Women's Health - Premenstrual syndrome(PMS): The Symptoms(revised edition with references)

By Kyle J. Norton 
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

 Premenstrual syndrome is defined as faulty function of the ovaries related to the women's menstrual cycle, effected over 70% to 90% of women in the US and lesser for women in Southeast Asia because of difference in living style and social structure. The syndrome also interferes women's physical and emotional states, and daily activities as a result of hormone fluctuation and occurs one to two weeks before menstruation and then declines when the period starts.

The Symptoms
1. Emotional symptoms
a) Unhealthy diet(6)
Since we all know that our diet contains high amount of saturated and trans fat, unbalance of levels of essential fatty acids causes inability of liver in secreting bile into the digestive system and in fat and protein metabolism(7) that causes nervous tension resulting in increasing the emotional symptoms of PMS such as depression, anger, and fatigue(1), poorer sleep quality(2) stress(5), anxiety(3), irritability, aggression, tension, anxiety, depression, lethargy, insomnia, poor coordination and concentration, etc.(4).

 b) Vitamins and minerals deficiency
It is unknown why women with PMS are found to have low levels of vitamin B6 and magnesium(8)(9). These may be caused by low levels of stomach acid or inability of digestive system in absorbing vital nutrients before period resulting in increasing nervous tension(10) and emotional and physical symptoms.

c) Hormone imbalance
Researchers found that women with PMS always have unbalance of levels of estrogen and progesterone before menstruation. It may be caused abnormal function of some glands in the body including the pituitary(14), thyroid gland(11). Over or under production of certain hormones such as serotonin, estrogen, progesterone, prolactin, adrenaline increases the nervous disorder resulting in symptoms of PMS.

d) Thyroid gland(10)
Women with PMS are found to have low thyroid function(12) resulting in increasing the risk of depression, stress, fatigue, tiredness, insomnia, etc.(13).

2. Physical symptoms
a) Foods and sugar craving
Strong liver is important for women with PMS. Unfortunately, most women with PMS are found to have sluggish liver function before menstruation caused by abnormal function of liver in carbohydrate synthesis and insulin regulating(15) resulting in foods and sugar craving(16).

b) Breast tenderness and water retention(17)
For what ever reasons, researchers show that some women with PMS are found to have high levels of prolactin and low levels of potassium as resulting in abnormal function of pituitary gland(18) and lymphatic function(19)(20) resulting in breast tenderness and water retention accordingly.

c) Palpitation(21)
Some women with PMS might experience heart palpitation, it is caused by malfunction of thyroid gland(23) and unbalance of estrogen and progesterone(24).

