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Menstrual cycle mood swings: The request could not be satisfied


Menstrually Related Mood Disorders – Center for Women’s Mood Disorders

Menstrually-related mood disorders are mood disorders associated with the menstrual cycle. Menopause and cycles of menstruation are time of intense hormonal fluctuation that can cause increased vulnerability to depression. Perimenopausal Depression, Premenstrual Syndrome (PMS), and Premenstrual Dysphoric Disorder (PMDD) are menstrually-related mood disorders treated in our program.


Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

Many women experience symptoms of Premenstrual Syndrome (PMS). In some instances the mood symptoms and emotional components of PMS are the most troubling. To women in such cases, PMS is often referred to as Premenstrual Dysphoric Disorder (PMDD).

Premenstrual Dysphoric Disorder is a more severe form of PMS, affecting 5-10% of women in their reproductive years. In contrast to PMS, PMDD is characterized by more significant premenstrual mood disturbance that can seriously impact relationships and impair functioning. Many women with PMDD experience clinical levels of depression or anxiety during the week or two before each menstrual cycle. It is not uncommon that the emotional symptoms of depression anxiety and irritability can seriously interfere with normal functioning and relationships.

Common symptoms include: irritability, depressed mood, anxiety, or mood swings. Mood symptoms are only present for a specific period of time, during the luteal phase of the menstrual cycle. Symptoms emerge one to two weeks before menses and resolve completely with the onset of menses. Women with PMDD should experience a symptom-free interval between menses and ovulation. An estimated 40% of women who seek treatment for PMDD actually have a premenstrual exacerbation of an underlying mood disorder rather than PMDD. Therefore, it is important for patients to be carefully evaluated for the presence of an underlying mood disorder in order to develop the best treatment plan.

For more information:

Watch these videos about PMDD:
The Biology behind PMDD
Oral Contraceptive relief for PMDD

Or read these articles about PMDD research at UNC:
Oral Contraceptives May Ease Suffering of Women with Severe PMS
Study finds hereditary link to premenstrual depression

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Perimenopausal Depression

Menopause is defined as the permanent cessation of the menses. Perimenopause is defined as the transitional period from normal menstrual periods to no periods at all. At this time menstrual periods gradually lighten and become less frequent. The transition to complete menopause may last anywhere from a few months to a few years.
During the perimenopausal transition you may experience a combination of PMS and menopausal symptoms or no symptoms at all. Some normal symptoms of the perimenopause period are hot flashes, insomnia, vaginal dryness, and mood problems. Symptoms of perimenopausal depression are emotional flatness, “inability to cope,” irritability, social isolation, tearfulness, decreased energy, and failure to enjoy normal activities and relationships.

Times of intense hormonal fluctuation can cause increased vulnerability to depression. Perimenopause may be a period of increased vulnerability to the onset of depression in women with no prior history of depression. Since symptoms are gradual in onset, women will not recognize symptoms as part of a reversible disorder, but rather will interpret them as a permanent change in their life.

For more information:
UNC researchers investigate estrogen replacement therapy to prevent depression and cardiovascular disease

PMS Emotions: Mood Swings In Women During Period

The most common emotional PMS symptoms are:

  • Irritability
  • Anger
  • Depression
  • Crying
  • Oversensitivity
  • Feeling nervous and anxious
  • Alternating sadness and rage

Getting to the Root of PMS Mood Swings

Although researchers don’t know exactly why PMS strikes, these emotional disturbances are thought to be connected to the rise and fall of hormones, specifically estrogen, throughout the menstrual cycle. Estrogen levels begin to rise slowly just after a women’s period ends, and it peak two weeks later. “Then estrogen levels drop like a rock and begin rising slowly before dropping again just before menstruation starts,” explains Livoti. These hormonal peaks and valleys are thought to cause mood swings and other menstrual symptoms.

“Stressful situations, such as a divorce or job loss, don’t cause PMS, but they can make it worse,” adds Livoti. Some research suggests that female hormones interact with brain chemicals in a way that can affect mood in those with PMS. “Reduced levels of estrogen during the luteal phase of the cycle could possibly cause a drop in serotonin, although more research needs to be done to confirm this link,” says Livoti. Lower serotonin levels are associated with depression, irritability, and carbohydrate cravings, all of which can be PMS symptoms.

Severe PMS: Beyond Run-Of-The-Mill Mood Swings

Between 3 and 8 percent of menstruating women have an even more severe condition called premenstrual dysphoric disorder (PMDD). These women become seriously depressed a week or two before their periods. “With PMDD, major depression and extreme irritation are the foremost symptoms,” says Livoti. “PMS is milder and usually involves physical menstrual symptoms, as well as emotional ones.”

Women with a family history of depression or who have previously experienced postpartum depression are at increased risk for PMDD, which is included on the American Psychiatric Association’s list of mental illnesses (the Diagnostic and Statistical Manual of Mental Disorders). To be diagnosed with PMDD, a woman must have at least five of the following symptoms around the time of her period:

  • Deep sadness or despair, with possible suicidal thoughts
  • Lasting irritability and anger, which may include frequent outbursts at loved ones
  • Feelings of tension or anxiety
  • Panic attacks
  • Mood swings
  • Crying
  • Disinterest in daily activities and relationships
  • Trouble thinking or focusing
  • Feeling out of control or overwhelmed
  • Fatigue
  • Low energy
  • Food cravings or binge eating

These symptoms will disappear shortly after menstruation starts. “If they last all month, that’s not PMDD,” says Livoti. Instead, another mental or physical illness may be the cause.

Treating PMS Symptoms, From Mild to Severe

For many women, lifestyle changes can be a successful part of PMS treatment. For women with severe PMS, medication may be needed. The following PMS treatment options can help stabilize mood swings and improve a woman’s emotional health in the weeks before menstruation:

  • Exercise. Physical activity can lift moods and improve depression. It’s believed that endorphins — feel-good brain chemicals that are released during exercise — may help counteract some of the hormone changes that may trigger severe PMS. “Exercising can also boost energy and help with cramps and bloating, which may help you feel better,” says Livoti. Aerobic exercise such as walking, running, bicycling, or swimming is recommended.
  • Small, frequent meals. Eating small meals throughout the day rather than two or three big meals may also help ease PMS symptoms. A large meal, particularly one high in carbohydrates, can cause blood sugar swings, which could worsen PMS. “Low blood sugar may contribute to crying spells and irritability that are often seen in women with severe PMS,” says Livoti. Try to eat six small meals a day to keep your blood sugar levels steady.
  • Calcium supplements. In a 2009 double-blind clinical trial of college women with PMS, those who supplemented their diet with 500 milligrams of calcium twice daily had significantly less depression and fatigue than those who didn’t. In fact, “a number of studies have shown that getting plenty of calcium can help ease mood changes related to severe PMS, although we don’t know exactly why,” says Livoti.
  • Avoid caffeine, alcohol, and sweets. Staying away from coffee and other caffeinated drinks for two weeks before your period may make a difference in your mood because caffeine can increase anxiety, nervousness, and insomnia. Cutting down on alcohol may also be helpful because alcohol acts as a depressant. And steering clear of candy, soda, and other sugary foods, especially in the week before your period, may help ease severe PMS symptoms by preventing mood swings associated with blood sugar fluctuations.
  • Stress management. Stress can make severePMS symptoms worse, so finding ways to give stress the slip can help treatPMS. Try relaxation techniques such as meditation, deep breathing, and yoga. Individual or group therapy has also been found to be an effectivePMS treatment for women with severe mood swings and debilitating emotional changes.

    Antidepressants called selective serotonin reuptake inhibitors (SSRIs) that change serotonin levels in the brain have been shown to be helpful for women with severe PMS and PMDD. In fact, the U.S. Food and Drug Administration has approved three of these medicines — Zoloft (sertraline), Prozac or Sarafem (fluoxetine), and Paxil CR (paroxetine) — for the treatment of PMDD.

    Talk to your doctor about which of these approaches might work best for any moderate or severe emotional PMS symptoms you’re experiencing.

Premenstrual dysphoric disorder: Different from PMS?

What’s the difference between premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS)? How is PMDD treated?

Answer From Tatnai Burnett, M.D.

Premenstrual dysphoric disorder (PMDD) is a severe, sometimes disabling extension of premenstrual syndrome (PMS). Although PMS and PMDD both have physical and emotional symptoms, PMDD causes extreme mood shifts that can disrupt daily life and damage relationships.

In both PMDD and PMS, symptoms usually begin seven to 10 days before your period starts and continue for the first few days of your period.

