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Pre-menstrual Syndrome (PMS)

What is it?
This condition consists of several symptoms that occur in the days prior the start of a period, which then settle as the period starts. Mild forms of the syndrome are very common but the severe forms markedly affect a woman’s family and work life.

What are the symptoms?
There are many symptoms of PMS; the most common described are bloating, breast tenderness, mood changes, irritability and headaches. The exact cause of PMS is unknown, although many hormones have been implicated. It is known that the level of one the ‘happy’ receptors in the brain is lower pre-menstrually and that the change in the level of certain hormones is likely to trigger the symptoms.

What investigations might be required?
The most reliable way of diagnosing PMS is to complete a symptom chart for a couple of menstrual cycles. There are otherwise no scans or blood tests that can diagnose the condition.

What treatments are available?
General management techniques such as relaxation methods, exercise and other therapies such as reflexology, acupuncture and aromatherapy can all help. Dietary changes such as reducing intake of caffeine, alcohol, sugars and salt, eating regularly and consuming more fresh fruit and vegetables are useful.

No one medical treatment has been shown to be effective in all women. Many treatments are designed to suppress the normal ovarian cycle; others are aimed at increasing the ‘happy’ receptor level in the brain. Surgery is always a last resort and consists of removal of the ovaries with hormone replacement thereafter.

Treatment needs to be individualised after a full discussion of the options with your specialist.

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