80-90% of women experience symptoms alerting them about the upcoming menstruation: breast tenderness, bloating, acne, cravings, Joint pain, irritability, headaches, migraines
Appears to worsen in the 30-40s
Very common: up to 90% of women suffer.
Symptoms are severe in 3-5% of women, which is called premenstrual dysphoric disorder (PMDD)
Severe PMS with one of :
There is evidence for exercise, Vitamin B6 (100mg), Vitamin D (1000 IU), optimizing calcium intake (1200mg), magnesium supplementation (up to 1000mg), and eating a high tryptophan diet.
Cognitive behavioural therapy (CBT) can also help.
Download the chart here. Two months of prospective tracking are required to make a diagnosis of PMDD.
Hormonal suppression: combined oral contraceptive pill (taken continuously or in the usual fashion); other hormone therapy; GnRH agonists
Serotonergic reuptake inhibitors (SSRIs or SNRIs)