Both PMDD and PMS may cause bloating, breast tenderness, fatigue, and changes in sleep and eating habits. In PMDD, however, at least one of these emotional and behavioral symptoms stands out:

  • Sadness or hopelessness
  • Anxiety or tension
  • Extreme moodiness
  • Marked irritability or anger

The cause of PMDD isn’t clear. Underlying depression and anxiety are common in both PMS and PMDD, so it’s possible that the hormonal changes that trigger a menstrual period worsen the symptoms of mood disorders.

Treatment of PMDD is directed at preventing or minimizing symptoms and may include:

  • Antidepressants. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem, others) and sertraline (Zoloft), may reduce emotional symptoms, fatigue, food cravings and sleep problems. You can reduce symptoms of PMDD by taking SSRIs all month or only during the interval between ovulation and the start of your period.
  • Birth control pills. Taking birth control pills with no pill-free interval or with a shortened pill-free interval may reduce PMS and PMDD symptoms.
  • Nutritional supplements. Consuming 1,200 milligrams of calcium daily may possibly reduce symptoms of PMS and PMDD. Vitamin B-6, magnesium and L-tryptophan also may help, but talk with your doctor for advice before taking any supplements.
  • Herbal remedies. Some research suggests that chasteberry (Vitex agnus-castus) may possibly reduce irritability, mood swings, breast tenderness, swelling, cramps and food cravings associated with PMDD, but more research is needed. The U.S. Food and Drug Administration doesn’t regulate herbal supplements, so talk with your doctor before trying one.
  • Diet and lifestyle changes. Regular exercise often reduces premenstrual symptoms. Cutting back on caffeine, avoiding alcohol and stopping smoking may ease symptoms, too. Getting enough sleep and using relaxation techniques, such as mindfulness, meditation and yoga, also may help. Avoid stressful and emotional triggers, such as arguments over financial issues or relationship problems, whenever possible.

If you have symptoms of PMDD, talk with your doctor about testing and treatment options.


Tatnai Burnett, M.D.

March 11, 2021

Show references

  1. Yonkers KA, et al. Clinical manifestations and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder. https://www.uptodate.com/contents/search. Accessed Jan. 26, 2021.
  2. Casper RF, et al. Treatment of premenstrual syndrome and premenstrual dysphoric disorder. https://www.uptodate.com/contents/search. Accessed Jan. 26, 2021.
  3. AskMayoExpert. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Mayo Clinic; 2020.
  4. Ferri FF. Premenstrual dysphoric disorder. In: Ferri’s Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Feb. 10, 2021.
  5. Kellerman RD, et al. Premenstrual syndrome. In: Conn’s Current Therapy 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Feb. 10, 2021.
  6. Vitex agnus-castus. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 10, 2021.

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Period mood swings: PMS, symptoms, and treatments

Many people experience mood swings and other psychological symptoms before a period. For most, the symptoms are relatively mild. However, some females may experience severe symptoms that interfere with their personal relationships and day-to-day life.

This article outlines the causes of mood swings before a period and lists other symptoms that may occur around this time. We also provide information on how to treat mood swings, and when to see a doctor.

According to the MGH Center for Women’s Mental Health, some people are hypersensitive to natural hormone changes that happen during the menstrual cycle. This hypersensitivity may predispose a person to premenstrual mood swings.

Severe premenstrual mood swings can sometimes indicate an underlying health condition.

Premenstrual syndrome (PMS)

The term premenstrual syndrome (PMS) describes a variety of physical, emotional, and behavioral symptoms that occur before menstruation.

Many females who menstruate experience symptoms of PMS, and it is not uncommon for these to be mild. However, a proportion of those with PMS may experience more severe or clinically significant symptoms, as we describe below.

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is an extreme form of PMS. The chief difference between PMS and PMDD is the severity and duration of symptoms.

A person with PMDD will have significant mood swings that can interfere with personal and professional relationships. According to the Child Mind Institute, these symptoms can continue after a period has ended.

Premenstrual exacerbation (PME)

A female who has a preexisting mental health condition may find that the condition worsens prior to a period. The medical term for this is premenstrual exacerbation (PME).

Some mental health conditions that may become more severe shortly before a period include:

According to the International Association for Premenstrual Disorders, it can be difficult to distinguish between PMDD and PME. However, it is important for a person to receive the correct diagnosis, as the treatment options for each condition differ.

The symptoms and signs of PMS and PMDD are similar. The key differences between the two conditions are the severity and duration of symptoms.

A person who has either condition may experience physical, behavioral, or psychological symptoms or a combination of symptoms.

These include the following:

Physical symptoms

Behavioral symptoms

  • difficulty concentrating
  • fatigue
  • forgetfulness

Psychological symptoms

  • mood swings
  • feeling overwhelmed or out of control
  • crying without knowing the reason
  • loss of interest in most activities
  • sudden sadness
  • sensitivity to rejection
  • social withdrawal
  • anxiety
  • depressed mood
  • irritability

Mood swings and other symptoms associated with PMS are very common. According to one estimate, at least 90% of those who have a menstrual cycle experience physical or psychological symptoms of PMS. For most women, the symptoms are not severe.

However, PMDD is also not uncommon, affecting between 3–8% of people in their reproductive years. The symptoms usually develop when someone is in their 20s and may worsen over time.

Some major risk factors for PMDD include:

  • stress
  • a pre-existing mood or anxiety disorder
  • a family history of PMDD

There are several potential treatment and management options for people dealing with mood swings prior to their period. Some common options include the following:

Natural treatments and lifestyle changes

Certain nonmedical treatments might help to reduce the frequency and severity of premenstrual mood swings. Examples include:

  • Keeping a mood diary: People can try keeping a record of their mood swings and when they occur during the menstrual cycle. This can help a person recognize the hormonal causes of their mood swings, and anticipate them happening.
  • Eating a balanced diet: A balanced diet low in added sugars, sodium, and caffeine could help to reduce mood swings.
  • Exercising regularly: According to the MGH Center for Women’s Mental Health, regular aerobic exercise can lessen the emotional and physical symptoms of PMS and PMDD.
  • Reducing stress: Yoga, meditation, or talking therapy can help to reduce stress levels and balance mood.
  • Taking herbal supplements: According to a 2017 review of eight randomized controlled trials, the herbal medicine known as chasteberry is a safe and effective treatment for PMS and PMDD.
  • Taking calcium supplements: A 2017 study found that calcium supplements improved anxiety, depression, and emotional changes connected with PMS.


There are several medications that may help to treat mood swings before a period.

One option is an oral contraceptive. Some people notice an improvement in their PMS symptoms when taking an oral contraceptive, while others find that their symptoms worsen. As such, a person should monitor their symptoms closely and return to their doctor for alternative treatment if necessary.

If a person has severe PMS or PMDD, their doctor may prescribe one of the following medications:

  • Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs): The brain chemicals serotonin and norepinephrine are important for regulating mood. SSNRIs, such as venlafaxine and duloxetine, increase levels of these chemicals in the brain. They are usually the first-line treatment for PMDD.
  • Benodiazepines: These are a type of sedative drug. They relax muscles and help to slow down certain types of brain activity. Doctors may prescribe benzodiazepines to treat sleep and anxiety disorders. The benzodiazepine known as alprazolam appears beneficial in treating PMDD.
  • Antianxiety medications: According to a 2015 review, the antianxiety medication buspirone may be a useful treatment for PMDD.

People should talk to their doctor if they experience mood swings or other symptoms of PMS or PMDD. If the mood swings are severe or disruptive, a person should talk to their doctor as soon as possible.

During the consultation, a doctor may try to rule out possible psychological disorders, such as depression or anxiety. This will be an important step in differentiating PMDD from PME.

After making a diagnosis, the doctor may recommend certain lifestyle changes, or may prescribe medical treatments. If a person continues to experience mood swings, they should return to the doctor for a change of treatment.

Many females experience mood swings and other symptoms prior to their period. For some individuals, the mood swings are severe and could be a sign of PMDD or PME.

There are many steps a person can take to help reduce mood swings and other premenstrual symptoms. They may benefit from certain lifestyle changes, such as eating a healthful diet, exercising regularly, and reducing stress levels.

If symptoms are severe or lifestyle changes are not working, a person should see their doctor. The doctor will likely prescribe medications to help reduce the frequency and severity of mood swings.

PMS (premenstrual syndrome) – NHS

PMS (premenstrual syndrome) is the name for the symptoms women can experience in the weeks before their period. Most women have PMS at some point. You can get help if it affects your daily life.

What is PMS (premenstrual syndrome)?

