Why are you sick during the PMS

Premenstrual Syndrome (PMS) & Premenstrual Dysphoric Disorder (PMDS): Causes

The exact triggers of the symptoms in premenstrual syndrome have not yet been clarified, despite decades of research. According to the current state of knowledge, neither ethnic origin, culture, nor socio-economic status seem to have an influence on the development and severity of PMS. Why one woman is affected and the other, with the same hormonal situation, not, still raises questions.

Given the variety of symptoms, however, a single cause is excluded. Rather, it is a multifactorial disorder - that is, several factors are responsible for the symptoms. This is why many experts today describe PMS as psychoendocrine dysfunction. As a malfunction, the causes of which are to be found in the psyche, in the nervous system and in hormonal control. It is believed that the cyclical changes in sex hormones influence the production and activity of other hormones and neurotransmitters. This applies above all to the neurotransmitter serotonin: its concentration fluctuates with the hormonal changes in the menstrual cycle. After ovulation, the content of the nerve messenger in the body steadily decreases. Shortly before menstruation begins, it then sinks rapidly into the cellar.

Hypersensitivity, interactions and shifts

In the case of PMDS, a biological cause has now been proven: According to this, there is a genetically determined hypersensitivity to sex hormones.

There is also a clear connection with hormonal changes in the second half of the cycle after ovulation and the onset of menstruation. Apparently, the tendency to PMS increases when the luteal hormone (progestin) progesterone is produced in the second half of the cycle, while at the same time the estrogen release decreases. With the appropriate predisposition or particular stress, physical and mental complaints typical of PMS can occur.

Some women also seem to be more sensitive to the breakdown products of progesterone. An interaction of progesterone with, for example, serotonin is also being discussed.
In the second half of the cycle, there is also a natural increase in the hormone prolactin, which is produced in the pituitary gland. This stimulates swelling of the mammary glands (mastodynia) and can cause unpleasant pain.

The hormonal fluctuations can also lead to shifts in electrolytes and the fluid balance.

In addition to the above-mentioned influences on PMS, a reduced melatonin level and hypothyroidism are also discussed as causes. Lifestyle, especially diet and exercise, also play a major role in PMS: It is now accepted that too much sugar, caffeine, alcohol and nicotine and too little exercise favor premenstrual syndrome.

If the transition to the second half of the cycle and the menstrual period are prevented by medication or surgery, these women will not experience symptoms of premenstrual syndrome.