How common is it?
Nearly all women will experience some PMS symptoms at some time. But some women have such severe symptoms that they are unable to get on with day-to-day life, go to work or have normal personal relationships.

It is estimated that around five per cent of women suffer from PMS, at varying degrees of severity.

What are the symptoms of PMS?
Before your period do you suffer from:

• breast swelling or discomfort (mastalgia)
  
• abdominal bloating or cramps
  
• fatigue
  
• depression
  
• irritability or aggression
  
• headache
  
• cyclic weight gain

These symptoms could be due to Pre-Menstrual Syndrome (PMS). There are actually over 150 different symptoms that can be attributed to PMS.

How do I know if I've got it?
You know your symptoms are due to PMS if there is a symptom-free interval of at least seven days following your menstrual period.

If this isn't the case, and the symptoms are continuous, then you may have a different problem, which needs to be investigated by your doctor.

What causes PMS?
The short answer is: nobody really knows. Many women are told they have 'a hormonal imbalance', which doesn't mean anything.

The most recent research suggests that PMS is caused by the alteration in the level of a brain chemical called Serotonin. The hormones produced as part of a normal menstrual cycle appear to influence this chemical.

But it may be the case that there are a variety of causes for PMS, which differ from woman to woman.

Can PMS be treated?
PMS is one of the hardest gynaecological conditions to treat.

Although there are a whole host of different potential remedies, there's very little scientific proof to back their claimed benefits. What will work for one woman may not for another - and indeed it may aggravate her symptoms.

Medication therapies include taking supplements of vitamin B6 and Evening Primrose Oil. Other women find diuretics useful, while others find their symptoms improve if they take various hormonal preparations, such as the contraceptive pill.

Many women find that the most benefit is gained from non-pharmacological treatments such as:

• Dietary changes
  
• Reducing caffeine/alcohol
  
• Relaxation techniques, e.g. yoga
  
• Regular exercise
  
• Psychotherapy

Anti-depressants:
There is some evidence that certain anti-depressant medications e.g. Prozac may be useful for women who have predominantly psychological or emotional symptoms of PMS.

Hysterectomy:
Ultimately, for some women with severe PMS the only - drastic - option is the removal of the ovaries. It should only be considered as a very last resort, but it does cure PMS.

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