Premenstrual Syndrome (PMS), disorder characterized by a variety of physical and emotional symptoms that occur in women before menstruation. These symptoms typically begin at or after ovulation (release of an egg by the ovaries), and continue until menstruation begins.

The most common physical symptom of PMS is fatigue. Other physical symptoms may include cravings for sweet or salty foods, abdominal bloating, weight gain, sore breasts, swollen feet or hands, headaches, acne, and various gastrointestinal problems. The emotional symptoms of PMS generally include depression, irritability, anxiety, or mood swings. Approximately 2 to 5 percent of women have severe PMS symptoms, but many have only mild or moderate symptoms. PMS is most common in women in their 20s and 30s, and ceases entirely at menopause.

Many researchers believe that PMS is the result of changes in estrogen and progesterone hormone levels that occur during the menstrual cycle. Among other effects these hormonal changes may cause the body to retain more sodium and fluid, leading to swelling or bloating. Recent research suggests that low levels of certain neurotransmitters (chemicals that transmit messages between cells) that affect a woman's sense of well-being and relaxation, and also stimulate the central nervous system may contribute to the emotional symptoms.

PMS is diagnosed by recording symptoms for several menstrual cycles. Symptoms that occur in a predictable pattern (starting before menstruation, then disappearing when it begins) usually indicate PMS. A doctor may perform a physical exam, if necessary, to rule out the possibility that symptoms indicate the presence of disease.

Treatment of PMS involves finding the remedy or combination of remedies that work for each individual. For some women, dietary changes, such as eliminating caffeine and alcohol, and cutting back on salt, will alleviate symptoms. Doctors often recommend vigorous, aerobic exercise because it is thought that exercise stimulates the body's release of various neurotransmitters, supplementing those that are at low levels.

Medications used to treat PMS include diuretics (to ease fluid retention), oral contraceptives (for hormone control), and anti-anxiety medication, for extreme irritability. Low doses of progesterone (a reproductive system hormone) have been used on an experimental basis. Researchers also have conducted experiments using drugs that affect neurotransmitter levels.

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