Full form of pmsing. Understanding PMS: Symptoms, Causes, and Management Strategies
What is PMS and how does it affect women. What are the common symptoms of premenstrual syndrome. How is PMS diagnosed and managed. Can PMS symptoms change with age. What causes premenstrual syndrome in women. How does PMS impact other health conditions. What are effective strategies for coping with PMS symptoms.
Decoding PMS: A Comprehensive Overview
Premenstrual syndrome (PMS) is a complex condition that affects millions of women worldwide. It encompasses a range of physical and emotional symptoms that occur in the days leading up to menstruation. Understanding PMS is crucial for women’s health and well-being, as it can significantly impact daily life and overall quality of life.
PMS typically manifests about a week or two before the onset of menstruation. The severity and combination of symptoms can vary greatly from woman to woman, and even from cycle to cycle in the same individual. While some women experience mild discomfort, others may find their symptoms debilitating enough to interfere with work, school, or personal relationships.
PMS Prevalence and Risk Factors
How common is PMS? Studies indicate that up to 90% of women report experiencing some premenstrual symptoms. However, the severity and impact of these symptoms vary widely. Approximately 20-30% of women experience moderate to severe PMS symptoms that affect their daily functioning.
Certain factors may increase the likelihood of experiencing PMS:
- High levels of stress
- Family history of depression
- Personal history of postpartum depression or clinical depression
- Age (women in their 30s are most likely to experience PMS)
It’s important to note that while these factors may increase the risk, PMS can affect women of all ages and backgrounds.
The Spectrum of PMS Symptoms
PMS manifests through a wide array of symptoms that can be broadly categorized into physical and emotional/mental symptoms. Understanding these symptoms is crucial for proper diagnosis and management.
Physical Symptoms of PMS
What physical changes can women expect during PMS? Common physical symptoms include:
- Bloating and water retention
- Breast tenderness and swelling
- Headaches or backaches
- Gastrointestinal issues (constipation or diarrhea)
- Fatigue and changes in sleep patterns
- Acne flare-ups
- Joint or muscle pain
Emotional and Mental Symptoms
How does PMS affect mood and cognitive function? Emotional and mental symptoms can be equally challenging and may include:
- Irritability and mood swings
- Anxiety or tension
- Depression or feelings of sadness
- Difficulty concentrating
- Changes in appetite or food cravings
- Decreased interest in usual activities
- Social withdrawal
The combination and severity of these symptoms can vary greatly among women, making each individual’s PMS experience unique.
The Underlying Causes of PMS
Despite extensive research, the exact cause of PMS remains elusive. However, several theories have been proposed to explain its occurrence.
Hormonal Fluctuations
How do hormones contribute to PMS? The most widely accepted theory suggests that PMS is linked to the cyclical changes in hormone levels during the menstrual cycle. After ovulation, estrogen and progesterone levels begin to decline if pregnancy doesn’t occur. This hormonal shift is believed to trigger PMS symptoms in susceptible women.
Neurotransmitter Imbalances
Can brain chemistry play a role in PMS? Some research indicates that fluctuations in neurotransmitters, particularly serotonin, may contribute to PMS symptoms. Serotonin, often called the “feel-good” neurotransmitter, plays a crucial role in mood regulation, sleep, and appetite – all areas affected by PMS.
Genetic Predisposition
Is PMS hereditary? While not definitively proven, there is evidence to suggest a genetic component to PMS. Women with a family history of PMS or mood disorders may be more likely to experience severe symptoms.
Diagnosing PMS: A Multifaceted Approach
Diagnosing PMS can be challenging due to the wide range of symptoms and their similarity to other conditions. However, a systematic approach can help healthcare providers make an accurate diagnosis.
Symptom Tracking
How can women help in the diagnosis of PMS? Keeping a detailed symptom diary is crucial. Women should track their symptoms, noting their type, severity, and timing in relation to their menstrual cycle. This information can help healthcare providers identify patterns consistent with PMS.
Diagnostic Criteria
What criteria are used to diagnose PMS? According to the American College of Obstetricians and Gynecologists, PMS can be diagnosed if:
- Symptoms occur in the five days before menstruation for at least three consecutive cycles
- Symptoms end within four days after the onset of menstruation
- Symptoms interfere with normal daily activities
Differential Diagnosis
Why is it important to rule out other conditions? Many conditions share symptoms with PMS, including thyroid disorders, endometriosis, and mood disorders. A thorough medical history, physical examination, and sometimes laboratory tests may be necessary to exclude these conditions.
PMS Management: A Holistic Approach
Managing PMS often requires a multifaceted approach, combining lifestyle modifications, dietary changes, and in some cases, medical interventions.
Lifestyle Modifications
How can lifestyle changes alleviate PMS symptoms? Several strategies can help:
- Regular exercise: Engaging in moderate aerobic exercise can help reduce bloating, improve mood, and enhance overall well-being.
- Stress management: Techniques such as meditation, yoga, or deep breathing exercises can help manage stress-related symptoms.
- Adequate sleep: Maintaining a consistent sleep schedule can help regulate mood and energy levels.
- Limiting caffeine and alcohol: These substances can exacerbate symptoms like anxiety and breast tenderness.
