What is PMS?

In historical and modern times, many negative connotations regarding menstruation have existed and these may have contributed to some women's unpleasant expectations of the premenstrual phase. However, Premenstrual Syndrome (PMS) was first noted as a true medical disorder by the American Gynecologist, Dr. T. Frank in 1931. The medical community refers to PMS as a condition that is characterized by a constellation of physical and emotional symptoms that have a significant impact on a woman's day-to-day activities. This is in contrast to the common occurrence of premenstrual symptoms that many women experience. Up to 80% of women experience premenstrual symptoms but only 2-5% actually have PMS. The manifestations of PMS include a set of symptoms that occur during the luteal or premenstrual phase, 7-10 days prior to menstruation. These symptoms must resolve once a woman begins her period. Furthermore, for a woman to have PMS, she must be without symptoms in the follicular or pre-ovulatory phase of the menstrual cycle.

The criteria that physicians need to diagnose PMS are as follows: 5 (or more) of the below symptoms must occur during the luteal phase and be absent after menstruation. Also, at least 1 symptom must be from Group (A).

Group A

•Depressed mood, feelings of hopelessness •Anxiety, tension •Sudden and dramatic mood swings •Anger, irritability

GroupB

•Decreased interest in usual activities •Difficulty in concentrating •Fatigue, lack of energy •Change of appetite, overeating, food cravings •Sleep disturbances •Sense of being overwhelmed •Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle aches, bloating, weight gain

In addition, for a positive diagnosis of PMS, it is crucial that these disturbances interfere markedly with work, school, or personal relationships. The cyclic nature of these symptoms cannot be relied upon from memory. A woman must chart them on a daily basis for at least two to three months. Finally, these symptoms cannot be a worsening of a psychiatric disorder such as Major Depression or Anxiety Disorder. Only 50 percent of women who visit their physician believing that they have PMS actually meet the above criteria and have the diagnosis of PMS confirmed.

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