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Understanding Premenstrual Syndrome (P.M.S.).

Understanding Premenstrual Syndrome (P.M.S.).

No, premenstrual syndrome (PMS) is not trivial. This period preceding menstruation can be experienced in a more or less painful way depending on each woman, at different times in their lives. Nonetheless, between physical discomfort and sometimes psychological difficulties, the problems associated with PMS are important to recognise and identify. We explain how.

What is premenstrual syndrome?

Premenstrual syndrome is an often unpleasant period that precedes menstruation and affects approximately 80% of women of childbearing age. This period occurs during the 3rd phase of the menstrual cycle and is characterised by an accumulation of mild physical and psychological symptoms, which are nonetheless bothersome. During this time of the month, those affected are more likely to suffer from headaches, breast pain, bloating and acne, for example. Some also notice an effect on their mood, making them more irritable. Premenstrual syndrome is a known but unpredictable phenomenon, which depends on the individual and can be felt more or less intensely from one month to the next.

What are the causes?

The causes of premenstrual syndrome are poorly understood. Some studies suggest that it could be closely linked to hormonal fluctuations. The oestrogen/progesterone ratio at this time of the cycle would act as a signal at the level of target tissues, causing the various symptoms. However, other studies show that women diagnosed with premenstrual disorder do not have higher levels of oestrogen or progesterone than the general population. Thus, explanations as to why some women might be more sensitive to these sexual hormone fluctuations are lacking.

Similarly, menopausal women who had previously been diagnosed with Premenstrual Syndrome (PMS) exhibited recurring psychiatric and physical symptoms when they were undergoing hormone replacement therapy. Furthermore, it has been demonstrated that the suppression of oestrogens significantly improved the symptoms of PMS.

Mood changes can be attributed to the effect of oestrogens and progesterone on the serotonin, gamma-aminobutyric acid, and dopamine systems (neurotransmitters). They can also alter the renin-angiotensin-aldosterone system (RAAS), which could explain the bloating and swelling that occur during the luteal phase.

However, levels of sex hormones alone cannot fully explain premenstrual disorders. Indeed, studies on monozygotic twins suggest a possible genetic component to premenstrual disorders. On the other hand, no gene has been identified.

Sources:

  • HALBREICH U. The etiology, biology, and evolving pathology of premenstrual syndromes. Psychoneuroendocrinology (2003).

  • BODDEN S. & al. Premenstrual syndrome and premenstrual dysphoric disorder. American Family Physician (2016).

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