Who develops PMS?

PMS usually develops in women from their late 20’s to early 40’s. The greater the woman’s childbearing age, the more likely she is to experience PMS. Menopause (cessation of menstrual periods and childbearing around age 51) brings an end to PMS. When adolescent girls are affected by PMS, their symptoms tend to be more severe.

Affected women tend to have at least one child, and often experience post natal depression.

Smokers and women who are sedentary tend to have severe symptoms.

In 1990, Dr. Ebrahim Taghavi of Dunedin, New Zealand, postulated PMS may be an inherited disease. He treated seven related patients (three generations) successfully with amitriptyline, an antidepressant. PMS is more likely to co-occur in women with depression or mood disorders,
so PMS may be from deficient brain chemistry.

Prof. Jane Ussher is a PMS researcher at the University of Western Sydney, Australia. She contends PMS depression is not a usual development of perimenopause: “The rates of depression in women actually fall with age, with only 7 per cent of women aged 45-54 experiencing depression.
Prof. Ussher says PMS is more prevalent in women involved in heterosexual relationships, rather than lesbian relationships. She explained that men“... feel confused, they feel whatever they say is wrong.

A lot of them just don’t understand how it can be happening. Some feel quite helpless.” Prof. Usher states lesbians report less distress at premenstrual changes, greater acceptance of PMS by their same-sex partner, and less self-policing (negative self-blame, over-responsibility, and self-silencing).

What does not cause PMS?

Stress or emotional problems do not cause PMS, but they can aggravate it. Researchers have ruled out the following “likely suspects” that were erroneously implicated as causing PMS:

• Excess estrogen hormone
• Estrogen withdrawal
• Difficulty concentrating
• Vitamin B6 (pyridoxine) deficiency
• Poor glucose metabolism
• Electrolyte imbalance (sodium, potassium, bicarbonate)
• Fluid imbalance

It is now well established that the above causes are definitely not responsible for PMS.

Why does PMS develop?

The exact cause of PMS is still precisely unknown, but doctors
believe that PMS is most likely due to :

• Exaggerated response to rapidly fluctuating estrogen and reduced progesterone levels
• Loss of serotonin, a neurotransmitter that is dependent on estrogen
• Blocking of serotonin receptors, which can be improved by taking selective serotonin reuptake inhibitors (SSRIs) to increase the amount of serotonin circulating in the bloodstream
• Magnesium and calcium deficiency
• Increased endorphins (natural painkillers)
• Altered gamma-aminobutyric (GABA) system
• Hypoprolactinemia (too little prolactin hormone in the bloodstream) Sex hormones influence brain function, so it is not surprising that fatigue and lethargy develop when their levels decrease.

Recommended next page - Available treatments for PMS