Advancements in PME Treatment: From Conventional Therapies to Emerging Innovations

Premenstrual syndrome is a combination of physical, emotional, and psychological symptoms experienced by many females in the days and weeks before the menstrual period ⁽¹⁾.

PMS is known to occur during the luteal phase of the menstrual cycle, which is the period after ovulation and before menstruation ⁽²⁾.

What exactly causes PMS is not known but it is believed to occur due to the fluctuation in hormone estrogen and progesterone levels.

The symptoms of PMS vary from woman to woman and also range in severity. The symptoms experienced include:

• Tenderness in the breast
• Headaches
• Bloating
• Abdominal cramps
• Fatigue
• Pain in the joints and muscles
• Depression
• Anxiety
• Mood swings
• Irritability
• Difficulty in concentrating
• Changes in appetite

Premenstrual syndrome can impact a female’s life to a great extent. Some of the common effects include:

• It can strain interpersonal relationships. The females may feel less patient and may get easily upset during this time, leading to conflicts and strained communications.
• The work and school performance can be affected. Females may find it challenging to focus on tasks, make decisions, or perform optimally leading to decreased work or academic performance.
• The emotional symptoms of PMS may impact a female’s well-being. It may make them feel more vulnerable and experience lower self-esteem.
• The physical discomfort including breast tenderness, bloating, and cramps may make it difficult for women to engage in regular activities or participate in hobbies and exercise.
• All these symptoms may affect the quality of life of a person. Severe symptoms may lead to social isolation, reduced participation in activities, and decreased overall life satisfaction.
• In case the symptoms are severe and significantly impacting daily functioning, it is recommended to consult a healthcare professional for proper evaluation and management.

Pre-menstrual exacerbation refers to the worsening or intensification of pre-existing physical or psychological conditions during the premenstrual phase of the menstrual cycle ⁽¹⁾.

Some examples of premenstrual exacerbation include:

• Pre-Menstrual Exacerbation of Mood Disorders: Females with pre-existing mood disorders such as major depressive disorder or bipolar disorder, may experience worsening of depressive or manic symptoms during the premenstrual phase. There may be increased feelings of sadness, irritability, mood swings, or heightened anxiety.
• Pre-Menstrual Exacerbation of Anxiety Disorder: Females with anxiety disorder may experience heightened worry, restlessness, and physical symptoms like increased heart rate or shortness of breath.
• Pre-menstrual Exacerbation of Physical Condition: Certain physical conditions may worsen during the premenstrual phase. For example, females with migraine may experience more frequent or severe headaches and those with chronic pain may notice increased pain intensity.

There are several factors that may contribute to pre-menstrual exacerbation (PME):

• Hormonal Fluctuation: Rise and fall in estrogen and progesterone levels are considered significant factors in contributing to PME ⁽³⁾. These may influence neurotransmitter levels and sensitivity, thereby leading to mood changes and other symptoms.
• Neurotransmitter Imbalance: The neurotransmitter imbalance affects serotonin, dopamine, and gamma-aminobutyric acid (GABA), which play a role in mood regulation. Imbalance or fluctuation may contribute to mood swings, irritability, and other emotional symptoms ⁽⁴⁾.
• Sensitivity to Hormonal Changes: Some females may be more sensitive to hormonal fluctuation leading to exaggerated responses in symptoms during the premenstrual period.
• Genetic and Biologic Factors: Females with a family history of PME or other mood disorders are more likely to experience premenstrual exacerbation ⁽⁵⁾.
• Stress: Stress impacts hormonal regulation and overall well-being. Females with high levels of stress may be more prone to PME symptoms ⁽⁶⁾. Stress disrupts the delicate balance of hormones and neurotransmitters, worsening the symptoms of PME.
• Lifestyle Factors: Lifestyle factors including activity level, nutrition, sleep, and caffeine and alcohol consumption may make a person more susceptible to PME.
• Co-Existing Mental Condition: Females with preexisting mental conditions such as anxiety, and depression can be more susceptible to PME.

Pre-menstrual exacerbation (PME) significantly impacts the daily functioning and overall quality of life of females experiencing it. The emotional changes may make it difficult to manage stress, handle interpersonal relationships and cope with everyday challenges. They may find it difficult to focus on tasks, complete assignments, and make important decisions.

PME may affect work performance and productivity. There may be irritability, mood swings, and increased sensitivity. They may find it challenging to engage in social activity, hobbies, or recreational pursuits during this time.

All these things may impact daily functioning and decrease the quality of life.