Each woman’s symptoms are different and can vary from month to month.

The most common symptoms of PMS include:

  • mood swings
  • feeling upset, anxious or irritable
  • tiredness or trouble sleeping
  • bloating or tummy pain
  • breast tenderness
  • headaches
  • spotty skin or greasy hair
  • changes in appetite and sex drive

What can I do about PMS (premenstrual syndrome)?


  • regular exercise

  • eat a healthy, balanced diet

  • get plenty of sleep – 7 to 8 hours is recommended

  • try reducing your stress by doing yoga or meditation

  • take painkillers such as ibuprofen or paracetamol to ease the pain

  • keep a diary of your symptoms for at least 2 to 3 menstrual cycles – you can take this to a GP appointment

Non-urgent advice: See a GP if:

  • things you can do to help are not working
  • your symptoms are affecting your daily life

A GP can advise you on treatments that can help.


Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

  • visit their website
  • use the NHS App
  • call them

Find out about using the NHS during COVID-19

Treating PMS (premenstrual syndrome)

As well as changes to your lifestyle, a GP can recommend treatments including:

If you still get symptoms after trying these treatments, you may be referred to a specialist.

This could be a gynaecologist, psychiatrist or counsellor.

Causes of PMS (premenstrual syndrome)

It’s not fully understood why women experience PMS.

But it may be because of changes in your hormone levels during the menstrual cycle.

Some women may be more affected by these changes than others.

Premenstrual dysphoric disorder (PMDD)

A small number of women may experience more severe symptoms of PMS known as premenstrual dysphoric disorder (PMDD).

Visit the Mind website for more information about PMDD.

Page last reviewed: 20 April 2018
Next review due: 20 April 2021

The relationship between premenstrual syndrome and anger

Pak J Med Sci. 2019 Mar-Apr; 35(2): 515–520.

Havva Yesildere Saglam

1Havva Yesildere Saglam, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey

Fatma Basar

2Fatma Basar, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Kutahya University of Health Sciences, Kutahya, Turkey

1Havva Yesildere Saglam, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey

2Fatma Basar, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Kutahya University of Health Sciences, Kutahya, Turkey

Correspondence: Fatma Basar, PhD, Assistant Professor, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey. Email: [email protected]

Received 2018 Dec 14; Revised 2019 Jan 13; Accepted 2019 Jan 28.

Copyright : © Pakistan Journal of Medical SciencesThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



Premenstrual Syndrome (PMS) is a significant disorder affecting the daily life of women of reproductive age. The aims of this study was to determine the PMS prevalence and the examination of the relationship between PMS and anger.


This was a cross sectional study. The study was carried out with 720 women between the ages of 15-49 living in the province of Kutahya, Turkey. A Personal Information Form, the Premenstrual Syndrome Scale (PMSS) and the State-Trait Anger Scale (STAS) were used to collect data.


The PMS prevalence was 48.75%. There was a statistically significant difference between the groups in terms of constant anger, anger-in, anger-out and anger control subscales (p <.001). The average scores of women with PMS for constant anger anger-in and anger-out was significantly higher. The anger control scores were at a significantly lower level.


Women with PMS had higher anger and lower anger control levels. It should be advisable to recommend anger control management and provide social support so these women can cope with the symptoms. The result of our study emphasizes the importance of careful assessment of anger in women with premenstrual symptoms.

Keywords: Anger, Premenstrual syndrome, Prevalence, Women


PMS is a disorder characterized by physical, behavioral and emotional symptoms, which increases in severity during the luteal phase of the menstrual cycle.1 While the prevalence of PMS varies, 47.8% (32.6%-62.9%) was reported in a meta-analysis study.2 In women, physical symptoms such as breast tenderness, fluid retention leading to weight gain, fatigue, nausea, and constipation can occur in the premenstrual period. Also psychological symptoms such as the tendency to become angry, irritable, tense, anxious, and restless as well as behavioral symptoms like depression, nervousness, and crying are seen.3 Over 40 million women worldwide experience these symptoms.4 While approximately 90% of women have only mild premenstrual symptoms, approximately 20% have to cope with symptoms that severely disrupt their daily lives.5 Anger and irritability are one of the most severe and persistent symptoms of PMS that adversely affect women.1 It is reported that women frequently complain of anger and irritability in the premenstrual period.6 However, the relationship between anger and PMS has not been fully elucidated. There is not enough work on this subject. It is thought that hormonal changes in the menstrual cycle (fluctuations in estrogen and progesterone levels) affect the mood of women and trigger negative emotions such as anger and irritability. But no definitive evidence has yet been obtained on the relationship between PMS symptomatology and anger. There are few studies analyzing the relationship between PMS and anger. But, it is known that women who are able to control anger in daily life lose their anger management ability in the premenstrual period.

The aim of this study was to find out the prevalence of PMS, a common disorder affecting women throughout their reproductive years, and the relationship between PMS and anger. This study can contribute to the literature regarding the relationship between PMS and anger because there are limited studies available.


This cross-sectional study population consisted of 8230 women aged 15-49, who are registered in a family health center. The sample size of the study was calculated as 311 women with a 95% confidence interval and a 5% error margin, assuming a 30% incidence of PMS in the community. However, due to reliability of the study and the possibility of data loss, 720 women were initially contacted. The women included in the study were identified by the use of randomization tables. Study inclusion criteria were:

  1. Age between 15-49 years old

  2. Literate

  3. Experiencing menstruation

  4. Able to communicate openly

  5. Agreeing to be in the study

Pregnant, lactating or menopausal women were not included in the study, as well as those who had undergone urogenital surgery or had a chronic disease. Furthermore, woman with psychiatric disturbances, difficulty establishing open and honest communication or who were outside the age parameters of 15-49 were not included in the study.

Data Collection

Data were collected between October and December 2016 in a family health center in the central district of Kutahya, which has the largest female population in the area. A personal Information Form, the Premenstrual Syndrome Scale (PMSS) and the State–Trait Anger Scale (STAS) were used to collect data.

Personal Information Form

The form includes questions about the women’s socio-demographic, fertility and menstruation characteristics.

Premenstrual Syndrome Scale (PMSS)

PMSS was developed by Gencdogan to determine the severity of premenstrual symptoms.7 The scale is a 5-point Likert-type measure consisting of 44 items. The options are as follows: None (1 point), Very little (2 points), Sometimes (3 points), Often (4 points), Continuous (5 points). The lowest PMSS score is 44 and the highest score is 220. More than 50% of the total PMSS scores were classified as PMS positive. Higher PMSS scores indicate greater symptom severity during PMS. The Cronbach’s alpha coefficient of the scale is 0.75.7 In this study, the Cronbach’s alpha coefficient of the scale was 0.95.

The State–Trait Anger Scale (STAS)

The scale was developed by Spielberger to determine the manner of anger expression. It was translated and adapted into Turkish by Ozer. 8 The scale is a Likert-type measure consisting of 34 items. The options are evaluated as follows: Never (1 point), A little (2 points), Quite (3 points) and Very (4 points). The scale consists of Constant Anger, Anger-in, Anger-out and Anger Control subscales. High scores from constant anger show a high level of anger. High scores from the anger-in subscale indicate suppressed anger and high scores from the anger-out subscale indicate anger control issues. A high score from the anger control subscale indicates that the anger can be controlled.

The Cronbach alpha coefficients for the scale were 0.79 for the “constant anger” subscale, 0.78 for the “anger-out subscale”, 0.62 for the “anger-in subscale” and 0.84 for the “anger control subscale”.8 The Cronbach alpha coefficients for the scale of this study were 0.84 for the “constant anger” subscale, 0.79 for the “anger-out subscale”, 0.66 for the “anger-in subscale” and 0.82 for the “anger control subscale”

Statistical Analysis

The data were analyzed using SPSS Statistic Version 22.0 (SPSS, Inc., Chicago, IL, USA). Chi square (X2) analysis was performed to examine the relationship between PMS status and categorical variables (socio-demographic characteristics). To understand the difference between the two groups, t-test (t) was used in independent groups. Pearson-Correlation test was applied in the analysis of the relationship between PMS scores and constant anger and anger expression style scores. The results were evaluated at a significance level of p<0.05 and p<0.001.

Ethical Considerations

The purpose of the study was explained to each woman and their consent obtained. The ethical approval was obtained from the Eskisehir Osmangazi University Ethics Committee for Non-Interventional Clinical Investigations (80558721/G-252) dated 15.08.2016. The research permit (66581584/730.08.03) dated 05.09.2016 was issued by the Public Health Directorate of Kutahya. The authors have no ethical conflicts to disclose.


