Premenstrual syndrome: a psychological overview

This paper reviews the premenstrual syndrome (PMS) from a historical and psychological perspective. The physician must recognize that the premenstruum-the four days before the onset of the menses-is a `high risk' phase for women. They may demonstrate somatic and psychological complaints such as irritability, aggression, tension, anxiety, depression, lethargy, insomnia, poor coordination and concentration. Psychological disturbances can range from self-deprecation and the feeling that `everything is too much' to pronounced feelings of oppression and depression. Psychiatric patients may become even more disturbed at this time. Recent reviews on PMS have studied its etiology and its possible connection to hormone imbalance, but to date there is no complete explanation for the syndrome's psychological symptoms. The most promising treatments for the psychological symptoms of PMS are pyridoxine (although there are conflicting reports about it), antidepressants, benzodiazepines if anxiety and tension dominate, and ongoing psychotherapy for severe cases.