Wurtman defines PMS as "a cluster of physical, cognitive and emotional symptoms that range in intensity from barely noticeable to incapacitating." Women typically experience PMS a few days before their menstruation begins. While some women only have to deal with it for a few hours, others have to contend with various symptoms for a week or more.
Some of the most common physical symptoms of PMS include breast tenderness, bloating (fluid retention), acne flare-ups, fatigue, sleep disturbances and appetite changes with food cravings, especially for sweet carbohydrates. Meanwhile, the most common mood-related symptoms of PMS include anger and irritability, anxiety, oversensitivity, exaggerated mood swings and depression. All of these symptoms vary in terms of duration and severity from cycle to cycle.
According to statistics, about 20 to 30 percent of women suffer from clinically significant PMS -- that is, moderate to severe symptoms that affect their functioning. On the other hand, about five percent of those of childbearing age experience a serious form of PMS called premenstrual dysphoric disorder (PMDD). This condition occurs a week or two before ovulation and causes severe irritability, anxiety and depression.
Other psychological symptoms of PMDD include panic attacks, frequent crying, lack of interest in daily activities and relationships, trouble sleeping and trouble thinking or focusing. Physical symptoms include tiredness or low energy levels, cramps, bloating, breast tenderness, headaches and joint and muscle pain. While researchers have yet to identify the exact cause of PMDD, many speculate that hormonal changes and fluctuations in the levels of a brain chemical called serotonin may be involved.
Serotonin is a hormone produced by neurons that impacts the entire body. Besides facilitating communication between cells within the nervous system, serotonin also helps with various bodily functions, such as digestion, eating and sleeping. In fact, serotonin is the key hormone that stabilizes mood, happiness and feelings of well-being. Research has linked low levels of serotonin to overexcited neurons, poor bone health and high levels of anxiety and depression.
According to Wurtman, serotonin levels change throughout the menstrual cycle, and a decrease in serotonin activity may be responsible for some of the mood-related symptoms associated with PMS. Meanwhile, studies show that the amount of serotonin produced by brain neurons is controlled by food intake, so eating certain foods may be of considerable help to women suffering from PMS.
Carbohydrate consumption is known to trigger the release of insulin, a hormone that promotes the absorption of large neutral amino acids, except tryptophan, by skeletal muscles. This leaves large amounts of tryptophan in the blood, which can then be delivered to the brain. Neurons need tryptophan to produce serotonin. Therefore, eating tryptophan-rich foods like eggs, salmon, tofu, nuts and seeds with a certain amount of carbohydrates is a good way to boost serotonin levels naturally.
While investigating the effects of nutrient intake on PMS, Wurtman and her colleagues found that the calorie intake of women with PMS drastically goes up because of increased cravings for sweet and starchy carbohydrates. They also found that eating a carbohydrate-rich, protein-poor evening test meal just before the start of their periods significantly decreased the women's depression, tension, anger, sadness and fatigue scores. Wurtman and her team attributed these improvements to an increase in the women's serotonin levels brought about by their consumption of carbohydrates.
"Because synthesis of brain serotonin, which is known to be involved in mood and appetite, increases after carbohydrate intake, premenstrual syndrome subjects may overconsume carbohydrates in an attempt to improve their dysphoric mood state," the team concluded in their report, which appeared in the American Journal of Obstetrics & Gynecology.
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