The prevalence of PMS was 48.75%. There was no statistically significant difference between groups in terms of socio-demographic characteristics (except marital status) (p>0.05). 34.2% of the women with PMS were in the 15-24 age groups, 38.5% were university graduates, 60.7% were married and 73.2% were not working. Of the non-PMS women, 37.4% were in the 25-34 age group, 38.2% were university graduates, 68.3% were married, and 73.7% were not working ().


Socio-demographic characteristics of the women.

Without PMS (51.25%) With PMS (48.75%)

Variable n=369 % n =351 % X2 p
 Age 15-24 100 27.1 120 34.2 4.373 0.112
 Age 25-34 138 37.4 115 32.8
 Age 35-49 131 35.5 116 33.0
Educational Status
 Primary school 111 30.1 103 29.3 0.049 0.976
 High school 117 31.7 113 32.2
 University and above 141 38.2 135 38.5
Working status
 Yes 97 26.3 94 26.8 0.022 0.881
 No 272 73.7 257 73.2
Income Status
 Income more than expenses 54 14.6 38 10.8 4,060 0.131
 Income matches expenses 255 69.1 240 68.4
 Income less than expenses 60 16.3 73 20.8
Marital Status
 Single 117 31.7 138 39.3 4.553 0.033*
 Married 252 68.3 213 60.7

The mean age of first menarche of women with PMS is 13.30 ± 1.49, the menstrual cycle interval was 26.75 ± 4.38 days and the duration in days of menstrual bleeding is 6.10 ± 1.50. Women without PMS have a mean age at first menarche of 13.40 ± 1.47, a menstrual cycle interval of 26.32 ± 3.99 days and duration in days of menstrual bleeding of 6.15 ± 1.62. 71.5% of women with PMS have a regular menstrual cycle, while 86% have dysmenorrhea and 81.3% of Non-PMS Women has regular menstrual cycle with 67.2% dysmenorrhea. There was no statistically significant difference between the groups in terms of menarche age, menstrual cycle interval and menstrual bleeding durations (p>0.05). There is a statistically significant difference between the groups with and without PMS in terms of regular menstrual cycle, dysmenorrhea and the number of pregnancies (p<0.05). An irregular menstrual cycle, dysmenorrhea and no pregnancies were associated with PMS ().


Menstruation and fertility characteristics of the women.

Variable Without PMS With PMS t p

Error! Reference source not found.±SD Error! Reference source not found.±SD
Age of menarche 13.40±1.47 13.30±1.49 0.896 0.370
Menstrual cycle interval 26.32±3.99 26.75±4.38 -1.367 0.172
Menstrual bleeding duration in days 6.15±1.62 6.10±1.50 0.396 0.692

Variable Without PMS With PMS X2 p

n=369 % n =351 %

Menstrual cycle regularity
 Regular 300 813 251 715 9.600 0.002*
 Irregular 69 18.7 100 28.5
 Yes 248 67.2 302 86.0 35.368 <0.001**
 No 121 32.8 49 14.0
Number of pregnancies
 N/A 126 34.1 161 45.8 11.797 0.008*
 1 77 20.9 54 15.4
 2 97 26.3 87 24.8
 3 or more 69 18.7 49 14.0

The mean scores of women with PMS were 21.87 ± 5.81 for constant anger, 16.93 ± 3.97 for anger-in, 16.03 ± 4.53 for anger-out and 20.22 ± 4.39 for anger control. The mean score of Non-PMS Women were 17.98 ± 5.14 for constant anger, 14.75 ± 3.76 for anger-in, 13.98 ± 3.74 for anger-out and 21.40 ± 4.79 for anger control. There was a statistically significant difference between the groups in terms of constant anger, anger-in, anger-out and anger control subscales (p<0.001). The average scores of women with PMS for constant anger anger-in and anger-out was significantly higher. In addition, the anger control scores were at a significantly lower level ().


The relationship between PMS and the STAS subscales score averages.

Trait Anger Anger-in Anger-out Anger Control

Error! Reference source not found.±SD Error! Reference source not found.±SD Error! Reference source not found.±SD Error! Reference source not found.±SD
Without PMS 17.98±5.14 14.75±3.76 13.98±3.74 21.40±4.79
With PMS 21.87±5.81 16.93±3.97 16.03±4.53 20.22±4.39
p<0.001 p<0.001 p<0.001 p= 0.001
t=-9.495 t=-7.565 t=-6.573 t=3.451

There was a statistically significant positive moderate correlation between the total score from PMSS and the scores obtained from the subscales for constant anger, anger-in and anger-out (p<0.001). There was a statistically significant negative weak correlation between the total score from PMS and the scores from the subscales for anger control (p=0.001). There was a significant relationship between the PMS scores of the women and the scores for constant anger, anger-in, anger-out, and anger control ().


The relationship between women’s PMSS scores and STAS subscale scores.

State–Trait Anger Scale Score

Trait Anger Anger-in Anger-out Anger Control
PMSS Score r 0.479 0.356 0.348 -0.181
p p<0.001 p<0.001 p<0.001 p<0.001


The study results demonstrated that approximately half of the women suffered PMS (48.75%). Rezaa H et al. found the prevalence of PMS was 52.9%.9 In a meta-analysis study, the prevalence of PMS was reported to be 47.8%.4 In 2 different research studies carried out on women in the reproductive age group between 15-49 years in Turkey, the prevalence of PMS was seen to be 40% and 90% respectively.10,11

In this study, there was a statistically significant difference between the presence of PMS and anger (p<0.05). Women with PMS had higher anger and lower anger control levels. In literature it was reported that anger and irritability are one of the most severe and persistent symptoms of PMS.6,12,13 But there are few studies analyzing the relationship between PMS and anger.12-14 Ducasse D et al.5 found an impulsive-aggressive pattern of personality in women with PMS independently from the time of the menstrual cycle. Interestingly, trait anger remained associated with PMS independently of every other personality traits. In a study of Bostanci, analyzing the anger and anxiety levels of healthy and PMS-women, PMS-women were found to have consistently higher scores in anger, anger-in, anger-out and lower scores in terms of anger control.14 Ozturk Can H et al. found in a study with teachers that the anger levels of women with PMS are high but there was no significant relationship between PMS and anger control scores.15 Reihane et al. found the mean scores of psychiatric symptoms (Depression, Anxiety, Aggression, Interpersonal sensitivity) in the PMS group were significantly higher than the healthy group. There was a significant difference in mean score of depression, anxiety, aggression and interpersonal sensitivity between the 3rd and the 13th day of the cycle.16

The correlation between women’s PMS scores and anger scores were significant in this study. Similarly, the study of Soyda Akyol E et al. showed that PMS scores and anger scores were associated with premenstrual dysphoric disorder.17 Bowen R et al. found that women with PMS had more nervousness and depression. These differences were present regardless of the late luteal phase.18 Van der Ploeg investigated premenstrual affect changes with 844 women and found that women with PMS had higher anxiety, anger and depression scores.19 In the Hartlage and Arduino study, premenstrual disorders are also associated with anger.12 Similar to the literature, our results support a relationship between PMS and anger. Except these studies, there is no study examining the relationship between PMS and anger in the literature.


PMS are common disorders among women. As anger is among the most common symptoms in the premenstrual period, the alleviation of anger levels could increase the quality of life for women. In this context, it may be advisable to recommend anger control management and provide social support so these women can cope with the symptoms. The result of our study emphasizes the importance of careful assessment of anger in women with premenstrual symptoms. More advanced studies are needed to provide definitive evidence about the relationship between PMS and anger and to eliminate the gaps in the literature.

Author`s Contribution

HYS conceived, designed, did data collection, manuscript writing and final approval of manuscript.

FB conceived, designed, did review, editing of manuscript and final approval of manuscript.


Declaration of Interests: The authors have declared that no conflicts interests exist

Grant support: None.


