PMS 101

PMS: To some women the three letters could stand for "Painful Monthly Suffering" or "Pretty Much Stinks." But most could shrug them off as "Pretty Minor Symptoms."

That's because while nearly all women experience at least a few premenstrual symptoms from one cycle to another, only about 3% to 8% of women struggle with truly severe and sometimes debilitating symptoms in the days before their period starts.

Among the most common symptoms of PMS are acne, bloating, breast tenderness, cramps, food cravings, and mood changes. Other side effects of the monthly hormonal fluctuations include headaches, muscle aches, constipation, nausea, and changes in sleeping patterns. The symptoms of PMS are different for everyone and can even change from cycle to cycle for the same woman. Women close to menopause may suffer worsening PMS symptoms.

Then there is premenstrual dysphoric disorder (PMDD). PMDD is considered a more severe form of PMS. "Dysphoric" means an emotional state of anxiety, severe depression, anger, low self-esteem, or unease. So, women with PMDD suffer the same symptoms of those with PMS, only more strongly, and their experience is amplified by feelings of agitation and depression. Women with PMDD have premenstrual symptoms that are severe enough to interfere with their work, relationships, and social lives.

While the various symptoms of PMS and PMDD are clear, the causes are not so certain. Some researchers theorize that women with PMDD may have lower pain thresholds or lower levels of serotonin, a chemical in your brain that affects the transmission of nerve signals. In the same way that women with PMDD may be more sensitive to pain, those with PMS may be overly receptive to hormonal fluctuations.

After the point in a woman's cycle when she ovulates, two hormones ebb and flow: estrogen and progesterone. These two hormones may play a part in the PMS party. One theory is that low estrogen and progesterone could trigger trouble by affecting endorphins and serotonin, the brain's "feel-good" chemicals. On the other hand, researchers also find that women might experience PMS related symptoms despite normal hormonal levels.

Another brain chemical called GABA, may also play a role, although it is not well understood.

PMS may be a genetic burden to bear – and that's a risk factor women can't really change. But a woman may be able to find relief through medications, natural remedies, or shifts to her nutrition and lifestyle habits – and those changes could make all the difference.

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