Dietary Interventions
Can diet impact PMS symptoms? Nutritional changes may help alleviate certain PMS symptoms:
- Increasing calcium and vitamin D intake: These nutrients may help reduce mood swings and physical symptoms.
- Consuming complex carbohydrates: These can help stabilize blood sugar levels and mood.
- Reducing salt intake: This can help minimize bloating and water retention.
- Eating smaller, more frequent meals: This can help maintain stable blood sugar levels and reduce cravings.
Medical Treatments
When are medications considered for PMS? For women with severe symptoms that don’t respond to lifestyle changes, medical treatments may be recommended:
- Hormonal contraceptives: Birth control pills can help regulate hormonal fluctuations and reduce symptoms.
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) may be prescribed for severe mood-related symptoms.
- Diuretics: These can help reduce bloating and water retention.
- Pain relievers: Over-the-counter pain medications can help manage headaches and cramps.
PMS and Age: Understanding the Changes
The experience of PMS can evolve throughout a woman’s reproductive years, with symptoms often changing in nature and intensity as women age.
PMS in Younger Women
How does PMS manifest in younger women? Adolescents and women in their 20s may experience more physical symptoms, such as cramps and bloating. Emotional symptoms may be present but are often less pronounced than in older women.
PMS in Perimenopause
Does PMS worsen as women approach menopause? Many women report that their PMS symptoms intensify during perimenopause, the transition period leading up to menopause. This is likely due to the more erratic hormonal fluctuations characteristic of this stage.
Perimenopausal women may experience:
- More severe mood swings
- Increased anxiety or depression
- Worsening of physical symptoms like breast tenderness and bloating
- Changes in menstrual flow and cycle length
PMS After Menopause
What happens to PMS after menopause? PMS symptoms typically cease after menopause, as the cyclical hormonal changes that trigger PMS no longer occur. However, some women may experience symptoms similar to PMS due to hormone replacement therapy.
The Interplay Between PMS and Other Health Conditions
PMS doesn’t exist in isolation; it can interact with and exacerbate other health conditions, creating a complex interplay that requires careful management.
PMS and Mental Health Disorders
How does PMS affect women with existing mental health conditions? Women with depression or anxiety disorders may experience a worsening of their symptoms during the premenstrual phase. This phenomenon, known as premenstrual exacerbation, can make managing these conditions more challenging.
Strategies for managing the interplay between PMS and mental health disorders include:
- Adjusting medication dosages during the premenstrual phase
- Intensifying therapy or counseling sessions before menstruation
- Implementing stress-reduction techniques specific to this time of the cycle
PMS and Chronic Fatigue Syndrome
Can PMS worsen symptoms of chronic fatigue syndrome? Women with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report an exacerbation of their symptoms during the premenstrual phase. This may include increased fatigue, muscle pain, and cognitive difficulties.
Management strategies may include:
- Adjusting activity levels during the premenstrual phase
- Focusing on sleep hygiene and stress management
- Working with healthcare providers to adjust treatment plans as needed
PMS and Irritable Bowel Syndrome
How does PMS interact with irritable bowel syndrome (IBS)? Many women with IBS experience a worsening of gastrointestinal symptoms during the premenstrual phase. This may include increased bloating, abdominal pain, and changes in bowel habits.
Strategies for managing the PMS-IBS connection include:
- Modifying diet during the premenstrual phase to avoid trigger foods
- Increasing fiber intake to help regulate bowel movements
- Using stress-reduction techniques to manage both PMS and IBS symptoms
Beyond PMS: Understanding PMDD
While PMS is common, a small percentage of women experience a more severe form known as Premenstrual Dysphoric Disorder (PMDD).
Defining PMDD
What sets PMDD apart from PMS? PMDD is characterized by more intense emotional and behavioral symptoms that significantly impact daily functioning. It affects approximately 3-8% of women of reproductive age.
Key features of PMDD include:
- Severe mood swings, often including feelings of hopelessness or self-deprecating thoughts
- Intense anger or irritability
- Marked anxiety or tension
- Decreased interest in usual activities
- Difficulty concentrating
- Significant changes in appetite or sleep patterns
- Physical symptoms such as breast tenderness, bloating, or headaches
Diagnosing PMDD
How is PMDD diagnosed? PMDD is recognized as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Diagnosis typically requires the presence of at least five symptoms, including at least one mood-related symptom, occurring in the week before menstruation and improving within a few days after the onset of menses.
Treatment Approaches for PMDD
What treatment options are available for PMDD? Treatment for PMDD often involves a combination of approaches:
- Antidepressants: SSRIs are often the first-line treatment for PMDD
- Hormonal treatments: Certain birth control pills or gonadotropin-releasing hormone (GnRH) agonists may be prescribed
- Cognitive-behavioral therapy: This can help manage mood symptoms and develop coping strategies
- Lifestyle modifications: Similar to those for PMS, but often more intensive
Women experiencing symptoms suggestive of PMDD should seek professional help, as the condition can significantly impact quality of life if left untreated.
Empowering Women: Strategies for Living with PMS
While PMS can be challenging, there are numerous strategies women can employ to manage their symptoms and maintain their quality of life.
