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Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Premenstrual syndrome (PMS) is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation and typically ending with the onset of her menstrual flow. The most common mood-related symptoms are irritability, depression, crying, oversensitivity, and mood swings with alternating sadness and anger. The most common physical symptoms are fatigue, bloating, breast tenderness (mastalgia), acne, and appetite changes with food cravings.
A more severe form of PMS, known as premenstrual dysphoric disorder (PMDD), also known as late luteal phase dysphoric disorder) occurs in a smaller number of women and leads to significant loss of function because of unusually severe symptoms. The American Psychiatric Association characterizes PMDD as a severe form of PMS in which anger, irritability, and anxiety or tension are especially prominent.
About 80% of women experience some premenstrual symptoms. The incidence of true PMS has often been overestimated by including all women who experience any physical or emotional symptoms prior to menstruation. It is estimated that clinically significant PMS (which is moderate to severe in intensity and affects a woman's functioning) occurs in 20% to 30% of women. About 2% to 6% of women are believed to have the more severe variant known as PMDD.
The mood changes surrounding this condition have been described as early as the time of the ancient Greeks. However, it was not until 1931 that this disorder was officially recognized by the medical community. The term "premenstrual syndrome" was coined in 1953.
PMS remains an enigma because of the wide-ranging symptoms and the difficulty in making a firm diagnosis. Several theories have been advanced to explain the cause of PMS. None of these theories have been proven, and specific treatment for PMS still largely lacks a solid scientific basis. Most evidence suggests that PMS results from the alterations in or interactions between the levels of sex hormones and brain chemicals known as neurotransmitters.
PMS does not appear to be specifically associated with any personality factors or specific personality types. Likewise, a number of studies have shown that psychological stress is not related to the severity of PMS.
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