Dr Dimple Doshi

Premenstrual Syndrome (PMS): Causes, Symptom, Side Effect, Treatment

Home » Pre Menstrual Syndrome
  • Are you suffering from those crying spells?
  • Are you feeling low and nothing sounds appealing before your periods?
  • Are the mood swings taking over all your happiness?
  • Does the whole family know about it when you are not your original self?

If all these things are happening before your periods; then you are suffering from PMS.

Pre Menstrual Syndrome

The word premenstrual syndrome or PMS has become so common that it has become a verb now. Like I am PMSing.

As many as 75% women say they get PMS symptoms at some point in their life-time. For most women, PMS symptoms are mild.

Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD).6

ICD-10 Codes for Premenstrual Syndrome (PMS):

Premenstrual Syndrome (PMS) encompasses a range of physical and emotional symptoms occurring in the luteal phase of the menstrual cycle. The relevant ICD-10 codes are:

  • N94.3: Premenstrual tension syndrome (for general PMS)
  • N94.4: Dysmenorrhea (if the symptoms are associated with painful menstruation)

CPT Codes for Diagnosis and Treatment of PMS:

Diagnosis and management of PMS may involve several procedures:

  1. 99201 – 99215: Office or other outpatient visits (for consultation, evaluation, and management of PMS symptoms)
  2. 76830: Ultrasound, transvaginal (if there are concerns about structural abnormalities that might be contributing to symptoms)
  3. 58100: Endometrial biopsy (if endometrial pathology is suspected as contributing to symptoms)
  4. 58300: Endometrial biopsy (if further evaluation of the endometrium is needed)
  5. 87491: Chlamydia trachomatis test (if infections are suspected to be contributing to symptoms)
  6. 87591: Gonorrhea test (if infections are suspected to be contributing to symptoms)

 

Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.

PMS is a combination of physical and emotional symptoms that many women get after ovulation and before the start of their menstrual period.

The exact cause of PMS is not clear, but we do know that levels of estrogen and progesterone drop during the week before your period. Falling hormone levels may trigger the symptoms of PMS. Changes in brain chemicals or deficiencies in certain vitamins and minerals may also play a role.

PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin to rise again.

PMS may happen more often in women who:

  • Have high levels of stress
  • You consume too much caffeine
  • You are not physically active.
  • You smoke or drink.
  • You are not getting enough sleep.
  • Have a personal or family history of depression

Premenstrual syndrome changes with age; and is maximum between 21 to late 40s. It gets worse as you reach your late 30s or 40s.  PMS stops when you get menopause or when you are pregnant. In both cases you do not get menses.  After pregnancy, PMS might come back, but you might have different PMS symptoms.

Foods that worsen PMS are:

  • Salt. Excess salt in the diet leads to water retention and bloatedness leading to.
  • Sugar; sweets ;  (ice creams; cake; cold drinks)
  • Coffee and caffeinated drinks
  • Alcohol.
  • Spicy foods.
  • Red meat.

Some women get their periods without any signs of PMS or only very mild symptoms. For others, PMS symptoms may be so severe that it makes it hard to do everyday activities like go to work or school.

  • Cravings for salty foods and sweet foods like chocolates or cakes
  • Appetite changes; either eating too much or little.
  • Lack of sleep
  • Constipation
  • Feeling warm or feverish 
    • Bloatedness
    • Facial swelling
    • Acne
    • Pain and tenderness  in breasts; swelling in breasts
    • Headache
    • Back pain and joint pains
  • Low tolerance to noise or light
  • Mood swings; irritability; depression; crying spells;hostile behaviour; feeling of sadness
  • Anxiety or tension
  • Trouble with concentration or memory
  • Low sex drive 
  •  

About half of the women who have full-blown PMS will probably show worsening of their pre existing medical conditions.. like:

  1. Depression and anxiety disorders
  2. Migraines
  3. Asthma
  4. Allergies
  5. Chronic fatigue syndrome
  6. Irritable bowel syndrome
  7. Ulcerative colitis
  8. Bladder pain

PMS is not completely curable but you can have relief from the severity of the symptoms by taking your doctor s advice.

Here are some tips to ease the symptoms of PMS:

  1. Drink plenty of fluids to ease abdominal bloating
  2. Eat a balanced diet to improve the overall health and energy level; like plenty of fruits and vegetables
  3. Cut down on your sugar; salt; caffeine and alcohol
  4. Don’t smoke ; avoid alcohol
  5. Take vitamin supplements like folic acid; vitamin B6; calcium and magnesium; vitamin D
  6. Sleep at least 8 hours a day to reduce fatigue
  7. Exercise to reduce bloating and water retention.
  8. Reduce stress through exercising; reading; doing yoga or meditation

Symptoms treatment:

  1. 1.Pain killers to stop body pain; head ache or joint pain
  2. Diuretic to stop bloating and water retention
  3. Supplements like; folic acid; vitamin B6; calcium; vitamin D; Omega 6 fatty acids
  4. herbal supplements like black cohosh; chaste berry or evening prim rose oil etc. may be of some help.
  5. Severe cases may require antidepressants; anxiolytics or behavioural therapies.