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The Etiology Of PMS

July 14, 2010

The vast majority of women (90%) will experience premenstrual syndrome (PMS) during the luteal phase of their menstrual cycles while 20%-30% will report moderate or severe symptoms during this time. Those women whose symptoms are at the most severe end of the scale have what is known as premenstrual dysphoric disorder (PMDD).

Only 3%-8% of women in their childbearing years will have symptoms so severe they fall under the category of PMDD. In addition to these two conditions, there is something even worse and this is called premenstrual magnification (PMM). PMM is a condition in which women will experience symptoms all through their cycles with the symptoms becoming worse on some level or on many levels (gynecological, medical, or psychological) in the days just prior to menstruation.

Defining PMS

These three medical terms make up a large body of symptoms that can range from mild to quite severe. However, it may prove difficult for a physician to confirm a diagnosis for any one of these conditions. For this reason, there is not a physician or expert alive who can give an accurate, exact definition of PMS.

One reason for this is that PMS is confirmed through the process of excluding other conditions. This method of diagnosis suggests that there may be many conditions that are linked to PMS, though no one quite knows how this works.

Many experts say that PMS is due to fluctuating levels of hormones and neurotransmitters. The theory arises from the idea that the symptoms evaporate with the start of menstruation.  Ovulation causes the corpus luteum to be formed. The corpus luteum produces estrogen and progesterone, the two hormones experts believe may be responsible for causing premenstrual symptoms. Once the period arrives, these hormones are no longer produced.

Some believe that serotonin and gamma amino butyric acid (GABA), both of which are neurotransmitters, are involved in the triggering of premenstrual symptoms. Others believe other hormones and their mechanisms are responsible for PMS. But no one can prove any of these theories with any certainty.

Fluctuating Hormones

One theory tends to stand out from the crowd because it differs from the others in large measure. In this unusual theory, PMS is caused by chronic infections that are exacerbated by the cycles of change in the immunosuppressive system which occur as a result of fluctuating levels of progesterone and estrogen.  So far, research has only found a tenuous link between chronic infections, PMS, and changes in immunosuppression from hormone fluctuations.

Those who like this theory believe that changes are wrought in the body's immune function throughout the menstrual cycle as the hormones do their balancing act. This theory holds that chronic infections will become worse during the luteal phase of the menstrual cycle leading to PMS symptoms. Examples of infections that are said to go into active phases during the luteal cycle include yeast infections, herpes, cytomegalovirus, and peptic ulcers. Ailments that may worsen before menstruation include: Crohn's disease, multiple sclerosis, lupus, rheumatoid arthritis, asthma, and chronic fatigue syndrome.

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