Chapter 7 – Abnormal Uterine Bleeding and Other Disorders of the Menstrual Cycle

Premenstrual syndrome (PMS)

Premenstrual syndrome covers a wide range of psychological symptoms such as anxiety, depression, mood swings and loss of confidence.(35) There are also common somatic symptoms like mastalgia and bloating.(33, 35, 36, 37, 38, 39, 40, 41)

It is estimated that 40 per cent of women experience PMS symptoms and 5-8 per cent of these suffer severe PMS.(35) In premenstrual syndrome there is a clear relationship between the luteal phase of the menstrual cycle and the development of symptoms. Symptoms must be present during the luteal phase of the cycle, decline with menses which is then followed by a symptom free week.(35) It is the timing, rather than the range of symptoms, which supports the diagnosis of PMS, together with demonstration that these symptoms cause significant impairment of the individual’s daily functioning.(42) Exclude symptoms due to other psychiatric, gynaecological or medical illness.

Symptoms of premenstrual syndrome usually start to be problematic in the adolescent years and decline in the perimenopausal period. They are usually of greatest severity when a woman is in her 20s to mid-30s, but women most likely to seek treatment after the age of 30 years.(36)

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Premenstrual dysphoric disorder (PMDD)

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Cause of PMS

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Diagnosis

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Management

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Therapeutic medical options

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Alternative and non-pharmacological therapies

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Other treatment options and specialist referral

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