What Causes PMS and how is it Diagnosed?

Mary’s premenstrual symptoms became extreme after her 3-year-old daughter was born. Two weeks to the day her periods starts, she knows her menstruation is on its way. It’s as if a light switch turns on, and here comes the monster! 

PMS is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation and typically ending with the onset of her menstrual flow. The most common mood-related symptoms are irritability, depression, crying, oversensitivity, and mood swings with alternating sadness and anger. The most common physical symptoms are fatigue, bloating, breast tenderness (mastalgia), acne, and appetite changes with food cravings.

Mary however, like many women just accepts these symptoms as an inevitable consequence of the menstrual cycle which cannot be addressed.  

PMS remains an enigma because of the wide-ranging symptoms and the difficulty in making a firm diagnosis. Several theories have been advanced to explain the cause of PMS. None of these theories have been proven, and specific treatment for PMS still largely lacks a solid scientific basis. Most evidence suggests that PMS results from the alterations in or interactions between the levels of sex hormones and brain chemicals known as neurotransmitters.

The diagnosis of PMS can be difficult because many medical and psychological conditions can mimic or worsen symptoms of PMS.

There are no unique physical findings or laboratory tests to positively diagnose premenstrual syndrome. Your doctor may attribute a particular symptom to PMS if it's part of your predictable premenstrual pattern. To help establish a premenstrual pattern, your doctor may have you:

• Keep a diary. Record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also be sure to mark the day your period starts and ends. If the changes occur consistently around ovulation (midcycle, or days 7-10 into the menstrual cycle) and persist until the menstrual flow begins, then PMS is probably the accurate diagnosis. Keeping a menstrual diary not only helps your doctor to make the diagnosis, but it also helps you understand your own body and moods.
• Fill out a questionnaire. On the first day of your period, you fill out a questionnaire. The questions pertain to any PMS symptoms you experienced during the prior two weeks. This tool helps your doctor know whether you might benefit from further evaluation.

Once the diagnosis of PMS is made and understood, you can start your Self Help on winning the battle over PMS or depending on the severity, your doctor may prescribe PMS medications or Supplements.