While there are substantive links to the hormones produced during the course of the woman's menstrual cycle, there is not yet a clear picture of the cause of PMS.  Evidence indicates the cause of the symptoms are tied to the relationship between the hormone levels of estrogen and progesterone.  Most women are subject to premenstrual syndrome symptoms to some degree during the child-bearing years, but not all women are affected  at the same level or in the same way.  Stress and anxiety may make the symptoms worse, but they are not the causative agent for PMS.

 

The amount of effect which the symptoms have in the activities of daily life, as well as  the type of symptoms which occur and at what times in the monthly cycle they occur all play a part in determining a diagnosis of premenstrual syndrome.  There is no definitive physical or chemical test which can determine the presence of PMS.

 

Premenstrual syndrome is found in almost every culture throughout the world.  Approximately 80% of women of child-bearing age have emotional and/or physical symptoms during the period just prior to menstruation which are severe enough to impair their daily activities.  Approximately thirty percent of women seek treatment due to the severity of the symptoms.  Very severe symptoms such as those associated with PMDD (premenstrual dysphoric disorder occur in 3-8 percent of women.

 

Several risk factors are associated with PMS, but there is no single characteristic with a 100% correlation to premenstrual syndrome.  Thus there is not 'cause' of PMS.

For example, each of the following factors are related to the prevalence of PMS symptoms and their severity without being direct cause and effect:

• A woman whose mother had PMS symptoms is more than likely to have PMS

• A sedentary lifestyle and a high sugar diet

• Consumption of caffeine in high levels.

• Alcohol abuse

• Stressful lifestyle

• Multiple pregnancies

Age

PMS symptoms often start by age 29 but are occasionally found in teenagers at a level classified as moderate to severe.  Treatment is often not sought for the symptoms until she reaches age 35 or so.  By the time the woman enters into her forties when menopausal symptoms typically begin, the symptoms of PMS lessen and eventually disappear.

 

Psychological Factors

There appears to be a genetic link between Seasonal Affective Disorder (SAD), Premenstrual dysphoric disorder (PMDD) and Premenstrual Syndrome (PMS).Women who suffer from PMS do better with psychological support groups.  Women who suffer major episodes of depression in the target age group are more likely to have PMS, and for women with PMDD major depression is almost inevitable.

 

Cultural Factors

There is a significant difference in the manifestation of PMS amongst various cultural groups.  Western women are more likely to focus on the symptom of depression, while Chinese women target pain as the most significant symptom of premenstrual syndrome.  In the United States, Hispanic American women report symptoms which are most severe and Asian American women report a reduced level of symptoms.  Caucasian American women report symptom frequency somewhere between the other two.