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PMS: Often Joked About, But Not A Laughing Matter

What Are the Symptoms?

More than 150 different symptoms have been attributed to PMS.  Yet there is no standard, agreed upon list of diagnostic criteria for the diagnosis of PMS, although all versions include three elements:  symptoms, severity, and timing.  PMS can last for a day or two in some women, up to 14 days in others, always in the days preceding menstruation.  Most women with PMS report 6 or more of the following symptoms, usually including some physical symptoms, some psychological, and some cognitive.  The symptoms that most commonly cause women to seek medical attention are those of depression, anxiety or irritability.

PMS symptoms range in severity from mild to incapacitating and generally fall into one of three categories:

  • Physical symptoms -- bloating, fluid retention and weight gain; breast swelling or tenderness; swelling of feet and ankles; headaches; food cravings (especially for salty or sweet foods); acne breakout; fatigue or "low energy"; palpitations; dizziness; insomnia; backaches; or muscle pain.

  • Psychological and emotional symptoms -- Mood swings, crying spells, difficulty concentrating, and aggressiveness or hostility are also quite common. Some women describe feeling well one moment, and then burst into tears without warning or specific provocation.  Sufferers often report feeling overwhelmed or out of control.  Unexplained sadness, low self esteem, depression and even hopelessness may occur. Other symptoms include decreased interest in usual activities, decreased energy, increased appetite and food cravings, sleep disturbances, and decreased libido. Anxiety, tension, and "edginess" may also occur, but less commonly; panic attacks are rarely associated.

  • Cognitive symptoms-These symptoms are less frequently reported, but can cause a significant impact.  They include impaired short-term memory, difficulty concentrating, and "fuzzy" thinking.  All of these symptoms may also be associated with or exacerbated by the sleep disturbances associated with PMS.

Although the specific collection of PMS symptoms varies from woman to woman (and may even vary for an individual woman from cycle to cycle), the most common four complaints seem to be irritability, backaches, muscle pains, and bloating. 

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 PMS symptoms appear to be most troubling in women who smoke, have stressful lives, rarely exercise, get insufficient sleep, or who have a poor diet. 

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