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Premenstrual syndrome (PMS) refers
to a group of physical and behavioral symptoms that occur in a
cyclic pattern during the second half of the menstrual cycle.
Premenstrual dysphoric disorder (PMDD)
is the severe form of PMS. The prominent symptoms are anger,
irritability, and internal tension that are severe enough to
interfere with daily activities.
Mild PMS is common, affecting up to
75 percent of women with regular menstrual cycles; PMDD affects only
3 to 8 percent of women. This condition affects women of any
socioeconomic, cultural, or ethnic backgrounds.
PMDD is usually a chronic condition
that can have a serious impact on a woman's quality of life.
Fortunately, a variety of treatments and self-care measures can
effectively control the symptoms in most women.
What are
the causes?
During the second half of the menstrual cycle, levels of the
hormones estrogen and progesterone increase until approximately day
21 and then begin to fall. This is the last 14 days of a 28-day
cycle, with the first day of menstrual bleeding being day one of the
menstrual cycle. Tissues throughout the body are sensitive to these
changing hormone levels. Studies suggest that rising and falling
hormone levels may also influence chemicals in the brain, including
a substance called serotonin, that affect mood.
However, why some women develop PMDD
and others do not is not known. Levels of estrogen and progesterone
are similar in women with and without PMDD. The most likely
explanation, based upon several studies, is that women who develop
PMDD are exquisitely sensitive to changes in hormone levels.
What are the
symptoms?
The most common symptoms of PMS and
PMDD are fatigue, bloating, irritability, and anxiety. Other
possible symptoms include the following:
- Feeling sad, hopeless, or
worthless
- Feeling tense, anxious, or "on
edge"
- Variable moods with frequent
tearfulness
- Persistent irritability, anger,
and conflict with family, coworkers, or friends
- Decreased interest in usual
activities
- Difficulty concentrating
- Feeling fatigued, lethargic, or
lacking in energy
- Changes in appetite, which may
include binge eating or craving certain foods
- Sleeping excessively or difficulty
sleeping
- Feeling overwhelmed or out of
control
- Breast tenderness or swelling,
headaches, joint or muscle pain, weight gain
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