Some of the emotional symptoms associated with PMS are:
- anxiety or confusion
- mood swings and tension
- crying and depression
- an inability to concentrate
No one knows what causes PMS. However, researchers now know that PMS is not a simple result of an imbalance of estrogen and progesterone — commonly referred to as "female hormones," or any other single hormonal factor.
A complex interaction of neurotransmitters (such as dopamine, norepinephrine and serotonin) as well as other brain chemicals are now suspected of having a more direct relationship in triggering PMS. But, exactly how these brain chemicals change with or affect the menstrual cycle remains unclear. Estrogen excesses, progesterone deficiencies, vitamin B6 deficiencies, low levels of serotonin (a brain chemical that affects mood), an excess of prolactin (a protein hormone that induces lactation) and altered glucose metabolism are among the many different theories that attempt to explain PMS, but none has been proven.
Features of PMS that distinguish it from other menstrual cycle symptoms are:
- symptoms tend to increase in severity as the cycle progresses
- symptoms are relieved when menstrual flow begins or shortly after
- symptoms are present for at least three consecutive menstrual cycles