Premenstrual syndrome

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Clinical manifestations

While more than 150 symptoms have been ascribed to PMS the vast majority of patients seem to have one or some of the following established symptoms (table 2)

Table: 2 Clinical features of PMS

Symptom %

Fatigue 92

Irritability 91

Bloating 90

Anxiety/ tension 89


Breast tenderness 85

Mood lability 81

Depression 80

Food cravings 78

Acne 71

Increased appetite 70

Oversensitivity 69

Swelling 67

Expressed anger 67

Crying easily 65

Feeling of isolation 65

Headache 60

Forgetfulness 56

Gastrointestinal symptoms 48

Poor concentration 47

Hot flashes 18

Heart palpitations 14

Dizziness 14

The most common physical manifestation is abdominal bloating; breast tenderness and headaches are among the other major physical complaints. The most common behavioral symptom is an extreme sense of fatigue. Other frequent behavioral complaints include irritability, tension, depressed mood, labile mood, increased appetite, forgetfulness and difficulty concentrating. Other common findings include acne, oversensitivity to environmental stimuli, anger, easy crying, and gastrointestinal upset.

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