d) Menstrual cramps
Some women may experience menstrual cramps(25) which will disappear as soon as period start. It may be caused by irregular function of ovaries in hormones secretion or essential fatty acids deficiency(26) resulting in balancing levels of estrogen and progesterone and over production of certain hormone in the prostaglandins family(27).
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References
(1) Ecological validity and clinical utility of Patient-Reported Outcomes Measurement Information System (PROMIS®) instruments for detecting premenstrual symptoms of depression, anger, and fatigue by Junghaenel DU¹, Schneider S², Stone AA², Christodoulou C², Broderick JE².(PubMed)
(2) Sleep quality and the sleep electroencephalogram in women with severe premenstrual syndrome by Baker FC¹, Kahan TL, Trinder J, Colrain IM.(PubMed)
(3) Premenstrual anxiety and depression: comparison of objective psychological tests with a retrospective questionnaire by Chisholm G¹, Jung SO, Cumming CE, Fox EE, Cumming DC.(PubMed)
(4) Premenstrual syndrome: a psychological overview by Riven L.(PubMed)
(5) Menstrual mood disorders are associated with blunted sympathetic reactivity to stress by Klatzkin RR¹, Bunevicius A², Forneris CA², Girdler S².(PubMed)
(6) Factors associated with premenstrual syndrome - a survey of new female university students by Cheng SH¹, Shih CC, Yang YK, Chen KT, Chang YH, Yang YC.(PubMed)
(7) Beneficial effects of enteral fat administration on liver dysfunction, liver lipid accumulation, and protein metabolism in septic rats by Hayashi N¹, Kashiwabara N, Yoshihara D, Takeshita Y, Handa H, Yanai M, Maeda J, Yamakawa M.(PubMed)
(8) Vitamin and trace element status in premenstrual syndrome by Mira M¹, Stewart PM, Abraham SF.(PubMed)
(9) A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study by De Souza MC¹, Walker AF, Robinson PA, Bolland K.(PubMed)
(10) Nutritional factors in the etiology of the premenstrual tension syndromes by Abraham GE.(PubMed)
(11) Thyroid axis function during the menstrual cycle in women with premenstrual syndrome by Girdler SS¹, Pedersen CA, Light KC.(PubMed)
(12) Thyroid function and treatment in premenstrual syndrome by Nikolai TF¹, Mulligan GM, Gribble RK, Harkins PG, Meier PR, Roberts RC.(PubMed)
(13) TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebo-controlled trial (Basel Thyroid Study) by Meier C¹, Staub JJ, Roth CB, Guglielmetti M, Kunz M, Miserez AR, Drewe J, Huber P, Herzog R, Müller B.(PubMed)
(14) The hypothalamic-pituitary-gonadal axis in mood disorders by Young EA¹, Korszun A.(PubMed)
(15) Carbohydrate responsive element binding protein (ChREBP) and sterol regulatory element binding protein-1c (SREBP-1c): two key regulators of glucose metabolism and lipid synthesis in liver by Dentin R¹, Girard J, Postic C.(PubMed)
(16) The high-sweet-fat food craving among women with premenstrual dysphoric disorder: emotional response, implicit attitude and rewards sensitivity by Yen JY¹, Chang SJ, Ko CH, Yen CF, Chen CS, Yeh YC, Chen CC.(PubMed)
(17) Effect of an oral contraceptive containing 30 microg ethinylestradiol plus 3 mg drospirenone on body composition of young women affected by premenstrual syndrome with symptoms of water retention.by Fruzzetti F¹, Lazzarini V, Ricci C, Quirici B, Gambacciani M, Paoletti AM, Genazzani AR.(PubMed)
(18) http://en.wikipedia.org/wiki/Pituitary_gland(wikipedia)
(19) [Regulation of the interstitial fluid volume]. [Article in Japanese] by  Kawahara K1, Yasuoka Y, Kawada H.(PubMed)
(20) Impairment of lymphatic function in women with gynoid adiposity and swelling syndrome by L'Hermitte F1, Behar A, Pariès J, Cohen-Boulakia F, Attali JR, Valensi P.(PubMed)
(21) The incidence of premenstrual tension in a gynecologic clinic by Hargrove JT, Abraham GE.(PubMed)
(22) Heart rate variability in premenstrual dysphoric disorder by Landén M¹, Wennerblom B, Tygesen H, Modigh K, Sörvik K, Ysander C, Ekman A, Nissbrandt H, Olsson M, Eriksson E.(PubMed)
(23) Thyroid hormones and the heart by Vargas-Uricoechea H, Sierra-Torres CH.(PubMed)
(24) Hormone replacement therapy (estrogen and progesterone): is it necessary for heart disease prevention? by Freeman R.(PubMed)
(25) Premenstrual syndrome and premenstrual dysphoric disorder among Jordanian women by Hamaideh SH¹, Al-Ashram SA, Al-Modallal H.(PubMed)
(26) Effect of omega-3 fatty acids on intensity of primary dysmenorrhea by Rahbar N¹, Asgharzadeh N, Ghorbani R.(PubMed)
(27) [Etiopathogenesis of dysmenorrhea].[Article in Polish] by Mrugacz G¹, Grygoruk C, Sieczyński P, Grusza M, Bołkun I, Pietrewicz P.(PubMed)