Self-Care and Mindfulness
How can self-care practices help manage PMS? Incorporating self-care routines can be particularly beneficial during the premenstrual phase:
- Practicing mindfulness meditation to manage mood swings and anxiety
- Engaging in gentle exercises like yoga or tai chi
- Taking relaxing baths or using aromatherapy
- Prioritizing activities that bring joy and relaxation
Building a Support Network
Why is social support important for managing PMS? Having a strong support network can make a significant difference in coping with PMS:
- Communicating openly with partners, family, and friends about PMS experiences
- Joining support groups or online communities for women with PMS
- Seeking professional help when needed, such as counseling or therapy
Workplace Strategies
How can women manage PMS symptoms in the workplace? Implementing strategies to manage PMS at work can help maintain productivity and well-being:
- Planning important tasks or meetings around the menstrual cycle when possible
- Taking short breaks for relaxation or gentle exercise
- Keeping healthy snacks on hand to manage cravings and maintain energy levels
- Using stress-management techniques like deep breathing or brief meditation sessions
By employing these strategies and working closely with healthcare providers, women can effectively manage PMS symptoms and maintain their overall health and well-being throughout their menstrual cycles.
Premenstrual syndrome (PMS) | Office on Women’s Health
Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. Most women, over 90%, say they get some premenstrual symptoms, such as bloating, headaches, and moodiness.3 For some women, these symptoms may be so severe that they miss work or school, but other women are not bothered by milder symptoms. On average, women in their 30s are most likely to have PMS.4 Your doctor can help you find ways to relieve your symptoms.
What is PMS?
PMS is a combination of physical and emotional symptoms that many women get after ovulation and before the start of their menstrual period. Researchers think that PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant. PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin rising again.
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. Severe PMS symptoms may be a sign of premenstrual dysphoric disorder (PMDD). PMS goes away when you no longer get a period, such as after menopause. After pregnancy, PMS might come back, but you might have different PMS symptoms.
Who gets PMS?
As many as three in four women say they get PMS symptoms at some point in their lifetime.5 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
PMS may happen more often in women who:
- Have high levels of stress7
- Have a family history of depression8
- Have a personal history of either postpartum depression or depression9,10
Does PMS change with age?
Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause.11
This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse.
PMS stops after menopause when you no longer get a period.
What are the symptoms of PMS?
PMS symptoms are different for every woman. You may get physical symptoms, such as bloating or gassiness, or emotional symptoms, such as sadness, or both. Your symptoms may also change throughout your life.
Physical symptoms of PMS can include:12
- Swollen or tender breasts
- Constipation or diarrhea
- Bloating or a gassy feeling
- Cramping
- Headache or backache
- Clumsiness
- Lower tolerance for noise or light
Emotional or mental symptoms of PMS include:12
- Irritability or hostile behavior
- Feeling tired
- Sleep problems (sleeping too much or too little)
- Appetite changes or food cravings
- Trouble with concentration or memory
- Tension or anxiety
- Depression, feelings of sadness, or crying spells
- Mood swings
- Less interest in sex
Talk to your doctor or nurse if your symptoms bother you or affect your daily life.
What causes PMS?
Researchers do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role.13 These changing hormone levels may affect some women more than others.
How is PMS diagnosed?
There is no single test for PMS. Your doctor will talk with you about your symptoms, including when they happen and how much they affect your life.
You probably have PMS if you have symptoms that:12
- Happen in the five days before your period for at least three menstrual cycles in a row
- End within four days after your period starts
- Keep you from enjoying or doing some of your normal activities
Keep track of which PMS symptoms you have and how severe they are for a few months. Write down your symptoms each day on a calendar or with an app on your phone. Take this information with you when you see your doctor.
How does PMS affect other health problems?
About half of women who need relief from PMS also have another health problem, which may get worse in the time before their menstrual period. 12 These health problems share many symptoms with PMS and include:
- Depression and anxiety disorders.These are the most common conditions that overlap with PMS. Depression and anxiety symptoms are similar to PMS and may get worse before or during your period.
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Some women report that their symptoms often get worse right before their period. Research shows that women with ME/CFS may also be more likely to have heavy menstrual bleeding and early or premature menopause.14
- Irritable bowel syndrome (IBS). IBS causes cramping, bloating, and gas. Your IBS symptoms may get worse right before your period.
- Bladder pain syndrome. Women with bladder pain syndrome are more likely to have painful cramps during PMS.
PMS may also worsen some health problems, such as asthma, allergies, and migraines.
What can I do at home to relieve PMS symptoms?
These tips will help you be healthier in general, and may relieve some of your PMS symptoms.
- Get regular aerobic physical activity throughout the month.15 Exercise can help with symptoms such as depression, difficulty concentrating, and fatigue.16
- Choose healthy foods most of the time.17 Avoiding foods and drinks with caffeine, salt, and sugar in the two weeks before your period may lessen many PMS symptoms. Learn more about healthy eating for women.
- Get enough sleep. Try to get about eight hours of sleep each night. Lack of sleep is linked to depression and anxiety and can make PMS symptoms such as moodiness worse.12
- Find healthy ways to cope with stress. Talk to your friends or write in a journal. Some women also find yoga,18 massage,19 or meditation20 helpful.
- Don’t smoke. In one large study, women who smoked reported more PMS symptoms and worse PMS symptoms than women who did not smoke.21
What medicines can treat PMS symptoms?
