What exactly is Premenstrual Syndrome? How common is it, and what triggers it? These seemingly simple questions can be surprisingly complex to answer. If you look up PMS online, sources like betterhealth and Jeanhailes describe it as a series of symptoms connected to the menstrual cycle, affecting 75% to 90% of women. Yet, another perspective sees PMS as a symptom that only significantly impacts a smaller group. This definition disparity mirrors the current state of PMS research, which can often seem confusing and contradictory. Thankfully, attitudes are changing. PMS, once stigmatised, is now being studied more objectively, and even Premenstrual Dysphoric Disorder ( PMDD ) is recognised as a legitimate gynecological condition. This shift is paving the way for more scientific exploration and funding. As understanding and acceptance of PMS grow, we’re here to shed light on what we know so far. In this post, we’ll delve into some surprising historical aspects of PMS, explore the biological theories behind it, and discuss why, despite advances, there’s still much to learn. Join us as we unravel the complexities of PMS, a subject that is as intriguing as it is relevant to many lives.

Basic Takeaways of Premenstrual Syndrome

• What’s PMS? Although there isn’t a clear definition for this condition, we can say that it is a condition that might be noticeable by physical, emotional, and behavioural symptoms. The signs appear after you ovulate and stop when your period starts.
• What is the cause of PMS? We still might not know the actual cause of PMS. But several theories explain why some women have more severe premenstrual symptoms than others. These symptoms include rapid hormonal shifts, neuro-chemical differences, and hormone sensitivity.
• Are there any risk factors for PMS? Various risk factors may be associated with this condition, including a history of depression, smoking, drinking, and genetics.
• Why do we know little about PMS? There are various reasons why research does not provide enough information about PMS. This includes society’s confusing backstory view on the condition, practical limitations to the menstrual cycle, research, historical gender bias in medical research, lack of funding from scientific bodies, and difficulties experienced when studying the complex and adequately defined topic.

What’s Premenstrual Syndrome?

Premenstrual syndrome is a multifaceted and often misunderstood condition affecting many women. Defined by a complex array of over 200 physical, emotional, and behavioural symptoms , PMS can manifest differently in every individual. These symptoms typically emerge after ovulation and subside with the onset of menstruation. The diversity of PMS symptoms is vast, ranging from physical discomforts like bloating and headaches to emotional disturbances such as mood swings and depression. Some women may primarily suffer from severe headaches, while others might grapple with water retention or gastrointestinal issues. The experience of PMS is highly individualised, and there’s no standardised “way” for women to experience it. Here’s a closer look at some common emotional and physical symptoms of PMS:

Common emotional and physical symptoms of PMS

The complexity of PMS symptoms makes it challenging to draw a clear line between what constitutes PMS and what might be considered normal variations in a woman’s cycle. While an estimated 15% of individuals with menstrual cycles report significant distress from PMS symptoms, an additional 2-6% experience severe enough symptoms to be diagnosed with Premenstrual Dysphoric Disorder ( PMDD ), a more intense form of PMS. Understanding PMS requires recognising its complicated nature and how it manifests in each individual. The broad range of symptoms and their varying intensity can make PMS a deeply personal and sometimes debilitating experience. Continued research and awareness are vital to help clarify this common condition and provide support and effective treatments for those affected.

What We Don’t Know About PMS

As said above, the description of Premenstrual syndrome is somehow complicated. Authorities in the medical field are still debating what constitutes premenstrual syndrome—they are still deciding whether the condition may determine any of the premenstrual symptoms or all the signs that affect someone individually. This question becomes even more complicated if additional branches of PMS, such as PMDD, are identified. The “why” of PMS is more precise than the “what,” which might explain why PMS researchers are still trying to comprehend it.

What Triggers Premenstrual Syndrome?

If you explore various scientific studies on premenstrual syndrome, you’ll find that researchers commonly agree on one aspect – the exact causes of this condition are not well understood. Generally, it’s recognised that PMS is linked to hormone changes, specifically the rise and fall of progesterone and estrogen levels after ovulation. Studies have shown that PMS symptoms can reappear during the postmenopausal stage when women are given cyclical progesterone, and treatments that reduce estrogen can ease PMS symptoms. A few theories are currently attempting to explain why PMS occurs. These will be described in more detail below, but it’s important to note that none completely dismisses the others. Considering the various ways each woman can experience PMS, it might be that all these theories have some truth.

Hormonal Differences: Theory 1

Research shows that hormone changes trigger PMS symptoms. A study of 46 Brazilian women found significant differences in hormonal patterns during the premenstrual phase. The key findings are:

• No PMS: Progesterone levels steadily declined over the eight days before menstruation.
• With PMS: Progesterone levels sharply dropped in the last three days before their periods.
• This sudden drop in progesterone may cause a hormonal imbalance, increasing the impact of estrogen.
• Although the sample size was small, these observations suggest a link between rapid hormonal shifts and the severity of PMS symptoms, highlighting the need for more research into targeted treatments.

