The premenstrual syndrome

definition

Premenstrual syndrome is a combination of several symptoms that occur periodically a few days before the menstrual period. The symptoms are both physical and psychological.The premenstrual syndrome is a multifactorial disease that has psychological, hormonal and neurological components.

Many women suffer from a mild form of premenstrual syndrome, but in some cases the symptoms can be so severe that the women have noticeable restrictions in everyday life. In these cases, drug therapy may be necessary.

You can find out which symptoms you can use to recognize premenstrual syndrome here:
You can recognize premenstrual syndrome by these symptoms

CAUSES: What causes premenstrual syndrome?

The exact cause of premenstrual syndrome is not yet known. However, since PMS is a periodic symptom, the most likely trigger is hormonal fluctuation during a woman's cycle. Since this does not explain the whole clinical picture, it is probably a multifactorial disease.

Psychological and neurological causes are discussed as further factors in addition to hormone fluctuations.

SYMPTOMS: What are the symptoms of PMS?

Premenstrual syndrome is characterized by many symptoms, both psychological and physical. Premenstrual syndrome is a combination of up to 30 different symptoms, all of which can be combined with depression. Abdominal pain, flatulence, loss of appetite or hunger attacks are some of the physical symptoms that a particularly large number of those affected report. Acne and skin blemishes are also common symptoms.

Many affected women also experience water retention all over their bodies. The hands, feet and breasts are particularly affected. Since this is also visible, it is a psychologically problematic symptom. The premenstrual syndrome can also lead to a variety of psychological complaints in addition to depression. These include anxiety, sleep disorders, concentration problems, irritability and aggressiveness, and mood swings. Not all affected women develop all symptoms, but the symptoms can also appear separately from one another. The severity of the symptoms also varies from person to person.

If there is a predominance of psychological symptoms and severe depression, gynecologists speak of a premenstrual dysphoric disorder, also called PMDS. This particularly severe form of premenstrual syndrome affects less than five percent of affected women.

Read more about this under: I recognize premenstrual syndrome by these symptoms

nausea

Premenstrual syndrome is often accompanied by symptoms in the gastrointestinal tract. This also includes nausea and vomiting. These can arise either directly after ingestion or completely independently. Some women also feel pre-menstrually nauseous from certain foods they normally enjoy eating or drinking.

Some smells can also be perceived as more unpleasant and lead to nausea. For many women, regular over-the-counter medications help relieve nausea.

You can find more information at: Premenstrual Syndrome and Nausea.

Hot flashes and night sweats

Hormonal fluctuations can lead to hot flashes. These are characterized by a sudden sensation of warmth that starts in the chest area and then spreads over the whole body.
These hot flashes are often accompanied by sweats on the affected parts of the body and can also wake the affected woman up. Frequent sweats therefore also lead to sleep disorders. In premenstrual syndrome, some women can experience such hot flashes.

Abdominal pain

Many women with premenstrual syndrome experience severe abdominal pain both premenstrually and during their menstrual period. This cramp-like pain is caused by tension in the uterine muscles.

Over-the-counter pain relievers such as ibuprofen or paracetamol can be used for the pain. If the bleeding is heavy, aspirin should be avoided as a pain reliever, as this weakens blood clotting and can increase the bleeding. Many women also use a hot water bottle or warm tea to relieve pain.

What helps against menstrual pain? Read on here.

depression

There are strong hormone fluctuations in the female cycle. Hormones, including the fluctuating sex hormones, influence the whole body and also have a direct effect on the psyche. This can lead to a depressive mood completely independently of other illnesses or, in the case of a fundamentally existing depression, trigger or intensify a depressive episode. Women who are under great strain in their families or at work are particularly prone to depressive moods during their cycle. These can occur without other symptoms of premenstrual syndrome being present.

In severe cases, the women are given antidepressants, which, however, are only used due to severe side effects when other therapies have failed.

For more information, also read: Premenstrual Syndrome and Depression.

DIAGNOSIS: How can PMS be diagnosed?

The diagnosis of premenstrual syndrome is usually made by a gynecologist. In a detailed conversation, he asks many questions about symptoms and when they occur. For the diagnosis, it is helpful if those affected keep a complaint diary in which they record when they have their menstrual period and when which symptoms occur.

A laboratory examination is always part of the diagnosis, as the inflammation markers can be elevated during the symptoms and the laboratory can also be used to rule out other possible diagnoses.

THERAPY: What helps with PMS symptoms?

Initially, an attempt is usually made to get a grip on the symptoms with relaxation exercises, exercise and a balanced diet. If this attempt fails, there is the option of hormonal treatment. Here, hormonal contraceptives are used that prevent ovulation and supply the body with a constant dose of hormones. In this way, the hormone fluctuations that are often causal can be prevented and the symptoms should decrease. In this case, the pill should be taken continuously and without a break.

