Premenstrual Syndrome

Are you one of the millions of women who suffer from premenstrual symptoms without knowing that it is a disease and that there is now a treatment for it. Please contact us to speak to a Pharmacist for more information on this condition (0800 HORMONE or info@pharmaceutical.co.nz).

Symptoms of Premenstrual SyndromeMenopause

  1. Pain (congestive dysmenorrhea): Starts up to 14 days before period as heavy continuous lower abdominal pain, increasing in severity on the first day of menstruation, then gradually ceases.
  2. Water retention: Bloating, heaviness, weight gain (2-4 Kg), breast soreness and swelling, generalized rheumatic pain, abdominal bloating and heaviness.
  3. Food cravings and alcohol binges.
  4. Tension: This can be in the form of depression, tiredness or irritability.
  5. Headaches: Sinus or vacuum headache, tension headache and migraines.
  6. Recurrent problems: Premenstrual epilepsy, rhinitis or hay fever, premenstrual asthma, loss of sense of smell, dizziness and vertigo, cystitis and urethritis, varicose veins, boils, sties, acne, conjunctivitis and glaucoma.

Three Requirements must be fulfilled in Order for the Correct Diagnosis to be made:

  1. Symptoms should be present every month for at least the previous three months.
  2. Symptoms must be present premenstrually and should not start before ovulation (14 days before the start of menstruation).
  3. There must be complete absence of symptoms after the start of menstruation for a minimum of seven days.

Hormones, the Menstrual Cycle and Premenstrual Syndrome

The average length of the menstrual cycle is 28 days, although this can vary between women and from one cycle to the other. The length of the cycle is calculated from the first day of the period (bleeding) till the day before the next period begins.

A variety of glands and their hormones control the menstrual cycle, and it is divided to the following phases:

a) The menses (bleeding or period) phase:

This phase commonly lasts from day 1 to day 5. If no fertilisation takes place, a drop in the level of estrogen and progesterone hormones causes the lining of the uterus (endometrium) to shed out, and together with some bleeding from the damaged blood vessels will pass out through the vagina.

b) The follicular phase:

Days 6-14. Under the effect of the pituitary gland hormones (mainly FSH), one follicle in an ovary matures and forms an egg (ovum). Under the effect of the estrogen secreted from the ovary, the uterus builds up to about 3 mm in thickness. Just before day 14 (mid cycle) a surge of hormones (with a peak of estrogen) stimulates the follicle in the ovary to release the egg, which then passes through the fallopian tube to the uterus.

c) The luteal or secretory phase:

Days 15-28. After the follicle releases the egg, it transforms into the Corpus luteum which secretes progesterone. If the egg is not fertilized, the corpus luteum gradually disappears and stops progesterone production which causes the lining of the uterus to break down and bleeding starts. In many women who experience PMS, progesterone and its metabolites (allopregnanolone) may be low during the luteal phase [1, 2] .In some women a true progesterone deficiency may not exist, however they may not have enough progesterone to balance out excessive estrogen levels [3].

References

1. Monteleone, P., et al., Allopregnanolone concentrations and premenstrual syndrome. Eur J Endocrinol, 2000. 142(3): p. 269-73.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10700721

2. Rapkin, A.J., et al., Progesterone metabolite allopregnanolone in women with premenstrual syndrome. Obstet Gynecol, 1997. 90(5): p. 709-14.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9351749

3. Munday, M.R., M.G. Brush, and R.W. Taylor, Correlations between progesterone, oestradiol and aldosterone levels in the premenstrual syndrome. Clin Endocrinol (Oxf), 1981. 14(1): p. 1-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7194756