1. Walsh S, Ismaili E, Naheed B, O’Brien S. Diagnosis, pathophysiology and management of premenstrual syndrome. Obstet Gynaecol. 2015;17(2):99–104. doi:10.1111/tog.12180. [Google Scholar]2. Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S. Epidemiology of Premenstrual Syndrome (PMS)-A systematic review and meta-analysis study. J Clin Diagn Res. 2014;8(2):106–109. doi:10.7860/JCDR/2014/8024.4021. [PMC free article] [PubMed] [Google Scholar]3. Elnagar MAE-R, Awed HAEM. Self–Care Measures Regarding Premenstrual Syndrome among Female Nursing Students. Int J Nurs. 2015;5(2):1–10. doi:10.15520/ijnd.2015.vol5.iss02.53.01-10. [Google Scholar]4. Ezeh O, Ezeh C. Prevalence of prementrual syndrome and copıng strategıes among school girls. Afr J Psychol Stud Soc Issues. 2016;19(2):111–119. [Google Scholar]5. Ducasse D, Jaussent I, Olie E, Guillaume S, Lopez-Castroman J, Courtet P. Personality traits of suicidality are associated with premenstrual syndrome and premenstrual dysphoric disorder in a suicidal women sample. PloS One. 2016;11(2):1–19. doi:10.1371/journal.pone.014⇍. [PMC free article] [PubMed] [Google Scholar]6. Raval CM, Panchal BN, Tiwari DS, Vala AU, Bhatt RB. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian J Psychiatry. 2016;58(2):164. doi:10.4103/0019-5545.183796. [PMC free article] [PubMed] [Google Scholar]7. Gencdogan B. A new scale for premenstrual syndrome. Psychiatry Turkey. 2006;8(2):81–87. [Google Scholar]8. Ozer AK. A preliminary study of the State–Trait Anger Scale (STAS) Turk Psikoloji Dergisi. 1994;9(31):26–35. [Google Scholar]9. Rezaee H, Amidi Mazaheri M, Sadrhashemi F. Premenstrual Syndrome and Spousal Social Support among Women in Isfahan City (Iran) Glob J Health Sci. 2017;9(4):233–239. doi:10.5539/gjhs.v9n4p233. [Google Scholar]10. Erbil N, Bolukbasi N, Tolan S, Uysal F. Determination of the premenstrual syndrome and affecting factors among married women. J Human Sci. 2011;8:427–438. [Google Scholar]11. Adiguzel H, Taskin O, Danaci AE. The symptomatology and prevalence of symptoms of premenstrual syndrome in Manisa Turkey. Turk J Psychiatry. 2007;18:215–222. [PubMed] [Google Scholar]12. Hartlage SA, Arduino KE. Toward the content validity of premenstrual dysphoric disorder:do anger and irritability more than depressed mood represent treatment-seekers’experiences? Psychological Rep. 2002;90(1):189–202. doi:10.2466/pr0.2002.90.1.189. [PubMed] [Google Scholar]13. Steiner M, Peer M, Palova E, Freeman EW, Macdougall M, Soares CN. The premenstrual symptoms screening tool revised for adolescents (PSST-A):prevalence of severe PMS and premenstrual dysphoric disorder in adolescents. Arch Women’s Ment Health. 2011;14(1):77–81. doi:10.1007/s00737-010-0202-2. [PubMed] [Google Scholar]14. Bostanci A. Master’s Thesis. Istanbul: Psychology Department, Maltepe University; 2010. Evaluation of anger and anxiety levels in premenstrual syndrome. [Google Scholar]15. Ozturk Can H, Baykal Akmese Z, Durmus B. Premenstrual Syndrome Incidence And Trait Anger And Anger Style Between The Relatıonships In The Prımary School Teachers. E-J New World Sci Acad. 2015;10(1):1–14. doi:10.12739/NWSA.2015.10.1.4B0005. [Google Scholar]16. Firoozi R, Kafi M, Salehi I, Shirmohammadi M. The Relationship between Severity of Premenstrual Syndrome and Psychiatric Symptoms. Iran J Psychiatry. 2012;7:36–40. [PMC free article] [PubMed] [Google Scholar]17. Soyda Akyol E, Karakaya Arısoy EO, Caykoylu A. Anger in women with premenstrual dysphoric disorder:its relations with premenstrual dysphoric disorder and sociodemographic and clinical variables. Compr Psychiatry. 2013;54(7):850–855. doi:10.1016/j.comppsych.2013.03.013. [PubMed] [Google Scholar]18. Bowen R, Bowen A, Baetz M, Wagner J, Pierson R. Mood instability in women with premenstrual syndrome. J Obstet Gynaecol Can. 2011;33(9):927–934. doi:10.1016/S1701-2163(16)35018-6. [PubMed] [Google Scholar]19. Van der Ploeg HM. Emotional states and the premenstrual syndrome. Pers Individ Differ. 1987;8(1):95–100. doi:10.1016/0191-8869(87)90015-8. [Google Scholar]

5 Steps For Relieving Your PMS Symptoms

In the days before menstruation begins, many women navigate body aches, cramps, mood swings, even constipation and diarrhea. A subset of women have premenstrual symptoms so severe that they interfere with daily life.

“True premenstrual syndrome, or PMS, describes emotional and physical changes in the days leading up to a woman’s period that interfere with her ability to perform daily activities,” says Page Animadu, M.D., an obstetrician/gynecologist at Henry Ford Health System. “So while many women have premenstrual symptoms, only about 3 to 8% experience symptoms that are so severe that they can’t perform daily activities.”

Premenstrual Syndrome Explained

The menstrual cycle is typically described as a 28-day cycle with four phases. Each phase requires a woman’s body to produce different hormones, each of which comes with its own set of physical and emotional changes.

Here’s how the phases break down:

  • Menstrual phase: Days 1–5
  • Follicular phase: Days 6–13
  • Ovulation: Days 14–16
  • Luteal phase: Days 16–28

PMS is a syndrome caused by changing hormone levels during the luteal phase. After ovulation, women may feel tired, cranky and off-kilter. Those symptoms progress as you get closer to menstruation.

“Sometimes women are so fatigued they aren’t able to work or even concentrate,” Dr. Animadu says.

Symptoms include:

  • Swollen or tender breasts
  • Constipation or diarrhea
  • Bloating
  • Cramping
  • Headaches
  • Mood swings
  • Fatigue
  • Difficulty concentrating

How To Manage PMS

Whether you’re trying to conceive or not, your body goes through the same cycle each month to prepare itself to support a pregnancy. Producing the best egg, releasing it and providing an environment suitable for a baby requires a surge of hormones like estrogen and progesterone followed by a sudden drop. That drop can cause a decrease in the body’s production of feel-good hormones, such as serotonin.

“Women need to be assured that nothing is wrong with them; they’re just experiencing a physiological response to the drop in hormones that cause joy and happiness,” Dr. Animadu says.

There are several things you can do to help compensate for changing hormone levels.

  1. Eat a balanced diet. Cleaning up your diet can significantly reduce PMS symptoms. Eat a diet that’s high in fruits, vegetables (especially leafy greens), legumes and whole grains, as well as healthy fats like omega-3s and omega-6s. Limit processed foods and saturated fats. “Processed foods can make you feel bloated,” Dr. Animadu says. Not sure you’re getting the nutrients you need? Talk to a registered dietitian to help fill the gaps.
  2. Exercise regularly. While it may seem counterintuitive, exercise can help keep PMS at bay. Not only is exercise a proven mood booster, it can also help you feel more energized. Plus, exercise helps reduce stress and stave off chronic disease.
  3. Get sufficient sleep. It’s important to get more sleep in the days before your period begins. “If you usually need seven hours of sleep each night, try to get eight,” suggests Dr. Animadu. “When you’re tired, it’s more difficult to concentrate and you can become more easily agitated.”
  4. Try supplements. A variety of different vitamins and minerals can help ease PMS symptoms. A few of the most popular include vitamin B6 (for energy), vitamin D (for mood lifting) and magnesium (for PMS-induced headaches). “Unfortunately, there’s not a one-size-fits-all nutrient mix to help alleviate PMS,” Dr. Animadu says. “But there are a plethora of nutrients that can make a difference.” Consult with a healthcare professional before introducing supplements. If you get too much of one nutrient, it can undermine your body’s ability to absorb others.
  5. Relax. When you’re premenstrual, practicing relaxation techniques can help you feel better, both emotionally and physically. If you’re suffering from cramps, you can help tense muscles relax with a heating pad, warm bath or even certain essential oils. The key is to find what works for you and stick with it.

PMS Treatment Options

If you’re still suffering from severe PMS symptoms after adopting the above strategies, see your healthcare provider. While lifestyle changes are the first-line recommendation for PMS, there are plenty of prescription and over-the-counter treatments available to help.

“Combined oral contraception (birth control), including estrogen and progestin, can help alleviate PMS symptoms,” Dr. Animadu says. “If you don’t notice an improvement within three cycles, your doctor may recommend antidepressants — either continuous or only during the luteal phase.”

It’s important to note that some women have a more severe form of PMS called premenstrual dysphoric disorder, or PMDD. PMDD can cause severe changes in mood in the days before your period begins. Treatment for both PMS and PMDD is largely the same.

