Frequently, women of reproductive age experience symptoms during the late luteal phase of their menstrual cycle, and collectively these complaints are termed premenstrual syndrome (PMS) or premenstrual tension (PMT). Nearly 300 different symptoms have been reported and typically include both psychiatric and physical complaints.


Symptoms must begin at least 5 days before menses and remit within 4 days after menses onset.

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration
  • Change in libido
  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea


Pathophysiology of Premenstrual Syndrome

Sex Steroids -Premenstrual syndrome is cyclic. Symptoms begin following ovulation and resolve with menses

Central Nervous System Interaction.-Estrogen and progesterone are neuroactive steroids and influence the central nervous system (CNS) neurotransmitters: serotonin, noradrenaline, and GABA. Th e predominant action of estrogen is neuronal excitability, whereas progestins are inhibitory.

Serotonin-Decreased serotonergic activity has been noted in the luteal phase.

Renin-Angiotensin-Aldosterone System -Sex steroids also interact with the renin-angiotensin-aldosterone system (RAAS) to alter electrolyte and fl uid balance. The antimineralocorticoid properties of progesterone and possible estrogen activation of the RAAS system may explain PMS symptoms of bloating and weight gain.


  • Eat organic fruits, vegetable
  • Regular exercise
  • Avoid smoking
  • Eating foods high in fiber
  • Drinking an adequate amount of fluids
  • Avoid alcohol
  • Avoid tobacco
  • Reduce your depression
  • Get plenty of sleep.
  • Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia)




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