PMS has been called everything from a hormonal dysfunction to a mental illness to the feminist issue of the 80s. Although it is known that
PMS is associated with ovulation, the true cause remains unknown. It is clear that two components are essential for PMS to occur. The first is the "trigger", which is clearly identified as ovulation and the resulting, reproductive hormonal changes. The second is the "vulnerability" to the "trigger" that produces the mood changes of
PMS. What makes one women "vulnerable" and another not, is unknown. This is the key to identifying the cause of
PMS. Many factors have been suggested, but refuted, as contributors to the "vulnerability", such as a woman's social and economic status, number of children, diet, amount of exercise, stress level, personality and characteristics of the menstrual cycle. However, current data supports serotonin, a chemical in the brain, as having an important role in
PMS. While no other cause has been nearly as conclusive as serotonin, other possible factors have been investigated and are interesting to consider. Some theories that have been suggested include:
Serotonin
Cyclic fluctuations in reproductive hormones
Abnormal thyroid function
Endorphin deficiency
Vitamins and minerals
Serotonin
Serotonin is a neurotransmitter. A neurotransmitter is a chemical that is involved in sending messages along nerves in the brain, spinal cord, and throughout the body. Serotonin affects mood. Impaired serotonin activity has been linked to symptoms of depression, anxiety, impulsivity, aggression and increased appetite. Since depression is also a major symptom of
PMS, scientists have questioned the role of serotonin in PMS. Abnormal serotonin levels and activities have been found in women suffering from
PMS. Furthermore, drugs that enhance serotonin activity, called specific serotonin reuptake inhibitors (SSRI) (e.g., Prozac, Zoloft, Paxil), are effective in the treatment of PMS.
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Cyclic fluctuations in reproductive hormones
While it seemed logical to many that the reproductive hormones involved in the menstrual cycle were the cause of PMS, research has proven that there are no differences in estrogen, progesterone,FSH, LH, prolactin, and testosterone levels between women with and without
PMS. This only confirms that ovulation acts as the "trigger" but is not in itself the cause. In the past, progesterone supplementation was supported as a treatment for PMS, but has been proven to be ineffective. As discussed in treatments, the only hormonal therapy that works is a regimen that prevents ovulation from occuring.
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Abnormal thyroid function
Thyroid disease is common in women. Symptoms of hypothyroidism, or low activity of the thyroid gland, can resemble symptoms of
PMS. For this reason, it was thought that the thyroid gland played a role in the cause of
PMS. Any woman who suffers from
PMS-like symptoms should get her thyroid checked. However, it is clear that the majority of women with
PMS have completely normal thyroid function. Thus, supplementation with thyroid hormone in the treatment of
PMS is not helpful and may in fact, be dangerous.
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Endorphin deficiency
Endorphins are opium-like chemicals manufactured by the body. Opium-like chemicals, including endorphins, are involved in the sensation of euphoria and the perception of pain. Thus, some have proposed that
PMS is a state of endorphin deficiency. Endorphin levels in the blood do fluctuate. However, these levels are not felt to reflect the activity of endorphins in the brain. Therefore, there is not enough evidence to support this theory.
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Vitamins and minerals
Scientific research has not been able to confirm a difference in the levels of vitamins and minerals between those women with symptoms of
PMS and those without. One particular vitamin that has received a great deal of attention is Vitamin B6. Vitamin B6 plays an important role in the synthesis of dopamine, a neurotransmitter that may also be involved in physical and emotional well-being. Thus, Vitamin B6 deficiency has been hypothesized as a cause of
PMS. Some researchers have shown improvements in PMS symptoms in women taking vitamin B6 daily, while others have not. However, it is important to limit the amount of vitamin B6 that you take, since neural toxicity has been reported. Therefore, Vitamin B6 supplements should only be taken with the supervision of a doctor.
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