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To find a doctor or certified nurse midwife at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936). 

Dr. Page Animadu is an obstetrician and gynecologist who sees patients at Henry Ford Medical Center – Detroit Northwest.

Tags: Women’s Health, Page Animadu

How to stay productive in different phases of the menstrual cycle

During menstruation, as well as the “terrible and terrible” premenstrual period, doing something can be difficult: heaviness, fatigue, bad mood pile on. But the changes in the emotional background are not limited to this. And if you clearly understand how the menstrual cycle works and what happens to women’s well-being in each of its phases, you can learn to plan your life so as to remain productive.

Why it is important to understand your physiology and act in tandem with it

The menstrual cycle and menstruation itself have long been a taboo “indecent” topic. Any discomfort and mood swings associated with changes in hormone levels were presented as a flaw and a deviation from the norm, so women got used to hiding them, tried not to pay attention to them and act as if there were no cycle.

Indeed, hormonal “slides” can give some women quite unpleasant sensations, both emotional and physical.But learning to understand and feel these processes is much more effective than ignoring them or pretending that nothing is happening.

How the menstrual cycle works and how to plan things in different phases

Three main hormones are involved in the regulation of the normal menstrual cycle : estrogen, progesterone and testosterone. Under their influence, the female body goes through four main phases every month.

1. Menstruation itself

What happens

This is the period from the first to the last day of menstrual bleeding, its usual duration is 3-7 days.During menstruation, levels of all three hormones remain low.

How it affects productivity

During this period, attention, energy and creativity are almost at zero. The woman feels tired, lethargic, drowsy, absent-minded.

How to plan tasks
  • If circumstances permit, take a day off, lie down, sleep well.
  • If you can’t give up, give yourself some relaxation and work at a calm pace.
  • Try to postpone activities and projects that require high concentration and total commitment.Take care of yourself and find an opportunity to recover.
  • Do not schedule important meetings for these days.

2. Follicular phase

What happens

The body begins to prepare for a possible pregnancy, the thickness of the uterine lining increases. The level of estrogen and progesterone rises sharply. Testosterone levels remain relatively low and rise slightly towards the end of the follicular phase. On average, it lasts 16 days.

How it affects productivity

With the rise in estrogen levels, productivity also skyrockets.The woman feels a surge of energy, becomes more concentrated and active. This is the best time to learn, to start new projects, to make a leap towards your goal.

How to plan tasks
  • Get creative, generate ideas, brainstorm.
  • Write down the big and difficult tasks that you put off at the very beginning of the cycle.
  • Spend time on difficult and large-scale projects over which you have to smash your head.
  • Learn.

In a word, use these two weeks to the fullest.

3. Ovulation

What happens

In the ovary, the membrane of the mature follicle is torn, the egg is released into the abdominal cavity. This process takes about 24 hours, but changes in hormone levels – estrogen and testosterone peaks – stretch for about 3-4 days.

How it affects productivity

Concentration, energy, attention, creativity are still high.Unless, of course, you have to endure painful sensations.

How to plan tasks
  • Important meetings and difficult conversations that require determination and assertiveness are best scheduled for these days.
  • Ovulation is the most “extraverted” period, when the topic will be new acquaintances, interesting collaborations, joint creative projects, communication with friends.
  • Try using a burst of courage and activity to finish off a long project or ask for a raise.

4. Luteal phase

What happens

If the egg remains unfertilized and pregnancy does not occur, the uterus prepares to reject the functional part of the endometrium. The level of testosterone decreases, estrogen and progesterone – first increases (progesterone at the beginning of the luteal phase reaches its peak), and then drops sharply. The luteal phase lasts 12-14 days.

How it affects productivity

Due to high levels of progesterone, the level of activity decreases – there comes a quiet period when you want to spend time alone with yourself and relax.Sometimes in the luteal phase, women become whiny and irritable, their appetite increases.

How to Schedule Tasks
  • If possible, prefer tasks you can work on alone over group tasks.
  • Take care of yourself: sleep at least 7 hours a day, rest if tired.
  • Choose calm routine tasks that do not require a lot of effort and attention: answer standard letters, edit a plan or report, put documents in order, draw up lists and tables, collect the necessary information.
  • Use this time to be in touch with yourself, analyze recent events, plan things for the coming weeks.

How to track the phases of the menstrual cycle

The safest and easiest way is to keep a menstrual calendar. You can do this on paper by drawing a plate yourself or by printing it from the Internet, or you can use special applications.

The beginning of the cycle is the first day of menstrual bleeding.It is the beginning and end of menstruation that is marked on the calendar.

Ovulation, if you do not feel it, can be determined by making a special test. It is sold at the pharmacy. In women with a regular cycle, ovulation occurs exactly in the middle between periods. Accordingly, the follicular phase is the interval between the last day of menstruation and ovulation, and the luteal phase is between ovulation and the beginning of the cycle.

You can also use your menstrual calendar to keep track of how you feel on a particular day, and take short notes about your mood and productivity.This will allow you to more accurately define your own rhythms. In addition, the menstrual calendar is important in order to detect gynecological diseases or pregnancy in time.

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“Uncontrolled hormones”: common myths and truth about PMS

PMS is confused with menstruation, attributed to him all the changes in a woman’s mood, and then they believe that he turns a woman into an uncontrollable monster, then that he does not exist at all.Gazeta.Ru has dealt with popular myths about this condition.

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PMS and menstruation are the same

PMS – premenstrual syndrome – occurs 2-10 days before menstruation.Perhaps those who confuse these terms do not know how the abbreviation stands. Be that as it may, women, showing a bad mood, often hear in response comments about the onset of menstruation.

Ancient physicians spoke about the “painful state” of women before menstruation.

For the first time, the scientific basis for PMS was summed up in 1931 by gynecologist Robert Frank, associating this condition with a decrease in progesterone levels. He, however, noticed the influence of the period before menstruation mainly on behavior – his patients at this time committed “stupid and reckless acts.”Only by the 1960-1970s, the British endocrinologist Katharina Dalton brought together not only behavioral, but also physical symptoms and found their possible cause – a change in the ratio of hormones in the body.

The widespread dissemination of information about PMS played a cruel joke – women during this period were almost demonized, considering them absolutely uncontrollable. For example, Dr. Edgar Berman, a member of the National Priorities Committee of the US Democratic Party, stated that women are unsuitable for managerial positions due to imbalances due to “uncontrolled hormones.”

PMS is when a woman becomes nervous before her period and cries a lot

PMS has over 150 possible symptoms, and not all of them are related to mood. They also include changes in eating habits, swelling, bloating, clumsiness, headaches, nausea and vomiting, and even pain in the heart. Emotional symptoms come to the fore simply because they are visible to others.

PMS occurs due to fluctuations in hormones

The causes of PMS have not been finally established to this day.Hormonal theory is prevalent, but there are other options. So, PMS is associated with a deficiency of calcium and magnesium, a decrease in serotonin levels (by the way, depression is also associated with it), the body’s susceptibility to hormones (and not their concentration), a lack of vitamin B6, a genetic predisposition and even a woman’s allergic reaction to her own progesterone …

“It all depends on the mental state of a woman at one time or another. For example, when everything is calm at work and at home, then, of course, PMS will not be so pronounced,” she told the Gazeta.Ru “obstetrician-gynecologist and surgeon Aigul Azimova. – I think that it is stupid to write off everything on hormones. The level of hormones cannot influence the woman’s condition so much. All changes that occur are absolutely functional monthly normal state. Therefore, more to look widely at this question for both the woman and the doctor. ”

In addition, in 2016, American experts suggested that the presence of PMS symptoms may be associated with an acute inflammatory process, the biomarker of which is C-reactive protein (CRP).After examining more than 3,000 women, they found that those who complained of sudden mood swings, colic and bloating, back pain, increased appetite and chest pain before menstruation, in most cases, CRP was increased.

“Most women experience some form of PMS symptoms. Recognizing that PMS is associated with an underlying inflammatory process opens up new avenues for treatment and prevention,” commented the study, where it was published, editor of the Journal of Women’s Health, Dr. Susan Korshtein.

5 facts about menstruation that you did not know (prices for services)

You probably think you know all about this aspect of a woman’s life.

While there is at least one problem related to the menstrual cycle, which neither you nor your experienced friends are able to solve. This is not surprising for gynecologists who are ready to answer the most common questions of their patients.