Over-the-counter and prescription medicines can help treat some PMS symptoms.
Over-the-counter pain relievers you can buy in most stores may help lessen physical symptoms, such as cramps, headaches, backaches, and breast tenderness. These include:
- Ibuprofen
- Naproxen
- Aspirin
Some women find that taking an over-the-counter pain reliever right before their period starts lessens the amount of pain and bleeding they have during their period.
Prescription medicines may help if over-the-counter pain medicines don’t work:22
- Hormonal birth control may help with the physical symptoms of PMS,12 but it may make other symptoms worse. You may need to try several different types of birth control before you find one that helps your symptoms.
- Antidepressants can help relieve emotional symptoms of PMS for some women when other medicines don’t help. Selective serotonin reuptake inhibitors, or SSRIs, are the most common type of antidepressant used to treat PMS.23
- Diuretics (“water pills”) may reduce symptoms of bloating and breast tenderness.
- Anti-anxiety medicine may help reduce feelings of anxiousness.
All medicines have risks. Talk to your doctor or nurse about the benefits and risks.
Should I take vitamins or minerals to treat PMS symptoms?
Maybe. Studies show that certain vitamins and minerals may help relieve some PMS symptoms. The Food and Drug Administration (FDA) does not regulate vitamins or mineral and herbal supplements in the same way they regulate medicines. Talk to your doctor before taking any supplement.
Studies have found benefits for:
- Calcium. Studies show that calcium can help reduce some PMS symptoms, such as fatigue, cravings, and depression.24,25 Calcium is found in foods such as milk, cheese, and yogurt. Some foods, such as orange juice, cereal, and bread, have calcium added (fortified). You can also take a calcium supplement.
- Vitamin B6. Vitamin B6 may help with PMS symptoms, including moodiness, irritability, forgetfulness, bloating, and anxiety. Vitamin B6 can be found in foods such as fish, poultry, potatoes, fruit (except for citrus fruits), and fortified cereals. You can also take it as a dietary supplement.
Studies have found mixed results for:
- Magnesium.24 Magnesium may help relieve some PMS symptoms, including migraines. If you get menstrual migraines, talk to your doctor about whether you need more magnesium. 26 Magnesium is found in green, leafy vegetables such as spinach, as well as in nuts, whole grains, and fortified cereals. You can also take a supplement.
- Polyunsaturated fatty acids (omega-3 and omega-6). Studies show that taking a supplement with 1 to 2 grams of polyunsaturated fatty acids may help reduce cramps and other PMS symptoms.27 Good sources of polyunsaturated fatty acids include flaxseed, nuts, fish, and green leafy vegetables.
What complementary or alternative medicines may help relieve PMS symptoms?
Some women report relief from their PMS symptoms with yoga or meditation. Others say herbal supplements help relieve symptoms. Talk with your doctor or nurse before taking any of these supplements. They may interact with other medicines you take, making your other medicine not work or cause dangerous side effects. The Food and Drug Administration (FDA) does not regulate herbal supplements at the same level that it regulates medicines.
Some research studies show relief from PMS symptoms with these herbal supplements, but other studies do not. Many herbal supplements should not be used with other medicines. Some herbal supplements women use to ease PMS symptoms include:
- Black cohosh.28 The underground stems and root of black cohosh are used fresh or dried to make tea, capsules, pills, or liquid extracts. Black cohosh is most often used to help treat menopausal symptoms,29 and some women use it to help relieve PMS symptoms.
- Chasteberry .30 Dried ripe chasteberry is used to prepare liquid extracts or pills that some women take to relieve PMS symptoms. Women taking hormonal birth control or hormone therapy for menopause symptoms should not take chasteberry.
- Evening primrose oil. The oil is taken from the plant’s seeds and put into capsules. Some women report that the pill helps relieve PMS symptoms, but the research results are mixed. 29
Researchers continue to search for new ways to treat PMS. Learn more about current PMS treatment studies at clinicaltrials.gov.
Did we answer your question about PMS?
For more information about PMS, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:
- Premenstrual Syndrome (PMS) — Information from the American Congress of Obstetricians and Gynecologists
- Premenstrual Syndrome — Information from the National Library of Medicine
Sources
- Freeman, E., Halberstadt, M., Sammel, M. (2011). Core Symptoms That Discriminate Premenstrual Syndrome. Journal of Women’s Health; 20(1): 29–35.
- Dennerstein, L., Lehert, P., Bäckström, T.C., Heinemann, K. (2009). Premenstrual symptoms—severity, duration and typology: an international cross-sectional study. Menopause International; 15: 120–126.
- Winer, S. A., Rapkin, A. J. (2006). Premenstrual disorders: prevalence, etiology and impact. Journal of Reproductive Medicine; 51(4 Suppl):339-347.
- Dennerstein, L., Lehert, P., Heinemann, K. (2011). Global study of women’s experiences of premenstrual symptoms and their effects on daily life. Menopause International; 17: 88–95.
- Steiner, M. (2000). Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. Journal of Psychiatry and Neuroscience; 25(5): 459–468.
- Potter, J., Bouyer, J., Trussell, J., Moreau, C. (2009). Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population Survey. Journal of Women’s Health; 18(1): 31–39.
