symptoms worse. The top dietary culprits to avoid during PMS include:

    • Salt

    • Sugar

    • Caffeine

    • Alcohol

  • But at the same time you're avoiding the "bad" foods, it's important to get plenty of the "good" vitamins and minerals that your body needs.

    Most women should consider a high-quality supplement that provide endocrine support for balancing female hormones. FemGuard + Balance by Designs for Health supports hormonal balancing in the form of vitex, polygonum and black cohosh, along with DIM and chrysin for protection and optimization of beneficial estrogen aromatase activity. This special formula, which also contains calcium, magnesium and key B vitamins, may also reduce PMS, perimenopause, and menopausal symptoms. For added benefit and the convenience of all in one support, women may also choose either the Women's Twice Daily Essential Packets with Iron and the Women's Twice Daily Essential Packet "without Iron". Both of these kits include the exclusive FemGuard + Balance along with a high antioxidant multivitamin/mineral, abone support formula, and fish oils.

  • Get plenty of sleep.

  • Manage stress in your life. How you choose to manage stress is up to you-you may feel better from taking some time alone with your journal or going for a long walk outside. Others may prefer to call a close friend or listen to music.

  • Another exceptional way to relieve stress that many are not aware of? Stretching!

  • Don't smoke.

Sources Premenstrual syndrome (PMS) fact sheet Premenstrual Syndrome (PMS) (PMS): Symptoms