Premenstrual syndrome (PMS) is a condition that affects a woman’s emotions, physical health, and behavior during certain days of the menstrual cycle, generally just before her menses. PMS is a very common condition. Its symptoms affect more than 90 percent of menstruating women.
PMS symptoms, including mood swings, occur during the last (luteal) phase of the menstrual cycle, which starts after ovulation — typically day 14 to 28 of a woman’s monthly cycle. Once menstruation starts, mood swings usually disappear.
The most common emotional PMS symptoms are: Irritability, Anger, Depression, Crying, Oversensitivity,Feeling nervous and anxious, Alternating sadness and rage
Emotional disturbances are thought to be connected to the rise and fall of hormones, specifically estrogen, throughout the menstrual cycle. Reduced levels of estrogen during the luteal phase of the cycle could possibly cause a drop in serotonin, although more research needs to be done to confirm this link.
Lower serotonin levels are associated with depression, irritability, and carbohydrate cravings, all of which can be PMS symptoms.
Between 3 and 8 percent of menstruating women have an even more severe condition called premenstrual dysphoric disorder (PMDD). These women become seriously depressed a week or two before their periods. “With PMDD, major depression and extreme irritation are the foremost symptoms. PMS is milder and usually involves physical menstrual symptoms, as well as emotional ones.”
Women with a family history of depression or who have previously experienced postpartum depression are at increased risk for PMDD, which is included on the American Psychiatric Association’s list of mental illnesses (the Diagnostic and Statistical Manual of Mental Disorders).
To be diagnosed with PMDD, a woman must have at least five of the following symptoms around the time of her period:
- Deep sadness or despair, with possible suicidal thoughts Lasting irritability and anger, which may include frequent outbursts at loved ones, Feelings of tension or anxiety, Panic attacks, Mood swings, Crying, Disinterest in daily activities and relationships, Trouble thinking or focusing, Feeling out of control or overwhelmed, Fatigue, Low energy, Food cravings or binge eating, These symptoms will disappear shortly after menstruation starts.