- Gollenberg, A.L., Hediger, M.L., Mumford, S.L., Whitcomb, B.W., Hovey, K.M., Wactawski-Wende, J., et al. (2010). Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study. Journal of Women’s Health; 19(5): 959-967.
- Endicott, J., Amsterdam, J., Eriksson, E., Frank, E., Freeman, E., Hirschfeld, R. et al. (1999). Is premenstrual dysphoric disorder a distinct clinical entity? Journal of Women’s Health & Gender-Based Medicine; 8(5): 663-79.
- Richards, M., Rubinow, D.R., Daly, R.C., Schmidt, P.J. (2006). Premenstrual symptoms and perimenopausal depression. American Journal of Psychiatry; 163(1): 133-7.
- Bloch, M., Schmidt, P.J., Danaceau, M., Murphy, J., Nieman, L., Rubinow, D.R. (2000). Effects of gonadal steroids in women with a history of postpartum depression. American Journal of Psychiatry; 157(6): 924-30.
- Pinkerton, J.V., Guico-Pabia, C.J., Taylor, H.S. (2010). Menstrual cycle-related exacerbation of disease. American Journal of Obstetrics and Gynecology; 202(3): 221-231.
- American College of Obstetricians and Gynecologists. (2015). Premenstrual Syndrome (PMS).
- Dickerson, L., Mazyck, P., Hunter, M. (2002). Premenstrual Syndrome. American Family Physician; 67(8): 1743–1752.
- Boneva, R. S., Lin, J. M., & Unger, E. R. (2015). Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women. Menopause, 22, 826–834.
- El-Lithy, A., El-Mazny, A., Sabbour, A., El-Deeb, A. (2014). Effect of aerobic exercise on premenstrual symptoms, haemotological and hormonal parameters in young women. Journal of Obstetrics and Gynaecology; 3: 1–4.
- Aganoff, J. A., Boyle, G. J. (1994). Aerobic exercise, mood states and menstrual cycle symptoms. Journal of Psychosomatic Research; 38: 183–92.
- Kaur, G., Gonsalves, L., Thacker, H. L. (2004). Premenstrual dysphoric disorder: a review for the treating practitioner. Cleveland Clinic Journal of Medicine; 71: 303–5, 312–3, 317–8.
- Tsai, S.Y. (2016). Effect of Yoga Exercise on Premenstrual Symptoms among Female Employees in Taiwan. Int J Environ Res Public Health; 13(7).
- Hernandez-Reif, M., Martinez, A., Field, T., Quintero, O., Hart, S. , Burman, I. (2000). Premenstrual symptoms are relieved by massage therapy. J Psychosom Obstet Gynaecol; 21(1):9-15.
- Arias, A. J., Steinberg, K., Banga, A., Trestman, R. L. (2006). Systematic review of the efficacy of meditation techniques as treatments for medical illness. Journal of Alternative and Complementary Medicine; 12(8):817-32.
- Dennerstein, L., Lehert, P., Heinemann, K. (2011). Global epidemiological study of variation of premenstrual symptoms with age and sociodemographic factors. Menopause International; 17(3): 96–101.
- Rapkin A. (2003). A review of treatment of premenstrual syndrome and premenstrual dysphoric disorder. Psychoneuroendocrinology; Suppl 3:39-53.
- The Medical Letter. (2003). Which SSRI?. Med Lett Drugs Ther; 45(1170):93-5.
- National Institute for Health Research, U.K. (2008). Dietary supplements and herbal remedies for premenstrual syndrome (PMS): a systematic research review of the evidence for their efficacy.
- Ghanbari, Z., Haghollahi, F., Shariat, M., Foroshani, A.R., Ashrafi, M. (2009). Effects of calcium supplement therapy in women with premenstrual syndrome. Taiwanese Journal of Obstetrics and Gynecology; 48(2): 124–129.
- Office of Dietary Supplements. (2016). Magnesium.
- Rocha Filho, F., Lima, J.C., Pinho Neto, J.S., Montarroyos, U. (2011). Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. Reproductive Health; 8: 2. doi: 10.1186/1742-4755-8-2.
- Johnson, T. L., Fahey, J. W. (2012). Black cohosh: coming full circle? Journal of Ethnopharmacolgy, 141(3): 775-9. doi: 10.1016/j.jep.2012.03.050.
- Dietz, B. M., Hajirahimkhan, A., Dunlap, T. L., Bolton, J. L. (2016). Botanicals and their bioactive phytochemicals for women’s health. Pharmacological Reviews, 68(4): 1026-1073. doi: https://doi.org/10.1124/pr. 115.010843.
- Girman, A., Lee, R., Kligler, B. (2003). An integrative medicine approach to premenstrual syndrome. American Journal of Obstetrics and Gynecology, 188 (5), S56–S65.
All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.
Page last updated:
February 22, 2021
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What is premenstrual syndrome (PMS)?
Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The symptoms may range from mild to severe.
What is premenstrual dysphoric disorder (PMDD)?
Premenstrual dysphoric disorder (PMDD) is a severe type of PMS. With PMDD, the symptoms are severe enough to interfere with your life. PMDD much less common than PMS.
What causes premenstrual syndrome (PMS)?