Medicines can also be used directly against certain symptoms. Commercially available painkillers such as ibuprofen or paracetamol help against the pain. However, if the bleeding is severe, aspirin should be avoided, as this weakens the body's own hemostasis. Diuretics can be prescribed for water retention.
A combination therapy of psychotherapy and medication is usually used against the depressive mood. Mood enhancers such as sertraline or citalopram can be used. However, this is only used if the symptoms cannot be combated in any other way, as these preparations are associated with many side effects. The natural St. John's wort also helps against slight depressive moods.

Find out more about the here Treatment of Premenstrual Syndrome.

Home remedies

The first attempts at therapy for premenstrual syndrome are possible without any medication. Relaxation exercises, such as yoga, and regular exercise can help alleviate discomfort for some people. A balanced diet can also reduce premenstrual syndrome. Chocolate, caffeine and alcohol should be avoided and salt should also be consumed less. Taking magnesium as a dietary supplement is said to relieve stomach cramps. Certain oils, for example linseed oil and borage seed oil, are said to provide a good supply of omega-3 fatty acids and thus gently and naturally loosen the uterine lining.

Black cohosh is said to counteract mood swings and sleep disorders. Monk's pepper is said to help especially with depressive moods and listlessness in premenstrual syndrome and also work against pain and chest tension. Ginger is also said to relieve pain and normalize the cycle both in the premenstrual phase and during the menstrual period.

homeopathy

The emotional complaints associated with premenstrual syndrome can also be treated with alternative medicine. There are various homeopathic remedies for this. Sepia D12 is said to work against mood swings and depressive moods and also alleviate headaches and chest tension. Pulsatilla D12 is said to relieve the sad mood and crying attacks and reduce headaches and back pain.

Lachesis D12 is also said to work against overstimulation and aggression. The depression and the loss of libido should be soothed with Chloratum D12. Nux Vomica D12 is said to be effective against chest pain and abdominal cramps.

Chaste tree

Monk's pepper belongs to the verbena plants and got its name because it is said to reduce the sexual drive in monks. Monk's herb is used today because it has a regulating effect on female hormones and can thus alleviate the symptoms of premenstrual syndrome. So far there are no studies on the effectiveness of monk's pepper.

Breastfeeding women should not take monk's pepper, as the hormone prolactin is inhibited and thus milk production is restricted.

You can find more information here: The monk's pepper.

DURATION: When will I be symptom-free again?

Most women who suffer from premenstrual syndrome suffer from the symptoms again every month. Complete healing can usually only be expected with the onset of menopause. Each individual episode only lasts a few days and symptoms resolve spontaneously as the menstrual period begins.

The symptoms of premenstrual syndrome can usually be suppressed so well that the symptoms do not mean any restrictions in everyday life.

OTHER IMPORTANT QUESTIONS:

PMS despite the pill?

Since the exact cause of premenstrual syndrome is not yet clear, various possibilities are discussed. One possibility why premenstrual syndrome develops despite the pill is simply underdosing the pill. Not every woman needs the same amount of hormones in her cycle and gynecologists try low-dose preparations, especially when starting to take them, which is not always sufficient. The body is therefore still subject to fluctuations in the hormonal balance. The pill break, which many women still take after three weeks, causes cyclical hormone fluctuations and can thus trigger symptoms.

Since psychological factors also seem to play a role in the development of premenstrual syndrome, knowledge about the pill break and the upcoming withdrawal bleeding can already cause symptoms.

Another reason for premenstrual syndrome is taking the mini pill. This is a pure progestin preparation that only prevents the sperm from entering the uterus and does not prevent the egg cell from maturing. The mini pill allows the body to have an almost natural cycle and thus cannot prevent premenstrual syndrome.

Find out more about the topic here: Premenstrual syndrome despite the pill?

How do I distinguish PMS from pregnancy?

The premenstrual syndrome is a periodically recurring mixed picture of different symptoms that occur shortly before the menstrual period. Menstruation always begins after a few days, which usually rules out pregnancy. The women affected also know their symptoms, as these recur and similarly every month. Pregnancy and premenstrual syndrome are both associated with hormone fluctuations, and in both cases people may develop nausea, mood changes, abdominal pain, and other symptoms.

However, if you are pregnant, symptoms last longer than a few days and don't end with regular bleeding. If you are unsure whether it could be pregnancy, a test should be performed and a gynecologist should be consulted before taking any medication for each symptom, as some medications can harm an unborn child. A pregnancy test is a standard part of a gynecological examination, even if the person concerned denies the possibility of pregnancy.

How do I distinguish PMS from pregnancy? Get information here.