Premenstrual Syndrome (PMS) is a dynamic condition that varies in severity, intensity, and character as a woman moves through different life stages. By understanding how hormonal fluctuations affect PMS, women can better manage symptoms and seek appropriate care when needed.

How PMS Changes Throughout Life

Dr. Lynsel T, Consultant OBG at KMC Hospital, Mangalore, explains that PMS evolves from puberty to menopause due to hormonal changes, lifestyle factors, and overall health.

Teenage Years: The First Wave of PMS

• PMS often begins in adolescence, as puberty triggers hormonal surges.
• Symptoms may include:
  Mood swings
  Acne breakouts
  Severe cramping
• PMS during teenage years can be emotionally overwhelming, affecting social interactions and self-esteem.

20s & 30s: PMS Becomes More Predictable

• PMS stabilizes during the reproductive years, but stress, diet, and childbirth can influence symptoms.
• Common symptoms:
  Bloating & breast tenderness
  Headaches & fatigue
  Heightened emotional sensitivity (irritability, anxiety, depression)
• Many women in this stage seek treatment or lifestyle modifications to balance their personal and professional lives.

40s & 50s: PMS Before Menopause

• PMS can become unpredictable and more intense as hormones fluctuate irregularly before menopause.
• Symptoms may include:
  Longer-lasting mood swings
  Increased anxiety & depression
  Hot flashes & sleep disturbances
• Self-care and proactive symptom management become crucial during this phase.

Post-Menopausal Years: PMS Relief

• Once menopause occurs and oestrogen and progesterone production stops, PMS symptoms disappear.
• Many women experience emotional stability and fewer mood swings.

What Causes PMS?

Dr. Madhu Bindhu, Consultant Gynaecologist at Manipal Hospital, Vijayawada, explains that PMS occurs during the luteal phase (the time between ovulation and menstruation).

85% of women experience PMS to some degree.
5% of women suffer from severe PMS (PMDD – Premenstrual Dysphoric Disorder), which impacts daily life significantly.

Common Causes & Risk Factors

Hormonal fluctuations (changes in oestrogen & progesterone)
Genetics (family history of PMS)
Lifestyle factors (poor diet, stress, lack of sleep)
Reduced beta-endorphins (natural mood stabilizers)

How is PMS Diagnosed?

Doctors diagnose PMS based on symptoms appearing at least five days before menstruation for two consecutive cycles.

It’s important to rule out conditions like anxiety, depression, perimenopause, or irritable bowel syndrome (IBS), which may have similar symptoms.

How to Manage PMS Effectively

Lifestyle Modifications

Regular Exercise – Helps balance hormones & reduce stress.
Healthy Diet – Eat whole grains, fruits, and vegetables; avoid processed foods.
Adequate Sleep – Poor sleep worsens PMS symptoms.

Nutritional Supplements

Calcium & Vitamin D – Help reduce mood swings.
Magnesium – Eases bloating and irritability.
Omega-3 Fatty Acids – Reduce inflammation and depression symptoms.

Medical Treatment Options

• SSRIs (antidepressants) – For severe mood-related PMS (PMDD).
• Hormonal Therapy (birth control pills, progesterone IUDs) – Helps regulate hormone fluctuations.
• Pain Relievers (NSAIDs like ibuprofen) – Reduce cramps and headaches.

Stress Management Techniques

Yoga & Meditation – Improves emotional stability.
Cognitive Behavioral Therapy (CBT) – Helps manage anxiety & mood swings.
Counseling & Support Groups – Beneficial for severe PMS cases.

Why a Holistic Approach is Important

PMS is often overlooked, but it can affect daily life, relationships, and mental well-being. Dr. Bindhu recommends a multidisciplinary approach, involving:
Gynaecologists
Nutritionists
Psychiatrists
Counselors

Keeping a symptom diary for 2-3 months can help doctors create a personalized treatment plan based on individual patterns.

PMS changes with life stages, but with proper awareness, self-care, and medical support, women can manage symptoms effectively. Whether through lifestyle changes, medication, or holistic therapy, there are solutions to help navigate PMS and improve overall well-being.