Researchers don’t know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others.
What are the symptoms of premenstrual syndrome (PMS)?
PMS symptoms are different for everyone. You may get physical symptoms, emotional symptoms, or both. Your symptoms may also change throughout your life.
Physical symptoms may include:
- Breast swelling and tenderness
- Acne
- Bloating and weight gain
- Headache
- Joint pain
- Backache
- Constipation or diarrhea
- Food cravings
Emotional symptoms may include:
- Irritability
- Mood swings
- Crying spells
- Depression
- Anxiety
- Sleeping too much or too little
- Trouble with concentration and memory
- Less interest in sex
How is premenstrual syndrome (PMS) diagnosed?
You may wish to see your health care provider if your symptoms bother you or affect your daily life.
There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed with PMS, your symptoms must:
- Happen in the five days before your period for at least three menstrual cycles in a row
- End within four days after your period starts
- Keep you from enjoying or doing some of your normal activities
Your provider may wish to do tests to rule out other conditions which may cause similar symptoms.
What are the treatments for premenstrual syndrome (PMS)?
No single PMS treatment works for everyone. If your symptoms are not severe, you may be able to manage them with:
- Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen, to help ease cramps, headaches, backaches, and breast tenderness
- Getting regular exercise
- Getting enough sleep
- Eating healthy foods
- Avoiding salt, caffeine, sugar, and alcohol in the two weeks before your period
Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.
Some women take certain herbal supplements for PMS symptoms. But there is not enough evidence to prove that supplements are effective for PMS. Check with your provider before taking any vitamins or supplements.
If you are not able to manage your PMS symptoms, your provider may suggest prescription medicines. These medicines may also be used to treat PMDD. They include:
- Hormonal birth control, which may help with the physical symptoms of PMS. But sometimes they may make the emotional symptoms worse. You may need to try several different types of birth control before you find the right one.
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which may help with emotional symptoms.
- Diuretics (“water pills”) to reduce symptoms of bloating and breast tenderness.
- Anti-anxiety medicine to ease symptoms of anxiety.
Dept. of Health and Human Services Office on Women’s Health
Premenstrual Syndrome (PMS)
(Mayo Foundation for Medical Education and Research)
Premenstrual Syndrome (PMS)
(Department of Health and Human Services, Office on Women’s Health)
Also in Spanish
Premenstrual Syndrome (PMS) FAQ
(American College of Obstetricians and Gynecologists)
Black Cohosh
(National Center for Complementary and Integrative Health)
Chasteberry
(National Center for Complementary and Integrative Health)
Evening Primrose Oil
(National Center for Complementary and Integrative Health)
Mittelschmerz
(Mayo Foundation for Medical Education and Research)
Also in Spanish
Premenstrual Dysphoric Disorder (PMDD)
(American Academy of Family Physicians)
Premenstrual Dysphoric Disorder (PMDD): Different from PMS?
(Mayo Foundation for Medical Education and Research)
Also in Spanish
Water Retention: Relieve This Premenstrual Symptom
(Mayo Foundation for Medical Education and Research)
Also in Spanish
ClinicalTrials. gov: Premenstrual Syndrome
(National Institutes of Health)
Article: The effect of progressive muscle relaxation technique and myofascial release technique. ..
Article: Effect of curcumin on inflammatory biomarkers and iron profile in patients…
Article: The role of purity and frequency in the classification of perimenstrual. ..
Premenstrual Syndrome — see more articles
Normal Female Reproductive Anatomy
(National Cancer Institute)
Department of Health and Human Services, Office on Women’s Health
Also in Spanish
Find an Ob-Gyn
(American College of Obstetricians and Gynecologists)
Menstrual Period: Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
(Boston Children’s Hospital)
Also in Spanish
PMS, Cramps, and Irregular Periods
(Nemours Foundation)
Also in Spanish
Premenstrual Syndrome (PMS)
(Department of Health and Human Services, Office on Women’s Health)
pms hotel management system: which one to choose
The purpose of this article is to show hoteliers and business owners the points to pay attention to at the initial stages of work, when choosing or replacing an existing PMS.
Personal experiences and decisions
I have been in the hotel business for 15 years now. During this time, a certain experience in managing various types of hotels has been accumulated. And today I want to share with you my experience in choosing a hotel management system.
It so happened that during my work in hotels I managed to approach the issue of using PMS from different angles. In some hotels, I was just a user of an already existing product. In others, I had the opportunity to initially choose the system. Still others had to deal with the transition from one system to another.
It was the experience gained that made it possible to objectively evaluate the process of choosing and owning a PMS, not only as a user at the monitor, but also as the owner of this system with all the operational and content characteristics. Agree, these are different approaches, each of which has its own nuances. For example, someone wants speed and stability, but for someone saving in program and server maintenance is important. Also, when was the last time you asked your employees about the convenience of working on an existing PMS?
Network, franchise and free float
I note right away that in the article I focus on the Russian market and on colleagues who have the opportunity to influence the choice. However, this information will also be useful to other representatives of the hotel business.
You know that many chain or franchise hotels do not have the right to choose systems on their own and are completely dependent on the decision of the head office. This is primarily due to the rules of networks and the presence of already approved standards for the quality of work, as well as maintenance procedures.
