PMS appears to result from the interaction of cyclic changes in ovarian steroids with central neurotransmitters. The neurotransmitter which is most implicated in the
manifestations of PMS is serotonin. There may also be a role for trace elements in the pathogenesis of PMS. There are no consistent personality differences. While PMS may be a cause for stress, stress does not seem to affect the incidence or severity of PMS
Table 1: UCSD criteria for Premenstrual syndrome
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The presence by self report of at least one of the following somatic AND affective symptoms during the five days prior to menses in each of three menstrual cycles
Affective Somatic
Depression Breast tenderness
Irritability Abdominal pain
Confusion Headache
Social withdrawal Swollen extremities
Fatigue
Angry outbursts
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Relief of the above symptoms within four days of onset of menses with no recurrence until at least day 12 of cycle.
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Identifiable dysfunction in social or economic performance
Marital or relationship discord confirmed by the partner
Difficulties in parenting
Poor work or school performance, attendance/ tiredness
Increased social isolation
Legal difficulties
Suicidal ideation
Seeking attention for a somatic symptom(s)
Physical and behavioural symptoms in 2nd half of menstrual cycle.
USCD criteria useful in diagnosis of PMS and deciding treatment.
Due to interaction of ovarian steroids with neurotransmitters notably serotonin.