1. Why do I have premenstrual syndrome?

PMS, or premenstrual syndrome, happens because the body is sensitive to hormonal changes.During the week or 10 days before your period, progesterone and estrogen levels change dramatically. Symptoms may include mood swings, headaches, chest tightness, heaviness in the lower abdomen, and fatigue.

At least 90% of women experience this condition before their period, but about 20% experience symptoms so pronounced that they interfere with their normal activities and relationships.

Whatever your premenstrual syndrome, use the following advice from your gynecologists.Drink plenty of water. Eat small meals every two hours and refrain from alcohol and caffeine.

If mood swings are a problem, take calcium supplements, but your doctor should prescribe them. A high intake of calcium and vitamin D may reduce the risk of PMS, according to a study in more than 3,000 women. Those who drank about four servings a day of low-fat milk or orange juice had mild premenstrual syndrome. Some experts also argue that vitamin D and calcium deficiencies increase PMS symptoms.

2. Why are my periods irregular?

Some women do not ovulate regularly and therefore do not have regular periods either. Stress and illness can also have an extremely negative impact on the cycle.

But to talk about irregular periods, you need to know what a regular cycle is. A regular cycle means that from the first day of your period to the next day, 21 to 35 days pass each time.

Often women feel that they have an irregular cycle if their periods do not start on the same day.But there is no reason to worry. An error of a couple of days is quite acceptable. Sometimes women don’t remember exactly when the previous period started. Therefore, gynecologists advise keeping a menstrual calendar with an exact indication of the beginning of the first and last day of menstruation.

Other causes of irregular periods, besides pregnancy, are excessive weight gain or, conversely, sudden weight loss, malnutrition, exercise regimen and hormonal problems.

If your cycle does not return to normal next month, you should talk to your gynecologist.

3. Can you get pregnant during your period?

Possible, but unlikely. The main thing to know is whether it was menstruation or discharge between periods. Some women experience bloody discharge during ovulation, when there is every chance of getting pregnant.

If a woman had sex in the last days of her period and ovulation occurred in 2-3 days, and the sperm still remained in the vagina, it is possible to become pregnant, but extremely unlikely.

4. If my period starts on time, does it mean I’m not pregnant?

You cannot be 100% sure. Since often in the early stages of pregnancy there may be bleeding. And the difference between them and menstruation is difficult to notice, but discharge during menstruation usually progresses.

Gynecologists advise to take a pregnancy test and pay attention to other symptoms – nausea and dizziness. Ultrasound will give accurate results.

5. If you do not change the tampon for a long time, does the risk of toxic shock syndrome increase?

Toxic shock syndrome is a life-threatening illness caused by a bacterial infection.Microorganisms produce toxins that poison the body.

TSS is marked by a sharp rise in temperature, chills, diarrhea, vomiting, muscle pain, and a rash. Even well-absorbent tampons, if left unchanged for a long time, become a breeding ground for bacteria that begin to actively multiply.

How long can the tampon be used? Always follow the included instructions. Depending on the abundance of discharge and the quality of the tampons, some need to be changed every two hours, others can be used for 4-6 hours.But if you develop signs of toxic shock, never self-medicate – see your doctor right away.

90,000 Premenstrual Syndrome (PMS) in Women: Signs and Symptoms

Do you often have a pulling menstrual pain in the lower abdomen? Feeling extreme mood swings and extreme fatigue? You are not alone in this – we all go through this during menstruation. Understanding the reasons and following a few rules of thumb will help you feel good on critical days – just like any other day.

Do you often wonder what exactly in your body causes these not very strong, but annoying, and sometimes very serious menstrual pains? Let’s take a quick look at the causes of menstruation pain.

Dragging menstrual pain in the lower abdomen often appears at the beginning of menstruation, after the egg leaves the ovaries and passes through the fallopian tubes. Your uterus begins to contract to speed up the separation of the upper layers of mucose, which causes painful menstrual cramps.

You’ve probably heard that these hormones are responsible for mood swings during the menstrual cycle. Depending on the different levels of progesterone and estrogen that may affect the well-being of serotonin in the brain, you may feel tired and irritated during your period, or you may feel energized and in a good mood.

Here are 5 basic simple rules to help you reduce pain during your period and feel as good as possible on these days and any other day:


During periods of pain during menstruation, it is not time to overload your body, however, certain light to moderate-intensity outdoor exercise, such as walking, cycling or swimming, often works wonders.The movement will have a positive effect on your well-being and will help to stretch your abdominal muscles and reduce menstrual pain.

Relax and keep warm!

Place a bottle of warm water on your stomach when lying on the couch, or take a warm shower or bath to improve circulation. Heat dilates blood vessels and relieves tension. What you should not do for pain during your period is to take hot baths and go to the bathhouse.

Pamper yourself and cheer yourself up!

Choose a time and go out with friends or watch your favorite movie.Treat yourself to delicious and healthy food. Vegetables and fruits contain trace elements necessary for the female body during pain during menstruation: B vitamins, calcium, magnesium, vitamin E. By the way, dark chocolate has the ability to reduce appetite and increase serotonin levels.

Stay away from coffee!

Even if drinking coffee every day feels as natural to you as breathing, you should avoid drinking coffee for menstrual cramps. Caffeine constricts blood vessels and can worsen pain during menstruation.In addition, it is known to have a stimulating effect on the nervous system, and in combination with natural mood swings during menstruation, this can lead to a deterioration in your well-being.

Sleep a lot!

There are many reasons why good sleep is important – it maintains hormone and blood sugar levels and gives the body time to recover and forget about menstrual cramps. Sleep for 20-30 minutes after lunch to recuperate. Using a hot water bottle or heating pad for relaxation will make your nighttime or daytime sleep more pleasant during your period.

Premenstrual Dysphoric Disorder (PMDD) – Bayer Pharmaceuticals Russia

Monthly Crisis

Mood swings, depression, irritability, incontinence, and physical manifestations such as breast engorgement and feeling “bloated” are symptoms that many women regularly experience during your menstrual cycle. In medical terminology, this condition is referred to as premenstrual syndrome (PMS).

According to various estimates, from 3% to 8% of all women of reproductive age are subject to severe premenstrual disorders, which are called premenstrual dysphoric disorder or PMDD.This term describes a condition characterized by the simultaneous presence of at least five classic PMS symptoms – and in a particularly severe form – for example, extremely depressed mood accompanied by a feeling of deep despair, or severe irritability.

Symptoms of premenstrual dysphoric disorder can be very intense and prolonged, up to two weeks of the menstrual cycle. Symptoms of PMDD usually have a negative impact on a woman’s family and social life and limit her ability to work.

Because symptoms are at first glance nonspecific and, in addition, many consider them a normal part of their menstrual cycle, most women with PMDD are not diagnosed.

Susceptibility to hormones may be a factor in PMDD.

It is unclear why some women have PMDD and others do not. For a long time it was suspected that the reason lies in the different concentration of hormones in the body, but now we know that women with PMDD symptoms in this regard are practically no different from women without them.

Another suggestion was that it is not the concentration of hormones that is decisive, but mainly the susceptibility of certain receptors of the central nervous system to these hormones. In particular, susceptibility to the hormone progesterone and the increase in progesterone levels after ovulation may play a key role.

Possible solution – suitable contraceptive

To date, two different approaches have been developed based on scientific evidence.One of them is the direct effect on the receptors of the central nervous system. For example, some antidepressants may be prescribed to treat the emotional symptoms of PMDD.

Other therapeutic approaches are aimed at preventing ovulation Suppression of ovulation can be achieved, for example, using combined oral contraceptives (COCs). The problem is that COCs contain a synthetic progesterone component (progestin), which, like natural progesterone, can aggravate or even cause PMDD symptoms despite ovulation suppression.

Today, there are those on the hormonal contraceptive market that, in addition to contraception, have a registered indication – PMDD treatment. These drugs contain a progestin, which has antimineralocorticoid properties, which are mainly responsible for the relief of PMDD symptoms.

Patient Information

Every body responds to drugs and treatments differently. Therefore, it is not possible to say which of them will be most effective for you.Check with your healthcare professional.

Why women over the age of 50 often have mood changes

Menopause is a period of physiological changes that are usually accompanied by emotional reactions. The realization of the end of childbearing can be bitter and painful, and the changes that occur cause many anxiety about physical attractiveness. For most women, menopause passes without the development of severe psychological disturbances, but mood swings can significantly reduce the quality of life.

There are several stages of menopause, each with specific symptoms. Perimenopause is a period in which a decrease in the level of estrogen in the body is noted. At this time, unpleasant symptoms such as mood swings and hot flashes begin to appear. When a woman does not have a menstrual cycle for 12 months, menopause begins, followed by postmenopause. In this case, the emotional symptoms change somewhat. From beginning to end, the entire process described can take 2–10 years.