Independent hotels themselves decide this issue and often more than once during the entire cycle of the hotel. Personally, I know several cases of transition from one PMS to another. The reasons that led to such decisions and the results obtained will be explained below.
Are you familiar with PMS?
So what is PMS, what is it for, and how to choose it?
If we talk about a short and closer definition for me that explains this concept, then PMS (Property Management System, from the English “Property Management System”) is a system that allows the owner or manager to automate all cycles of guest service: from booking and check-in to the final payment of the guest. And also PMS is an opportunity to organize all business processes in the hotel: from the work of the maid service to full financial reporting.
I would like to note that a number of PMS are not recommended to be implemented in the work of chain hotels. The reason for this is the inconvenience and lack of functionality required for the full operation of the network. As an example, the reasons may be the following:
× Lack of a common database with the possibility of loading guests in any of the hotels.
× Lack of access to deposits of the company or individuals.
× And most importantly – the lack of the possibility of generating general reporting for the network.
Principles for choosing a PMS or 3 steps to choosing an assistant
At the moment, due to the exchange rate of the ruble and a number of other points, Russian products get a big advantage. Undoubtedly, some of them are competitive and worthy of choice. At the same time, our task is not just to fit into the budget and save money, but to acquire the best assistant in business, both for employees and owners. Therefore, I urge you to be objective and focus on functionality, not cost.
How to choose one and only PMS from such a huge range on the market? I would highlight the following steps:
STEP 1. Write down the points that you may not like in the system, including cost indicators.
STEP 2. Compare all these points and compare offers on the market.
Typically, at this stage, your list will narrow down to 3-5 solutions.
STEP 3. This is where things get interesting. Below are my recommendations for this stage:
× It is obligatory to personally meet both the company’s management and the technical management implementing the product. And here it is necessary to solve two nuances:
1. Development and integration.
Often sellers and future users understand the main functions in the program a little differently. It’s good if you manage to see in the eyes of sellers not only the desire to sell the product, but also the desire to make it better, update and adjust it to the modern market. After all, every year more and more applications are released into the world to improve the operation of the hotel, and, as a result, increase the profit of the enterprise. This is where you need to think ahead of time about integrating them with your PMS. It is worth immediately understanding whether the developers are ready to move in this direction or not.
2. Development of an additional interface.
As a rule, system vendors do not refuse to develop new interfaces, but request funds for this that are comparable to the cost of the PMS itself. All this leads to a stalemate, when the user becomes a hostage between the desire to automate the business, on the one hand, and the inability to implement it for financial reasons, on the other.
All this can be avoided thanks to a single meeting with the company’s management. Moreover, they love to do it and will be happy to chat with you!
Important: according to the result of the meeting, there must be a protocol, which should cover all the agreed points and the conditions for their implementation, even if in the form of a regular letter between both parties. At the same meeting, it would be right to ask about previous projects. Be sure to specify which of them were unsuccessful, what is the reason for what happened .
× It is desirable to meet with the current users of this system and those who have changed the system.
Discuss the experience of use, the pros and cons of working. If you are not from a million-plus city, then it makes sense to send your employee on a business trip for personal communication.
Checklist of questions for a personal meeting:
- · Are there any cases where the program freezes/crashes and how often?
- Is information lost after crashes?
- · Support response time, especially at night, on weekends and holidays?
- · Estimated time to resolve the issue?
- · Average time spent on training a new employee?
- · A list of stages and moments where the staff most often makes mistakes?
- · Required Internet speed for stable operation?
- · Regularity of changes in the cost of system maintenance?
- How often are updates released?
- · What is the nature of these updates: a new version or an improvement of the current work?
- · Do I need a separate server?
- · Is there a backup of the entire database and how often does it happen?
etc.
These and other important points must be reflected later in the contract, protecting yourself from unnecessary waste of time in the future.
Basic criteria for system selection or re-evaluation.
For all the time I have worked in the hotel business, I would single out the following:
- Spectrum of functionality.
- Operating speed.
- Easy to use.
- Reliability.
- Possibility of development and renewal
- Use of modern software products in the system.
- Plasticity of settings.
- Intuitive and clear interface.
- The ability to customize the system in accordance with the standards of the hotel.
- Multiuser.
- Differentiation of access rights.
- Orientation to the peculiarities of work on the territory of the Russian Federation (taxes, etc.).
- Availability of user manual.
- Timing of complete implantation of the system.
- Scope of interfaces with other systems.
- Availability and scope of internal interfaces.
- Implementation cost.
- Usage/support cost.
- Failure statistics and root causes.
- Product geography.
- Opportunities and conditions for developers to modify the system for a specific market or the wishes of the customer.
What about data retention law?
A separate point that I would like to draw attention to concerns not only those who are faced with choosing a system, but also those who have been using PMS for a long time and are satisfied with everything.
Surely, each of you, one way or another, heard about the law on the storage of data of citizens of the Russian Federation on servers in Russia. This is the so-called “Lugovoy’s law”, initiated by the Deputy Chairman of the State Duma Committee on Security and Anti-Corruption, a member of the LDPR faction Andrey Konstantinovich Lugovoi. In other words, any PMS falls under the monitoring of this legislation.
