What causes PMS?

The first thing to say about the causes of PMS is that medical science does not really understand why some women suffer physical and/or psychological symptoms each and every month whilst others do not suffer at all. Hence, it is fair to suggest that there is still a reasonable degree of mystery about the exact reasons why some women suffer and others don't.
It is however believed that a primary cause of premenstrual syndrome is the natural change in the balance of female hormones that happens every month as an integral part of the cycle of menstruation. As a result of these natural hormonal changes, there is a reduction in the level of progesterone in the body, are falling off of levels of the hormone that prepares the uterus to receive a fertilized egg.
At the same time, there is also an increase in levels of salt and water retained by the body, hence the feelings of being bloated and retaining too much water.
This does not of course explain exactly why these hormonal changes affect some individuals far more than they affect others. Whilst some experts suggest that all women suffer some symptoms of PMS, in the main these symptoms are mild or extremely mild, so this does not really take us much closer to discovering the course of PMS.
One line of current thinking about the causes suggests that it may be something to do with neurotransmitters that are created by the central nervous system reacting with changing levels of sex hormones which would otherwise be within what are regarded as normal limits by the medical profession.
In particular, it is believed that serotonin levels in the body may have some connection with the severity (or otherwise) of PMS that is suffered by an individual female, although there is no conclusive proof of this as yet.
Preliminary studies carried out in the USA some 20 years ago suggested that of women who suffered PMS most severely, perhaps as many as four in every ten showed significantly decreased levels of beta endorphins in the blood at the time of their ‘attacks’.
Beta endorphins are naturally occurring opioid neurotransmitters, which is one of the reasons why a lack of them as shown by 40% of women who suffered severe PMS has been likened by many medical professionals to withdrawal symptoms associated with ‘coming off’ opiate-based drugs like heroin.
Another possible contributory factor is family history as it is generally believed that women who are from families where more severe PMS is relatively common are more likely to be sufferers themselves. This contention is backed up by the fact that the occurrence of PMS is twice as likely to appear in identical twins than it is in fraternal twins (see previous link for substantiation).
The bottom line is, medical science has still not really established the exact reasons why some women suffer serious psychological and/or physical problems as a result of premenstrual syndrome, whereas others hardly suffer at all.
One thing that is however clear is that there are contributory factors associated with lifestyle and that these factors may increase the risk of suffering severe PMS.
These potential contributory factors include:
• Increased levels of stress and anxiety;
• Pre-existing depression;
• High caffeine intake;
• High alcohol intake;
• Tobacco usage;
• Increasing age (although for most women, PMS is likely to start for the very first time during their 20s or 30s and will probably disappear after they stop menstruating as well);
• Allergies to nuts etc;
• Dietary factors such as a lack of certain vitamins and minerals.
From this list of contributory factors, you can probably see that certain lifestyle changes could help to reduce the severity or the likelihood of PMS being a problem.
We will return to these in detail later after considering how members of the medical profession diagnose premenstrual syndrome.