Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about pre-menstrual syndrome.

And you can find written notes on this topic at zero-definals.com slash pre-menstrual syndrome

or in the gynecology section of the Zero-D definals obstetrics and gynecology book.

So let's get straight into it.

Pre-menstrual syndrome, also known as PMS, describes the psychological, emotional and physical

symptoms that occur during the luteal phase of the menstrual cycle, particularly in the days prior to the onset

of menstruation. These symptoms can be distressing and significantly impact quality of life.

Most women will experience some of the symptoms of premenstrual syndrome as part of a normal

menstrual cycle. The critical aspects are the severity of the symptoms and the impact these

symptoms have on the woman's functioning and quality of life. The symptoms of PMS resolve once

menstruation begins. Symptoms are not present before men are key, before the first period,

during pregnancy or after menopause. These are key things to

note when you take a history. Let's talk about the pathophysiology. Pre-menstrual syndrome is thought to be

caused by a fluctuation in estrogen and progesterone levels during the menstrual cycle. The exact mechanism is not known, but it may be due to

increased sensitivity to progesterone or an interaction between the sex hormones and the neurotransmitters

serotonin and gabber. Let's talk about the presentation. There's a long list of symptoms that can occur with pre-menstrual

syndrome, and these will vary with the individual. Common symptoms include a low mood, anxiety, mood swings,

irritability, bloating, fatigue, headaches, breast pain, reduced confidence, cognitive difficulties,

clumsiness and a reduced libido.

Women can experience these symptoms in the absence of menstruation after they've had a

hysterectomy endometrial ablation or they have the myrina coil fitted because the ovaries continue to

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