At the same time, I would like to draw your attention to the fact that PMS belonging to a Russian product does not mean that it will not be 100% subject to the law that comes into force on September 1, 2015. After all, most services in the Russian Federation use foreign servers for storing and processing data. You will ask why? Good price, stability, technical support and other reasons. We have it much more expensive and less stable. If today the issue of price has been resolved by itself due to the exchange rate, and the foreign server has become comparable to the domestic one, then other parameters have remained unchanged.
Of course, the law can be further pushed back in terms of implementation, but I try to reason on the fact and within the framework of the legislative situation that exists today in the country. Therefore, today it is necessary to pay close attention to this point and ask the creators of PMS to provide their vision of resolving this issue.
PMS demos
As a rule, a potential buyer is given the opportunity to get acquainted with the demo version. I want to draw everyone’s attention to the fact that these versions are completely “raw”, and they lack certain functionality or they have it in a stripped down form.
Of course, the brand of the company and its fame play a role. However, most people in charge of choosing a system make a number of mistakes.
– The first of them, and perhaps the most common: the initial choice of the system according to its own criteria – and only then adapting it to the necessary requirements in the hotel. But it should be the other way around: from the features and requirements of the object to the capabilities of the system itself.
– The second mistake is an attempt to immediately evaluate the return on investment spent on the product.
Here, rather, you need to be patient and wait for an objective understanding of the need for this product for business.
Escort: to be or not to be?
After choosing a system, the most voluminous issue becomes the maintenance of the system in the process of work. As a rule, the following components of service exist in the market:
· Telephone support.
· Helpdesk via e-mail.
· Free swimming and resolving issues through the system administrator, who is in the state.
Technical support can be round the clock or hourly. The manufacturer gives the choice to the consumer which option is preferable. There is usually a monthly fee for this.
Here I would like to draw attention to the fact that a good program does not require constant intervention from outside and provides the necessary and proven functionality in no more than 2-4 months. From experience, the real process of implementation and “grinding in” with the staff and the facility takes place just during this time. Further, a reliable system is simply obliged to work without any significant failures.
Important: these points must also be reflected in the agreements. For example, maintenance payments start only from the third or fourth month of use, and not immediately after installation or pre-installation settings.
At some point, it may seem that you are completely managing on your own and can easily refuse to be accompanied. I would recommend not to do this, since maintenance is not only solving problems, but also various cleaning of databases, clarification and implementation of changes related to legislation or other innovations, support in difficult situations, and so on.
There are programs that require licensed maintenance or updates. In such a case, you should seek free maintenance and updates, that is, at no additional cost, and as new versions are released by the developer. Especially if you pay monthly for maintenance.
Total per PMS?
Let’s talk about the total cost of ownership PMS . I would love to help you see the maximum product pricing listing.
So, what do you pay when implementing PMS? What makes up the price?
Try to fill in the empty lines by putting your price in front of each item. This way you will get the final PMS ownership figure.
Instead of terminals
Always try to take a modular system, and not a system that completely automates all hotel services due to its original functionality. There are two reasons:
1. You always have the opportunity to replace obsolete modules without touching others.
2. You do not create the basis for increasing the cost of maintenance in the event of a 100% need to replace something in the system, for example, due to changes in legislation.
09/05/2015
Hydraulic press for 100 30 tons Werther PR30 PMS 656S hand and foot drive 315900 rub in Moscow and St. Petersburg
Description
Characteristics
Video reviews
OMA 656S PR30/PMS Werther hydraulic press 30 t is a power unit with manual and foot hydraulic drive with the function of adjusting the piston feed rate. An effort of thirty tons is enough to work with cars, SUVs, small commercial vehicles and special equipment.
Werther PR30/PMS (OMA 656S)
- Press height 1920 mm;
- Total press width 1240 mm;
- Total press depth 650 mm;
- Stem tip adjustment up to 160 mm;
- Working table width 790 mm;
- Horizontal cylinder offset;
- Hydraulic two-stroke pump has foot and hand drive;
- Pressure gauge built into the frame;
- Automatic piston return after depressurization;
- Overload valve restricts the system to thirty tons of force for system safety;
- Winch for raising and lowering the working table;
- Automatic handle return;
- Chrome-plated hydraulic cylinder surface;
- V-blocks.
Werther-OMA PR30/PMS 656S Floor press complete with welded frame:
- Hydraulic press
- Pressure gauge
- 2 V block
- Reinforced hose
- Hand winch
- Foot pedal
- Pump
- Manual
- Packaging. plywood box
Replaceable hydraulic fluid according to GOST 17479.3-85 is used in the power device.
We recommend using:
At temperatures from +10 – viscosity 46 (41.4-50.6), Russian-made, it makes no sense to buy expensive ones.
In cold rooms – with a viscosity of 32 (29-35) – LUKOIL, TNK or others
Facts about our work:
- Best price, guaranteed.
- Delivery of goods to the transport company “Business Lines” is free of charge.
- Cash and non-cash payment (including VAT)
- Best Range: All leading brands and popular models are represented
- Qualitatively complete description with three-dimensional photographs and video reviews
- Characteristics of goods indicated on the site may be changed by the manufacturer without prior notice
- Service availability
- Managers on call 7 days a week
- We work honestly and openly, complete information.