According to the North American Menopause Society, USA, 23% of women experience mood swings before, during, or after menopause. For women taking hormonal drugs or undergoing uterine removal, emotional fluctuations are the first sign of the onset of menopause.

Many of the emotional responses are associated with a decrease in estrogen levels in a woman’s body during menopause. This is especially true for irritability, fatigue, stress, forgetfulness, anxiety and impaired concentration.

Scientists identify 5 of the most common emotional symptoms of menopause.

Irritability. About 70% of women report irritability as a major emotional problem in the early stages of menopause. At the same time, there is a decrease in tolerance and some things that did not cause concern before begin to annoy.

Depression is a common and severe “side effect” of menopause that affects 1 in 5 women during this period.

Anxiety.Many women report tension, anxiety, anxiety, and panic attacks during menopause. Some women develop anxiety for the first time at this age. If such a symptom has already been noted in the past, its severity may increase during menopause.

Sentimentality and episodes of tearfulness. With a change in hormonal levels, a woman may cry in a situation that has not previously caused her such emotions. Tears help reduce stress and relieve emotional stress.

Insomnia aggravates mood swings, as it reduces the quality of a person’s life. During menopause, this disorder is experienced by 40-50% of women.

According to experts, there are 2 main risk factors for the occurrence of significant mood swings during menopause: severe premenstrual syndrome and episodes of depression and other mental disorders in youth.

Some women report that during menopause they develop forgetfulness and impaired concentration.There is scientific evidence of cognitive decline during this period. Usually, these problems disappear when the postmenopausal period comes.

To cope with mood swings, scientists recommend seeking psychological or medical help. Hormone therapy is commonly used to treat menopausal symptoms, but this method is associated with certain health risks. Bioidentical hormones can also be obtained from certain foods, such as soy and fennel contain phytoestrogens, which are plant analogues of female sex hormones.Several types of antidepressants are helpful for hot flashes and depression.

The best way to combat the unpleasant symptoms of menopause is to combine standard treatment and a healthy lifestyle. Scientists have found that physical activity, diet, healthy sleep, and friendly support can help women cope with emotional symptoms. It is believed that Chinese gymnastics, yoga and meditation can improve mood, reduce stress, irritability and other manifestations of menopause.

Based on materials from www.newsmedicalnet.com

90,000 Mood swings in women, disorders

Frequent mood swings in women are both a reason for jokes and a cause for concern. And mood swings are often indicative of disorders in the functioning of body systems. They bring a lot of inconvenience to a woman’s life: emotional instability does not allow to reasonably cope with stress, does not make it possible to make the desired impression on loved ones, colleagues, partners.Mood swings should not be ignored – it is fraught with a worsening of these manifestations, and is also dangerous to health. After all, we can talk about a serious hormonal imbalance or the presence of a mental disorder.

Men can also suffer from mood swings – from aggression to apathy, from joy to sadness – but, oddly enough, the stronger sex is less prone to emotional swings.

In this material, we talk about how frequent mood swings can manifest, what causes it, how to correctly approach diagnostic issues and how we, the doctors of the Marina Ryabus clinic, help patients cope with this problem.Expert commentary on the material is given by the gynecologist Ekaterina Nikolaevna Kozlova.

Gynecologist, oncologist, surgeon

Mood swings in women can be observed at different age periods and, as a rule, in addition to external factors, the state of the hormonal background is of great importance. During periods of greatest hormonal changes, such as puberty, postpartum or premenopausal, these changes are observed more often.It is important that the woman does not accept this as the norm, but turns to a gynecologist who would help her with the selection of corrective therapy. In one case, this may be a recommendation of a behavioral nature (sleep and wakefulness, nutrition, physical activity), in the other – the appointment of suppression therapy or hormonal drugs. Quite often, in young active women, a bad mood is accompanied by a feeling of constant fatigue, despite good rest. This is an alarming symptom of chronic stress, which leads to “exhaustion” of the adrenal glands and long-term rehabilitation therapy.

Symptoms of mood swings

The main sign of mood swings is an inadequate response to circumstances. In other words, a situation in which a calm person would act rationally, in a person with sudden mood swings, will cause an inadequately intense or, conversely, passive reaction. Emotional instability manifests itself:

  • decreased concentration of attention; 90,030 90,029 appetite disorders;
  • tearfulness;
  • hysteria;
  • drowsiness;
  • Sleep disorders, insomnia;
  • nervousness;
  • apathy;
  • decreased performance.

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Types of mood swings

Globally, mood swings are usually divided by:

  1. cyclothymic – affective disorders associated with a sharp transition from high mood to apathy;
  2. depressive – chronic mood disorders associated with illness, medication, hormonal levels, etc.etc .;
  3. biopolar – constant mood swings, from a depressive state to inspiration on the verge of euphoria.

Cyclothymic disorders include two types of disorders – hypothymic and hyperthymic manifestations. In the first case, we are talking about situations of apathy, depression, uncertainty, dissatisfaction. In the second – about cases of increased activity, strong excitability, a small amount of sleep, etc. The essence of cyclothymic disorders is the inevitable cyclical transition from one state to another.

Depressive states are temporary, due to external causes associated with changes in hormonal levels, trauma. Depression can develop with medication. The hallmarks of depressive mood swings are feelings of depression, emptiness, self-doubt, and unwillingness to do anything. In other words, the patient loses his zest for life.

Bipolar disorders are conditions in which a person abruptly moves from a period of activity and creativity to a period of apathy and unwillingness to do anything.

The types of mood disorders listed above are typical for both women and men. In this article, we will pay attention to the fair sex.

Causes of mood swings in women

What causes changes in mood and condition in women

Women who complain of an unstable emotional state are not always able to answer the question of what exactly caused a shattered mood, excessive emotionality, or, conversely, sudden cold equanimity.Sometimes the cause of mood swings is stress – the accumulated tension results in depression and apathy; situational stress can provoke aggression or another form of violent reaction. Stressful situations are sometimes perceived by a woman as the primary source of mood problems. But not all women can understand that they are really stressed. They complain about their well-being and condition, claiming that everything is in order in their life and where this “swing” of mood comes from is unknown.

Emotional instability is inherent in women with thyroid diseases . Their specificity determines the instability of the psyche, often becomes the cause of lethargy, low concentration of attention, and drowsiness.

Hormonal imbalance in general is the basis for emotional leaps. That is why instability is characteristic of adolescent girls, pregnant and lactating women, and women in menopause. Changes in hormonal levels during ovulation and before menstruation also provoke increased emotionality and sensitivity (by the way, physical too.That is why we do not recommend for patients with hypersensitivity to undergo cosmetic procedures on the days of ovulation and menstruation). HRT (hormone replacement therapy), chosen incorrectly, also has a negative effect on a woman’s balance.

The mood swing can be triggered by taking hormonal oral contraceptives – at the stage of drug selection or with prolonged use of an unsuitable drug.

Irregular or insufficient sex life can also affect the mental and emotional state of a woman.In addition, infrequent sex is a risk factor for the development of many gynecological diseases.

Everyone knows that bad habits (alcohol, smoking, drug use) “shatter” the psyche, disrupting neural connections, putting unnecessary stress on the nervous system, liver, heart. As a result – anxiety, suspiciousness, panic states and other unpleasant manifestations.

Lack of physical activity, lack of sleep, high mental stress – these factors also provoke instability of emotions.


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Mood swings and cycles

Treatment of mood swings in women

To treat mood swings in women at different ages, you need to understand what to treat, and this requires extensive diagnostics. Arriving at the reception at the clinic of Marina Ryabus, the patient talks with the doctor – gynecologist, endocrinologist, the doctor collects anamnesis, conducts examination, ultrasound and other studies.Tests are prescribed, which you can take directly at our clinic. We work with proven laboratories, the best in Moscow, in terms of the expert level of diagnostics. According to the results of research in the body, violations, imbalances, pathologies are revealed. Treatment is prescribed based on the age of the patient, her reproductive plans, concomitant diseases. For control, it is necessary to visit the clinic according to the doctor’s prescriptions – usually every few months.

To resolve issues related to sudden mood swings, we invite you for a consultation at our clinic.An obstetrician-gynecologist, oncologist Ekaterina Nikolaevna Kozlova and gynecologist-endocrinologist Irina Sergeevna Vyatkina are receiving appointments at the Marina Ryabus Anti-Aging Medicine Clinic.