Pre-menstrual syndrome (PMS) refers to physical and emotional symptoms that occur before menstruation and lead to disruption in normal functioning in 3-4% of women. PMS is considered a normal menstrual phenomenon, but in severe cases called premenstrual dysphoric disorder (PMDD), it can cause mainly psychological symptoms. The document discusses diagnosing PMS by identifying symptoms that occur in the week before a woman's period and go away shortly after bleeding begins. Common symptoms include bloating, mood swings, breast tenderness, headaches, and food cravings.

1. Pre-menstrual SyndromePre-menstrual Syndrome
Dr. Helen WebberleyDr. Helen Webberley
Sexual Health, WorcesterSexual Health, Worcester
1818thth
September 2002September 2002

2. Pre-menstrual SyndromePre-menstrual Syndrome
Premenstrual TensionPremenstrual Tension
Premenstrual SyndromePremenstrual Syndrome
Premenstrual Dysphoric DisorderPremenstrual Dysphoric Disorder

3. What is it?What is it?
• Does it existDoes it exist
• How common is itHow common is it
• Is it a normal menstrual phenomenonIs it a normal menstrual phenomenon
• Is it psychological / psychiatric in aetiologyIs it psychological / psychiatric in aetiology
• Can it be treatedCan it be treated
• Does it need drug therapyDoes it need drug therapy

4. What is PMS?What is PMS?
• Nearly all women have premenstrual symptomsNearly all women have premenstrual symptoms
because they are a normal part of the cycle.because they are a normal part of the cycle.
• In some, 3-4% of women, the symptoms lead toIn some, 3-4% of women, the symptoms lead to
a disruption of the patient’s normal functioninga disruption of the patient’s normal functioning
and interpersonal relationships - this isand interpersonal relationships - this is
premenstrual syndrome.premenstrual syndrome.
• PMDD is considered the severe end of the PMSPMDD is considered the severe end of the PMS
spectrum and refers almost exclusively tospectrum and refers almost exclusively to
psychological symptoms.psychological symptoms.

5. Making the DiagnosisMaking the Diagnosis

6. SymptomsSymptoms
BloatingBloating Weight GainWeight Gain AggressionAggression
HeadachesHeadaches IrritabilityIrritability Poor concentrationPoor concentration
Skin problemsSkin problems FatigueFatigue TearfulnessTearfulness
Mood swingsMood swings DepressionDepression Breast tendernessBreast tenderness
MisunderstoodMisunderstood TensionTension AngerAnger
AnxietyAnxiety Panic attacksPanic attacks ConfusionConfusion
AsthmaAsthma EpilepsyEpilepsy StyesStyes
AcneAcne Alcohol abuseAlcohol abuse CravingsCravings
Binge eatingBinge eating Back acheBack ache Sinus problemsSinus problems

7. • Timing is more important than characterTiming is more important than character