ask the dr
Dr Andrew Weil
Many women describe bothersome symptoms associated with the luteal phase of their menstrual cycle, the period of time (about two weeks) between the release of an egg from the ovary and the onset of menstrual bleeding. Should the symptoms become more significant, however, a diagnosis of premenstrual syndrome (PMS) should be considered. The exact cause of PMS is unclear. A variety of physical, emotional and cognitive challenges are commonly described by women with PMS, including bloating, constipation, diarrhoea, breast tenderness, fluid retention, palpitations and acne, as well as mood swings, depression, anxiety, irritability, insomnia, increased appetite, changes in libido and fatigue. Symptoms usually disappear a few days after menstruation begins. Keep in mind symptoms may also be caused by other factors, particularly if they persist or do not follow a pattern consistent with the occurrence of menses. Keep a symptom diary to be sure your symptoms are actually tied to your cycle. A physical examination by your doctor and tests to exclude anaemia, thyroid and other disorders are important to determine the cause of symptoms compatible with PMS.