Pre-menstrual tension (PMT) – causes, symptoms and ways to help

Pre-menstrual tension – what is it?

Premenstrual tension (PMT) is the occurrence of significant premenstrual symptoms (considered to be more severe than what the average women would experience), which crop up before a women’s period. This is mean symptoms crop up during the luteal phase or second half of a woman’s menstrual cycle, but more often in the week or few days preceding the bleed. 

The names premenstrual tension (PMT) and Premenstrual Syndrome (PMS) are often used interchangeably, since both conditions are characterised by significant physical and/or mental or emotional changes in the week leading up to a women’s period. Whilst PMT and PMS are generally regarded to be the same thing, some would argue the name ‘premenstrual tension’ encompasses more of emotional or psychological aspects of this condition.

Premenstrual tension can be diagnosed by a doctor, however, there is no single diagnostic test for it. PMT, and similarly PMS are often diagnosed based on the symptoms and a women may only need to present with 1 or 2 symptoms to qualify for a diagnosis.

Up to half of women may be affected with PMT, and this may get worse for women in their 40s as they approach perimenopause.

If a woman experiences very extreme PMT or PMS (between 3-8% is the current estimates), they may instead by diagnosed with the more severe premenstrual dysphoric disorder (PMDD). This is when a women’s day to day ability to function as normal, is severely impeded.

What are the symptoms of pre-menstrual tension?

The symptoms of PMT can be vast and varied, but generally, they can be separated into physical and mental, psychological or emotional symptoms. Some commonly reported and recognised symptoms are as follows:

Physical symptoms of PMT

• Period pain or cramps
• Breast tenderness
• Bloating
• Headaches
• Skin changes

Mental, psychological or emotional symptoms of PMT

• Irritability
• Mood swings
• Low mood
• Lack of libido
• Anxiety
• Lack of concentration or coping ability

What are the causes of PMT?

The causes of PMT are not well understood by the medical community. Some more naturopathic or holistic practitioners would argue that factors including diet, lifestyle and the balance of hormones in the body can have a big bearing on the likelihood of PMT or PMS.

Research suggests that nutrients including B vitamins and zinc have been found to be particularly helpful with the psychological symptoms of PMS¹, whilst vitamin D, magnesium, and zinc may be helpful to reduce physical symptoms of PMS including pain or cramps, ² which backs the idea that factors such as diet may have some bearing.

What can be done to help?

Diet  - Whilst not a universally recognised approach, research suggests that following an unprocessed, anti-inflammatory may help to reduce inflammation, and provide the necessary nutrients to offset some of the symptoms associated with PMT or PMS. Following a Mediterranean diet rich in omega-3 fatty acids has also proved helpful, particularly for reducing monthly menstrual cramps, as well as some psychological symptoms.³

Lifestyle – Positive lifestyle habits may have a positive effect on alleviating PMT or PMS symptoms, especially when combined with other approaches such as dietary or supplement measures.

Research shows that gentle exercise could help due to it’s stress relieving effects and release of endorphins.⁴  Healthy sleep patterns have also been found to be helpful in the management of premenstrual symptoms.⁵

Herbal remedies – Many cases of PMS or PMT are presumed to be linked to some hormone imbalance. The herbal agnus castus, or fermented soy isoflavones can work in different ways, to rebalance hormones, depending on the likely hormone balance which is at play.

The herb Agnus castus can offset high oestrogen states by gently supporting the natural production of progesterone in the body, whilst fermented soy isoflavones can support women who suffer from low oestrogen states.

Conventional methods – Some doctors may recommend medications such as hormonal contraceptives to rebalance hormone imbalance. Whilst this may be successful in some cases, side effects such as nutrient deficiencies or other hormonal symptoms such as mood disturbances taking hold, must be considered as possible side effects. Conventional medications such as pain relief may also be considered, but once more, possible side effects should always be considered.

References

^{1  https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuae043/7659847}

^{2 https://www.cambridge.org/core/journals/nutrition-research-reviews/article/nutritional-practices-to-manage-menstrual-cycle-related-symptoms-a-systematic-review/F28E2DC079C7DC2F1AC07A0EFCDE0DE}

^{3 https://pubmed.ncbi.nlm.nih.gov/35266254/}

^{4 https://pmc.ncbi.nlm.nih.gov/articles/PMC7465566/}

^{5 https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02600-z}