Premenstrual syndrome or PMS
Definition and symptoms
It can be defined as a set of psychological or physical problems that undermine a woman's quality of life and are cyclical in nature in line with their period. They appear in the days preceding the period (7 to 10 days) and disappear with menstruation. 30% to 40% of women, even those on the pill, suffer from them and 3% to 8% suffer severe symptoms.
The syndrome is observed from the age of 20 on average and continues up to the peri-menopause.
It should be noted that PMS may appear or become worse during the peri-menopause (a period frequently covering many years prior to the menopause) in terms of both intensity and duration. Breast tenderness affects up to 70% of woman during the peri-menopause.
PMS is a complex syndrome which is still not fully understood. The main causes put forward are genetic, hormonal and nutritional.
- The timing of the start and finish of PMS symptoms suggests that hormonal fluctuations are a key factor as is heightened sensitivity to circulating hormones2.
- Hormonal fluctuations act on the concentrations of neurotransmitters (serotonin, GABA, dopamine) leading to psychological and behavioural disorders2-3-4-5-6.
2. Hantsoo L et al. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Curr Psychiatry Rep. 2015 Nov;17(11):87.
3. Schüle C et al. The role of allopregnanolone in depression and anxiety. Prog Neurobiol. 2014 Feb;113:79-87.)
4. Kugaya A et al. Increase in prefrontal cortex serotonin 2A receptors following estrogen treatment in postmenopausal women. Am J Psychiatry. 2003 Aug;160(8):1522-4.
5. Bertrand PP et al. The effect of low estrogen state on serotonin transporter function in mouse hippocampus: a behavioral and electrochemical study. Brain Res. 2005 Dec 7;1064(1-2):10-20.
6. Huo L et al. Risk for premenstrual dysphoric disorder is associated with genetic variation in ESR1, the estrogen receptor alpha gene. Biol Psychiatry. 2007 Oct 15;62(8):925-33.
In nutritional terms, B vitamins act in the synthesis of the neurotransmitters that are in deficit, of which notably vitamins B2, B3 and B6 could promote an imbalance of serotonin and dopamine. Women who suffer from PMS often have lower blood ratios of magnesium/calcium, an imbalance that may play a role in mood swings. It has also been observed that one-third of women with PMS have low levels of magnesium7. Vitamin B6 and magnesium are also essential for the proper functioning of an enzyme that converts omega 6 fatty acids into components recognised as slowing down inflammation or "peace" prostaglandins (Dr Kousmine). In the presence of PMS, reduced levels of these components have been observed8. It should also be noted that levels of this enzyme drop in the event of chronic stress, as does the "stock" of magnesium.
7. Saeedian Kia A et al. The Association between the Risk of Premenstrual Syndrome and Vitamin D, Calcium, and Magnesium Status among University Students: A Case Control Study. Health Promot Perspect. 2015 Oct 25;5(3):225-30.
8. Rocha Filho et al. Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels : a randomized, double blind, placebo-controlled study. Reproductive Health 2011, 8:2.
There are also a number of factors that favour PMS: stress, which makes it more severe, lack of sleep, tobacco, high-sugar diet, alcohol and caffeine drinks.
Did you know
Syndrome prémenstruel • Les solutions naturelles
Dr Bérengère Arnal
Editions Thierry Souccar • April 2014
Mamamélis : manuel de gynécologie naturopathique à l’usage des femmes
Editions Mamamélis • 5th edition revised and corrected 2016.