Women may experience emotional and physical changes prior to menstruation. The medical term for these changes is "premenstrual syndrome," commonly called PMS. More than 150 symptoms are associated with PMS, ranging from breast tenderness to nausea to anger and irritability.
Premenstrual emotional and physical changes occur in nearly 80% of menstruating women. The symptoms vary from woman to woman and from cycle to cycle. Their intensity ranges from mild to incapaciting. About 20% to 40% of women who have PMS experience symptoms that make life difficult and 2.5% to 5% experience PMS that is debilitating.
It is not clear what causes premenstrual syndrome. A combination of physiological, genetic, nutritional, and behavioral factors are likely involved. There is no diagnostic test for PMS. Tests may be used rule out other conditions in women who experience severe symptoms. Emotional and physical changes that are in sync with a woman's menstrual cycle are usually a telltale sign.
The most important indication of PMS is the cyclic nature of symptoms. There is usually a symptom free time period 1 week after menstruation ends. At least 25% of patients do not have a symptom free time period; therefore, they should be evaluated for other medical or psychiatric conditions.
Some women experience migraine headaches just prior to or during menstruation. These headaches, which are called menstrual migraines, may be related to hormonal changes and often do not occur during pregnancy.
PMS can be treated in a variety of ways. The initial and usually most effective treatment involves nonmedical changes in diet and lifestyle.