Private gynaecologist | The Surrey Park Clinic

Female Health • Gynaecology • Hormones

01483 454 016

Premenstrual Syndrome

What is Premenstrual Syndrome/Tension (PMS/PMT)?

This is the description given to the symptoms that some women get in the days leading up to their period which can include a range of emotional, physical and also psychological effects.

What are the symptoms of PMS/PMT?

Common symptoms include:

  • Disturbed sleep
  • Palpitations
  • Panic attacks
  • Hot flushes
  • Night sweats
  • Tiredness
  • Mood swings
  • Fluid retention and bloating
  • Changes to hair and skin
  • Back ache
  • Breast tenderness
  • Food cravings or change of appetite

What is the cause of PMS/PMT?

Hormonal factors

Changes in hormone levels are thought to be the main cause of PMS/PMT. More specifically, it is the decline in oestrogen and rise in progesterone for up to two weeks before the period starts which causes PMS/PMT.

The monthly cycle

Each month a follicle containing an egg develops and oestrogen levels rise. Once the egg is released at ovulation, oestrogen levels start to decline and progesterone levels start to rise. Progesterone works against oestrogen, and this combination of falling oestrogen and rising progesterone can result in the symptoms listed above.

Chemical factors

During the menstrual cycle some chemical levels in the brain fluctuate, such as serotonin. When serotonin levels are low it may cause tiredness and low mood, similar to those symptoms caused by declining oestrogen levels.

Other associated causes of PMS/PMT

If you are suffering from the above PMS/PMT symptoms, it is a very good idea to be screened for polycystic ovaries (PCOS), as there is a strong association between high sugar levels, high insulin levels, polycystic ovaries (PCOS) and exaggerated hormonal symptoms pre menstrually and menstrually. This screening may include a scan and possibly blood test which can be carried out here at The Surrey Park Clinic.

Diet can make PMS/PMT worse

High sugar, high carbohydrate snacking diets make PMT worse by worsening insulin levels which inactivates circulating hormones and 'paralyses' their effect. Therefore, change of diet can make a great difference to PMT (see PCOS). Higher protein, low GI, no snack diets can help.

How is PMS/PMT diagnosed?

At present there is no test which can diagnose PMS/PMT, however if you are experiencing some or many of the symptoms above and are finding that your quality of life is affected, you should see your GP, or alternatively make an appointment here at The Surrey Park Clinic where you will see a specialist Gynaecologist.

You may be asked to record your symptoms and how severe they are on a monthly chart so that we can identify patterns and assess the most appropriate treatment for you.

How is PMS/PMT treated?

There are various options outlined below:

Oestrogen replacement

This usually involves careful timing of the onset of symptoms and replacement of the oestrogen at the appropriate time. This is usually around a week before the period and during the menstrual time until a new egg starts to develop, resulting in a natural rise in oestrogen levels.

What happens if hormone symptoms are erratic?

This usually means that the quality of the developing egg is different each month, so some months are better than others. In this case careful charting of symptoms is important to try and keep levels steady.

Levelling out the rise and fall of symptoms or erratic fluctuations can be very helpful. There are several ways of doing this including:

  • Progesterone coil (Mirena)
  • Oral contraceptives ("The Pill")
  • Down regulation of ovarian oestrogen production such as pituitary suppressing injections including GnRH analogues such as Zoladex
  • and occasionally removal of the ovaries.

Alternative treatments/natural remedies

Natural oestrogenic products such as evening primrose oil, starflower oil and some containing trace elements such as magnesium and zinc can help.

What about natural progesterone?

Natural progesterone can be available in a cream form which can calm the symptoms of PMS/PMT. Natural progesterone is very similar in molecular configuration to oestrogen, not as strong and therefore in many women is preferable. It is completely different in molecular configuration to the synthetic progestogens used in the Pill, and HRT.

If you are struggling with PMT/PMS symptoms, we can make a real difference.

Just call 01483 454 016 to make an appointment or drop us an email. Our friendly team

handle all enquiries in complete confidence.

t: 01483 454 016
Stirling House, Stirling Road, Guildford, Surrey, GU2 7RF
The Surrey Park Clinic (IHG) Limited is the registered provider for the purposes of the Care Quality Commission (Provider ID: 1-711264535).
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