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Premenstrual Syndrome

Premenstrual syndrome (PMS) refers to a group of physical and behavioral symptoms that occur in a cyclic pattern during the second half of the menstrual cycle.  Common symptoms include anger, irritability, and internal tension that are severe enough to interfere with daily activities.

Mild PMS is common, affecting up to 75 percent of women with regular menstrual cycles; PMS can affect women of any socioeconomic, cultural, or ethnic background.


Tissues throughout the body are sensitive to hormone levels that change throughout a woman’s menstrual cycle.  Studies suggest that rising and falling levels of hormones may also influence chemicals in the brain, including a substance called serotonin, which affects mood.


The most common symptoms of PMS are fatigue, bloating, irritability, and anxiety.  There are other medical disorders that worsen before or during menstruation, such as migraines, chronic fatigue syndrome, pelvic and bladder pain, or irritable bowel syndrome. A careful medical history should be able to distinguish among these disorders.


There is no single test that can diagnose PMS.  The symptoms must occur only during the second half (luteal phase) of the menstrual cycle, most often during the five to seven days before the menstrual period and there must be physical as well as behavioral symptoms.  In women with PMS these symptoms should not be present between days 4 through 12 of a 28-day menstrual cycle.

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