For years, premenstrual syndrome (PMS) has been the punchline of many jokes and used as a possible explanation anytime a woman behaves in a way other than extremely pleasant. Even though it is discussed in a way that would lead you to believe that it could happen at any time, there is actually a definition and explanation for the disorder. PMS refers to a cluster of symptoms that usually begin the week or two before your period and end shortly after the start of your period. Symptoms can typically be broken into two categories, behavioral and physical. The most common symptoms include:
Behavioral
- Mood swings
- Tearfulness
- Anxiety
- Irritability
- Appetite changes
- Appearing overly sensitive
Physical
- Abdominal bloating
- Breast tenderness
- Fluid retention/weight gain
- Fatigue
- Acne
- Pain increase (headaches, joints)
- Hot flashes
Doctors typically define PMS as the presence of at least one symptom occurring within the 2 weeks before your period and ending shortly after it starts with some sort of impairment in functioning. While many women experience some combination of symptoms prior to their periods, up to 5% have a more serious disorder, premenstrual dysphoric disorder (PMDD) and this is the bully that none of us would wish on our worst enemy.
PMDD is a psychiatric disorder and is characterized by symptoms that can be disabling. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines PMDD as follows:
Symptoms occurring in the majority of menstrual cycles with at least 5 symptoms present in the final week before the onset of the period that start to improve within a few days after the onset of period and are essentially absent the week after the period
One or more of the following
-
- Mood changes (mood swings; feelings of sudden sadness or tearfulness; increased sensitivity to rejection)
- Increase in irritability, anger or conflicts with others
- Depression, feeling hopeless or low self-worth thoughts
- Feeling anxious, keyed up or on edge
One or more of the following
-
- Decreased interests in usual activities
- Difficulty concentrating
- Fatigue
- Appetite changes (increase or decrease)
- Sleep pattern changes (increase or decrease)
- Feeling out of control
- Physical symptoms such as breast tenderness, joint or muscle pain, bloating, or weight gain