What is PMS?!
Premenstrual 'syndrome' is a collection of symptoms that get worse in the late luteal phase, a week or so before their period. The syndrome include affective symptoms like depression, irritability and anxiety, and somatic symptoms such as bloating, swelling, breast pain and headaches. To be diagnosed as PMS, it must get worse in the last luteal phase and remit once menses starts. PMDD is a more severe form of this.
Our neurotransmitters are influenced by our hormones, and PMS is thought to be due to the interaction between these and the changes to hormones in the luteal phase.
What is interesting, is that although we blame hormones for PMS it's been shown that serum concentrations of these hormones are often normal in women with PMS and PMDD. It is the abnormal response to these hormones that is to blame.
Theories as to the cause include genetics (polymorphisms in the ESR1 gene), altered hypothalamic-ptuitary-adrenal response, alterations in serotonin and GABA. Previously, we thought the decrease in progesterone in the luteal phase was responsible but now research is focusing on estrogen's role. It seems estrogen in PMDD is lower in the early luteal phase which may prime the bran to struggle with progesterone levels.
The first and most important step is proper diagnosis. This includes blood tests to rule out other conditions, as well as symptom tracking along with cycle tracking to determine where in your cycle the symptoms occur. We also want to ensure ovulation is happening each month. It's important to point out that those on OCPs are not ovulating, and the symptoms are due to the progestins/estrogen in the birth control pills.
Once we have an idea as to where in your cycle these symptoms occur, we can better understand what treatment would be most effective!
Keep you eyes out for a follow up post on research backed PMS treatment ideas ❤️
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