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PMS: Causes and the Role of Hormones and Lifestyle

Millions of women are familiar with the physical and emotional challenges of premenstrual syndrome, or PMS. The symptoms present themselves in numerous ways, from mild or moderate to debilitating. They may be in the form of bloating or cramping, and can even cross over into bouts of crying and angry outbursts.

Strangely enough, experts continue to disagree on exactly what causes PMS. Statements such as "it's all in your head" continue to surface with a nod to the fact that fluctuating hormones might actually contribute to distress. Others suggest that genetics and lifestyle can factor into PMS. Indeed, some validity may lie in each of these theories. While research continues, it's helpful to understand how each reported cause could play a role.

Understanding the PMS Phase of a Menstrual Cycle

Any time from seven to 14 days before menstruation begins, the female hormone estrogen begins a rollercoaster ride. This is the "luteal," or last, phase of the menstrual cycle that follows ovulation and is the time when PMS occurs. Once menstruation begins, estrogen settles down and starts a steady, usually symptom-free rise toward ovulation. Then, the cycle repeats.

Estrogen receives credit for bloating, swelling and weight gain. As the ovaries release this hormone, it spreads throughout the body with possible influence on the central nervous system. Other hormones, including progesterone and a host of chemicals called "neurochemicals" also may be responsible for wreaking havoc on the body and the mind.

This combination of PMS and hormones contributes to a wide variety of symptoms - more than 150. The most commonly reported physical conditions include:

acne
bloating
clumsiness
constipation
cramping
fatigue
headache
loss of sex drive
tender breasts.

From an emotional standpoint, many women report the following:

aggressive behavior
anger
anxiety
crying
depression
mood swings.

The physical and emotional signs of PMS can also be a signal of other illness or disease. Experts feel that occasional symptoms may not be of significance in making a PMS diagnosis. Generally, the criteria used to rule out other factors include broad-based and well-recognized markers.

Relief from symptoms begins around or just after the start of menstruation.
Symptoms appear about the same time every month, although they may vary in type and severity.
Severity of symptoms escalates as the time of menstruation approaches.

In some cases, PMS can limit social interaction and work commitments. In a low percentage of women, this is indicative of a serious condition known as premenstrual dysphoric disorder. PMDD is currently categorized and treated as a mental imbalance.

Hormonal and Chemical Causes of PMS

Estrogen is not the only culprit when it comes to pinpointing causes of PMS. Other hormones and chemicals that traverse the nervous system possibly mesh and trigger responses during the monthly cycle.

Endorphins are the neurochemicals known as "mood elevators." They activate under intense exercise and often contribute to "runner's high." This euphoric feeling reportedly aids in pain reduction. Some research suggests that lower levels of endorphins also contribute to increased pain during the premenstrual cycle.
Other Neurotransmitters, including seratonin, lie within cells and send messages throughout the nervous system. As hormones make dramatic changes, they might possibly trip a switch that reduces seratonin in the brain, thus creating depression and sudden changes in temperament.
Progesterone is a second "sex" hormone that, when released from the ovaries, was once thought to be a major cause of many PMS symptoms. Levels of other hormones may also share in the burden or prevention of anxiety, water retention and breast enlargement or tenderness. These include cortisol and prolactin.
Prostaglandins are chemicals with hormonal properties. Dilating blood vessels falls within their effective functions. It's possible that suppression of these chemicals occurs during the luteal phase, which leads to interference of the menstrual cycle.
Water retention is common during PMS. When the body retains fluids, organs are hard at work filtering salts while the kidneys work overtime to handle the excess load. Gaining weight often has a negative impact on self-confidence, especially when emotions are already out of balance.

Lifestyle and Genetic PMS Causes

While most researchers agree that hormones and chemicals can be a cause of PMS, outside considerations are possible factors in this disorder. Some women experience few, if any, signs of PMS in their lifetimes. This fact raises theories that could revolve around significant environmental and lifestyle triggers that cause an imbalance in the female system and psyche that contribute to PMS.

Many professionals cite that diet and lack of nutrients could exacerbate PMS symptoms. These include consumption of:

alcohol
caffeine
fats
sugar.

In addition, a lack of fiber in a diet, as well as deficiencies in magnesium and calcium, could possibly cause PMS.

While no concrete evidence points to any one cause of PMS, it appears that connections between a number of factors possibly contribute. Recommendations of lifestyle and diet changes as relief for PMS symptoms have other healthful benefits as well.

Future research may also lead to medical and supplement offerings that will aid in changing chemical imbalances within the complexities of the female system.

Resources

Bekkar, Bruce, M.D. (2001). What is PMS? Retrieved July 30, 2007, from the Families First Web site: http://families-first.com/hotflash/faq/pms.htm.

Emedicinehealth.com (n.d.). Premenstrual Syndrome (PMS). Retrieved July 30, 2007, from the Emedicinehealth Web site: http://www.emedicinehealth.com/premenstrual_syndrome_pms

/article_em.htm.

Hendrick, Victoria, M.D. (2007). Premenstrual Syndrome. Retrieved July 30, 2007, from the U.S. Department of Health and Human Services Web site: http://www.4women.gov/faq/pms.htm.

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