THE MENSTRUAL CYCLE AND PREMENSTRUAL SYNDROMEAlthough this can differ from woman to woman, the average woman's mentrual cycle lasts 28 days before it repeats. The first day of the cycle is counted from the first day of a monthly period. Ovulation begins to occur around mid-way through the cycle, before the body begins to prepare for pregnancy in the uterus by altering the levels of progesterone and oestradiol.If pregnancy is unsuccessful and the egg released during ovulation is not fertilised, the body begins to break down left over tissue as the levels of progesterone and oestradiol begin to fall. This process usually takes place around seven days before the next period occurs. Premenstrual syndrome, or PMS, manifests itself through a set of symptoms that vary greatly from one woman to another, including their duration and intensity. It may include lower back pain, headaches, and irritability. These symptoms usually occur within two to 10 days before the menstruation, and gradually decrease with the onset of menstruation. These symptoms are cyclical, that is, they reappear every month. Premenstrual syndrome affects nearly 75% of women of childbearing age. In the majority of cases, the symptoms do not prevent them from going about their daily activities, although in rare cases they can become painful and even disabling. SYMPTOMS The majority of women experience mild symptoms before menstruation, and can be either physical or emotional or both. The intensity and duration varies wildly from one woman to another. The most common symptoms associated with premenstrual syndrome are: Physical symptoms: -Abdominal pain or cramps -Swelling of the lower abdomen (bloating) -Sensitive and swollen breasts -Severe fatigue -Headaches -Constipation or diarrhea -Skin problems (acne, itching) -Muscular pain (lower back, legs) -Abnormal appetite (always hungry\/loss of appetite) Psychological symptoms: -Irritability -Aggressiveness -Depression -Changing moods -Lack of motivation and energy -Difficulty concentrating CAUSES Although the exact causes of premenstrual syndrome are still unknown, we do know that it is related to ovulation and the menstrual cycle. Researchers believe that it could be caused by a hormonal fluctuation that occurs during the second half of the menstrual cycle. During this period, the secretion of estrogen decreases and that of progesterone increases. However, when the egg is not fertilized, progesterone decreases. The estrogen hormones then cause water retention and breast swelling. The fluctuation of these two hormones could also explain the emotional symptoms of premenstrual syndrome. TREATMENT AND PREVENTION Studies show that a change in lifestyle can help prevent premenstrual syndrome, or reduce the intensity of its symptoms. Substances that stimulate the body such as coffee, sugar, alcohol, and tobacco increase the severity of the syndrome. Stopping or reducing the consumption of these substances can improve symptoms. Exercising and physical activity, managing stress levels, and relaxing can also help to prevent PMS. If these methods do not eliminate or reduce the symptoms of premenstrual syndrome, certain alternative drugs and treatments can be effective. Anti-inflammatories, hormonal contraceptives, calcium supplements, magnesium supplements, and light therapy can also improve the lives of women who suffer from premenstrual syndrome.WHEN TO SEE A DOCTORWhilst most cases of PMS are not severe, the symptoms can hinder a woman from going about her daily activities whilst causing a great amount of pain and discomfort. If you've tried several at-home treatments but they aren't working, you can consult your GP to find a more specific from of treatment. If your symptoms are hindering your daily routine and the aforementioned options do not work, your doctor may refer you to a specialist.