What causes PMS?
The actual cause behind PMS is unknown, However, the following factors are seen as the main contributors to PMS:
- Hormonal changes during the menstrual cycle: The fluctuation in estrogen and progesterone, the hormones responsible for a period, is considered a leading cause of PMS. Therefore, when the levels of these hormones stabilize during pregnancy and breast-feeding PMS disappears.
- Changes in a certain chemical in the brain, called serotonin, is another cause of PMS. Fluctuation in serotonin levels causes depression, mood swings, fatigue, food cravings, and sleep problems.
- Undiagnosed depression may be present in some women with severe PMS symptoms.
How to diagnose PMS?
There is no particular finding, laboratory test, or investigation that helps diagnose PMS.
The doctor usually links a woman’s symptoms to a certain predictable premenstrual pattern. The doctor may ask a woman to record her symptoms in a diary for two cycles, as well as, ask her to note the dates of PMS symptoms appearance and disappearance, in addition to, the first and last days of the period.
The doctor may perform some blood tests or other physical assessments to test for conditions with symptoms similar to PMS such as thyroid disease, mood disorders, and chronic fatigue syndrome.
What medications are used to treat PMS?
If lifestyle changes are insufficient, occasionally the doctor may prescribe one or more medications to help relieve symptoms of PMS. These include:
- Anti-depressants: Especially selective serotonin reuptake inhibitors (SSRIs) which successfully control mood swings caused by PMS.SSRIs are the first-line treatment for severe forms of PMS and PMDD. They are usually taken in the two weeks before a period.
- Cognitive behavioral sessions
- Diuretics are used for bloating and fluid retention symptoms.
- Non-steroidal anti-inflammatory drugssuch as ibuprofen are used to ease cramps and breast pain.
- Combined hormonal contraceptive pills.