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You have no doubt heard a lot about Premenstrual Syndrome (PMS) at this point in your life. It’s a common syndrome, commonly referred to in the media and often inferred upon a woman whether they have it or not. It is such a well known condition that people feel comfortable applying it to women universally and diagnosing themselves or others at whim.
But PMS is a bit more nuanced than common knowledge would have you believe. There are many widely circulated myths about PMS and research continues to teach us more and more about this somewhat misunderstood condition.
First, PMS is a syndrome with a very large list of potential symptoms. To be diagnosed with PMS, a menstruating person needs to have both mood related symptoms and physical symptoms during the luteal phase that negatively impact their life. Let's unpack this.
Requirements for a PMS diagnosis
1. Symptoms
You must have mood and physical symptoms, usually at least one of each from the list below. Everyone thinks about cramps and mood swings but there are many others and cramps seem to be missing entirely. This list is from a validated symptom tracker.
Physical Symptoms
Joint or muscle pain
Headaches
Breast swelling
Feeling bloated
Weight gain
Have trouble getting to sleep or staying asleep
Sleep more, take more naps, find it difficult to get up when intended
Feel lethargic, fatigued or lacking energy
Specific food cravings
Increased appetite
Mood Symptoms
Feel depressed, sad, down or blue
Feel hopeless, out of control or overwhelmed
Feel worthless of guilty
Feel anxious, tense, keyed up, on edge
Have mood swings (suddenly feel sad or tearful)
Feel more sensitive to rejection
Feelings are more easily hurt
Feel angry or irritable
Have conflicts or problems with people
Have less interest in work, school, friends or hobbies
Have difficulty concentrating
2. Timing
The symptoms must be during the luteal phase.
The luteal phase is the stretch of time between ovulation, which occurs around day 14 (quite variable) and extends until the first day of menstrual flow. For many, this is a span of about 2 weeks. You can have symptoms just before menses but some people have symptoms for the whole two weeks. It is quite a range.
If these symptoms are occurring before ovulation, in the follicular phase, this could be a different condition that is worsened by normal hormonal change. We use trackers to help sort this out.
3. Impact
The symptoms must negatively impact your life.
This requirement is interesting. Even minor pain can significantly impact some people's lives. The tracker defines this impact as follows…
“At work, school, home, or in daily routine, at least one of the problems noted above caused reduced productivity or inefficiency”
“At least one of the problems above interfered with hobbies or social activities”
“At least one of the problems above interfered with relationships with others”
I must note, the ability to power through the symptoms, despite being uncomfortable, emotional, etc. does not disqualify someone as needing treatment or being diagnosed.
Over the next few weeks I will be publishing more information I want people to know about PMS. If you have PMS or premenstrual symptoms and need support, I am happy to see you in office, just click one of the Book Now buttons to book an appointment.
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