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Pre-menstrual Syndrome
   
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What is it?

Pre-menstrual syndrome (PMS) is a disabling condition that affects women during the latter part of the menstrual cycle and has no detectable cause.

What problems arise from it?

It causes physical and psychological symptoms that include fluid retention, tension, anger, irritability, depression and other personality changes. It may also cause breast tenderness, bloating of the abdomen, clumsiness and numbness of the fingers, thereby increasing accident proneness. Typically, the features are present about a week before the onset of the next menstrual period and subside with its onset. Occurrence of symptoms throughout the menstrual cycle would suggest another cause.

What causes it?

Nobody really knows what causes this often-distressing condition. Some doctors think that it is an exaggerated response by some women to the pre-menstrual changes that all women go through during the menstrual cycle. Other doctors have blamed it on an imbalance of female hormones during the menstrual cycle although this has yet to be conclusively proven.

How is it treated?

The treatment of PMS is varied largely because the cause is unknown. It can have devastating effects on the lives of some women and its sufferers need empathy from partners, friends, family and healthcare workers. Different medicines have been used for its treatment with varying degrees of success. Giving a female hormone (progesterone) in the second half of the menstrual cycle has met with limited success. Vitamin preparations (especially of the B group) and diuretics (medicines that increase excretion of fluid from the body) have also been used with varying degrees of success.

Suppressing the ovaries with nasal sprays, tablets or injections may offer some relief, but this is only short term and may be undesirable in women who are trying to conceive. Some women with more severe conditions respond to a particular type of anti-depressant that has been shown to be beneficial for this condition. Another small number of women (those with the most distressing features) might end up having their ovaries removed, a procedure that appears to cure the condition. They then are treated with hormone replacement therapy (HRT), which provides a steady supply of female hormones to the body.

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