What is premenstrual syndrome? – This is a combination of symptoms experienced by women before the onset of menstruation. It comprises mood, emotional, physical and behavioural changes which usually occur between the time of ovulation and the onset of menstruation. These changes may last for few days into the menstrual flow and may have significant impact on the normal daily functioning of those affected. 

How common is premenstrual syndrome?

Premenstrual syndrome is common in women, affecting almost 50% of women (i.e. one in every two women) of reproductive age. It is mild to moderate in majority of those women and may not disrupt their daily activities. It is however severe in some women as to affect their daily functions.

What are the symptoms of premenstrual syndrome?

For ease of understanding, these symptoms can be divided into physical, emotional and behavioural.

1. Physical symptoms: These include – abdominal cramping, bloating, breast pain, headache, constipation, diarrhoea and generalised body pain.
2. Emotional symptoms: These include – easy irritability / unprovoked anger, anxiety, restlessness, low mood / sadness with occasional crying and mood swing with occasional emotional outburst.
3. Behavioural symptoms: These include – increased appetite, low sex drive, forgetfulness / difficulty in concentrating and changes in sleep pattern.

When do symptoms of premenstrual syndrome start?

Premenstrual syndrome may start any time after ovulation. However, most commonly, the symptoms will start about a week before menstruation and may last few days into menstruation or stop at the end of menstrual flow.

What is the cause of premenstrual syndrome?

The cause of premenstrual syndrome is not known but suggestions have been made as to what could predispose to it. These include – cyclical hormonal changes (oestrogen and progesterone reach peak about a week before the onset of menstruation, after which they decline sharply concentration), previous mental health problem (such as depression, anxiety disorder etc), habits such as smoking, sedentary lifestyle, lack of adequate sleep as well as eating food high in sugar and fat.

How is premenstrual syndrome treated?

Women who have mild to moderate symptoms may not need any form of treatment. For those with severe or more persistent symptoms, the following medications may help relieve symptoms: pain relief drugs such as ibuprofen, diclofenac or acetaminophen; birth control pills such as combined oral contraceptive pills; supplements such as calcium, magnesium, vitamin B6, vitamin D, folic acid etc.

Other measures that may help improve symptoms include: adequate fluid intake, eating balanced diets, reduction in alcohol, salt and sugar intake, regular exercise, adequate rest from work, adequate sleep (at least eight hours at night) and hot compresses on the abdomen (to help relieve abdominal cramps).