Premenstrual syndrome (PMS) is a set of physical and psychological symptoms that start anywhere from a few days to two weeks before a woman gets her menstruation. A woman’s menstrual cycle lasts an average of 28 days. Ovulation happens when an egg is released from the ovaries, occurs on day 14 of the cycle. Menstruation occurs on day 28 of the cycle. PMS symptoms can start around day 14 and last until seven days after the start of menstruation.
Tissues in our body are sensitive to the hormone levels that change throughout a woman’s menstrual cycle. The rising and falling levels of hormones – like estrogen and progesterone – may influence other hormones and neurotransmitters, as they all work in a concerted fashion.
Oestrogen levels increase after menstruation, beginning a new cycle, which makes the endometrium or the uterus lining thicken. Later in the cycle (right around the time of PMS) the cells in the endometrium start to produce large amounts of hormone-like compounds that we call prostaglandins. They trigger off contractions in the uterine muscles, causing abdominal pain. High levels of prostaglandins during PMS are also associated with breast pain and headaches. On day 14th of our cycle, oestrogen levels drop and progesterone levels start to rise.
When oestrogen levels drop, a hormone called serotonin drops as well. Also called the happy hormone, serotonin normally makes us feel good and positively influences our mood. Low serotonin levels are thought to contribute to premenstrual depression, as well as fatigue, impulsive behaviour, irritability, crying spells and intense craving for food, especially carbohydrates.
The function of a region of the brain called the hippocampus (which is involved in cognition and memory) is affected. The hippocampus responds to oestrogens, so its low levels may cause forgetfulness. Oestrogen withdrawal occurs which is thought to be the trigger for headaches that arise during PMS.
Progesterone is the main hormone that causes water retention. It also activates the function of aldosterone which increases the size of the blood vessels facilitating the accumulation of water into the tissues. This is why physical symptoms like weight gain and swelling (abdomen, feet, and ankle), bloating, breast tenderness are most prevalent in PMS.
Higher progesterone levels also increase the production of an oily substance (‘sebum’) from glands called sebaceous glands in our skin, as well as close the pores. This excess production of sebum along with closed pores causes the sebum to build up in the skin and get stuck beneath the skins surface resulting in acne.
Progesterone and its breakdown products affect the quality of sleep sometimes. Furthermore, during PMS there is a decrease in the secretion of melatonin (the hormone that helps you fall asleep) which could explain the difficulty of falling asleep as well.
Other Lifestyle Causes
PMS symptoms appear to be most troubling in women who smoke, lead stressful lives, rarely exercise, sleep too little, have a diet high in Caffeine, Alcohol, Salt, Red meat and Sugary foods. Relieve your PMS symptoms with these evidence-based tips
Exercise: Including exercise in your routine can also help you sleep better and balance your hormones to a great extent.
Avoid caffeine and alcohol:Caffeine enhances PMS symptoms like irritability and jitteriness so cutting down on caffeine two weeks before your period may lessen many PMS symptoms. Regular use of alcohol causes major disturbances in the metabolism of brain serotonin levels.
Practise stress-relieving techniques: Cope with stress by talking to your friends or writing a journal. Some women also find yoga, massage, or meditation helpful. Eat a healthy, balanced diet
PMS symptoms can recur, but they typically go away after the start of menstruation. A healthy lifestyle and a balanced diet can reduce the symptoms for most women.