premenstrual syndrome

Last edited 09/2018

Premenstrual syndrome (PMS) or premenstrual disorder/premenstrual tension (PMT) is distinct entity from dysmenorrhoea which may can be defined as

 "distressing physical, psychological and behavioural symptoms not caused by organic disease which regularly recur during the luteal phase of the menstrual cycle, and significantly regress or disappear during the remainder of the cycle" (1).

When compared to normal physiological premenstrual symptoms, PMS symptoms cause greater impairment of normal daily activities (2).

• four in ten women (40%) experience symptoms of PMS and of these 5–8% suffer from severe PMS (2)
• in ethnic minority groups it is thought to be underreported (1)
• in UK only 20% of women with PMS symptoms seek medical help
• 13% of women took time off from work due to PMS (2)
• severe premenstrual symptoms are seen in around 5% of women (1)

Premenstrual dysphoric disorder (PMDD) is an additional term classified by the American Psychiatric Association in 1994 that requires fulfilment of strict criteria (2).
Note:

• care must be taken not to label women with underlying psychiatric or somatic disorders that do not appear to be influenced by the menstrual cycle as having PMS (2).

Reference:

• (1) The National Association for Premenstrual Syndrome (NAPS). Guidelines on Premenstrual Syndrome  
• (2) Management of Premenstrual Syndrome: Green-top Guideline No. 48. BJOG. 2017;124(3):e73-e105.   
• (3) Tackling premenstrual syndrome. MeReC Bulletin 2003;13(3),9-12