Hormone Sensitivity: Theory 2

Some women experience hormonal shifts during their menstrual cycle as a gentle breeze, while others feel them as sudden gusts. Although all bodies undergo similar changes in estrogen and progesterone, even slight variations can trigger stronger reactions like noticeable mood swings or physical discomfort.

Think of hormone levels as a weather forecast. For many, a small temperature change goes unnoticed. But for those with sensitive responses, even a minor drop in warmth can feel like a lingering chill. This heightened sensitivity, particularly during the luteal phase when PMS symptoms peak, explains why some women experience subtle shifts while others face more intense symptoms.

Brain imaging research supports this idea, showing that it’s not just hormone levels but how the brain interprets them that matters. In controlled studies where hormone levels were adjusted, only women with increased sensitivity developed significant PMS symptoms. Recognising this variation helps healthcare providers tailor treatments to ease these symptoms effectively.

What are PMS Risk Factors?

Several factors influence PMS and can worsen its symptoms:

Smoking

Studies link cigarette smoking to more severe PMS symptoms, such as mood swings and physical discomfort.

Alcohol Consumption

Regular alcohol intake may increase irritability and bloating, affecting PMS severity.

Depression and Mood Disorders

A personal or family history of depression can intensify emotional symptoms during the menstrual cycle.

Stress

High stress levels are associated with more severe PMS, highlighting the need for effective stress management.

Genetics

A family history of PMS raises susceptibility, indicating that genetics play a role.

Diet and Lifestyle

Diets high in caffeine, salt, or processed foods may trigger or worsen symptoms, while balanced meals and regular exercise can help reduce them.

Age and Hormonal Fluctuations

PMS is most common in women aged late 20s to early 40s, when hormonal changes can intensify symptoms.

Identifying these factors is key to creating effective strategies for managing PMS.

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Key Challenges in PMS Research

Despite progress in women’s health, several factors limit our understanding of premenstrual syndrome (PMS):

• Historical Underinvestment : Persistent biases have resulted in less research funding and reduced focus on women’s health compared to other medical conditions.
• Diagnostic Ambiguity : The wide range of PMS symptoms hampers the creation of consistent diagnostic criteria, complicating clinical studies and data analysis.
• Methodological Constraints : Current research methods inadequately replicate the menstrual cycle, as many lab models miss the complexities of natural hormonal changes.
• Complex Biological Interactions : Hormonal shifts, neurochemical changes, and genetic variability make it difficult for researchers to isolate the mechanisms behind PMS.

Improving research methods and securing targeted funding are crucial for advancing evidence-based understanding and treatment of PMS.

Premenstrual syndrome presents a unique challenge in the medical community due to the lack of a standardised definition . While Premenstrual Dysphoric Disorder (PMDD) has become a well-defined gynecological disorder with clear diagnostic criteria, PMS’s definition remains variable and inconsistent. Variability Across Countries and Professionals : The umbrella term “PMS” encompasses a wide range of symptoms, with over 200 identified premenstrual symptoms . This vast array of manifestations leads to differing interpretations and definitions among countries and medical professionals. How does one select a single cut-off point to diagnose PMS when the symptoms are so diverse? Impact on Research and Understanding : The absence of a standardised PMS diagnosis complicates the interpretation of research findings. Many studies categorise participants into “healthy” versus “PMS” groups, but the variability in defining PMS can lead to conflicting results. Analysing the data becomes challenging when examining everyone’s experience within these broad categories. A Potential Solution: Subcategories : One possible approach to this dilemma is to create subcategories based on various premenstrual symptoms. By grouping symptoms and studying their biological origins, researchers may gain a more nuanced understanding of PMS. This method could lead to more accurate diagnoses and targeted treatments. <img alt="What kind of symptoms are What kind of symptoms are PMS?

Conclusion

Premenstrual syndrome is a complex condition that continues to perplex both individuals experiencing it and the medical community attempting to understand it. The journey towards demystifying PMS is filled with historical biases, societal misconceptions, and scientific challenges. Yet, pursuing knowledge, empathy, and personalised care remains a beacon of hope for those affected by this complex syndrome. At Fertility2Family, we recognise the importance of understanding and compassionate support in reproductive health. Our commitment extends beyond providing quality ovulation tests and pregnancy tests . We strive to be a valuable resource for individuals on their fertility journey, offering insights, guidance, and encouragement through our fertility-related blog .

Evan kurzyp

Evan Kurzyp

Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.