Premenstrual Tension Syndrome

It is a condition that generally develops around the same time in the menstrual cycle and then subsides, causing physical, behavioral, and psychological distress with unknown causes. It can be detected with current tests and imaging methods. Typical psychological symptoms include anxiety, excessive irritability, depression, and restlessness. Physical complaints include abdominal bloating, breast tightness, fullness, tenderness, headache, and joint and muscle pain. It can lead to work loss, decreased daily activity, and disruption to relationships. According to recent studies, severe premenstrual tension syndrome (PMNS) is detected in 12-30% of women, depending on the diagnostic method used. Most women experience one or more physical or mood symptoms. It can cause moderate to severe loss of daily activity and disruption to relationships in 5-8% of patients. In fact, some studies suggest that clinically relevant PMS can be recognized in more than 20% of women of reproductive age. In retrospective studies, many women reported the onset of PMS in their teens. However, the onset of severe symptoms usually occurs in the late 20s. Many women do not seek treatment until as long as 10 years after the clinical symptoms appear. Mild symptoms are described in more than 50% of women after ovulation. While the exact cause is unknown, it is thought to develop as a result of hormonal changes that occur almost immediately following ovulation, or even the absence of ovulation. In women predisposed to the condition, the rise and fall in ovarian hormones after ovulation trigger symptoms. Women with PGD are more sensitive to hormonal fluctuations despite having normal hormone levels. A decrease in serotonin, a hormone released from the brain during ovulation, is reported to cause PGD symptoms.

In women sensitive to hormonal changes, symptoms begin during puberty, increase before menstruation, improve significantly during pregnancy, and worsen postpartum. Symptoms can intensify throughout the menstrual cycle and for several years before menstruation ceases. These individuals may experience three types of hormone-related mood swings: premenstrual depression, postpartum depression, and postmenopausal depression.

There are no symptoms during pre-puberty, post-menopause, or pregnancy, when hormone levels don't fluctuate cyclically. Because symptoms disappear after hysterectomy and ovarian removal, most patients prefer the night sweats and hot flashes experienced during menopause to the premenstrual symptoms of tension. Even after hysterectomy and ovarian replacement, menstrual headaches and symptoms of PMS persist despite the absence of menstruation.