Complications

Premenstrual syndrome (PMS), and in particular premenstrual dysphoric disorder (PMDD), can have an adverse effect on women's relationships with co-workers, partners, and children.

Risk for Suicide

As many as 10% of women who report PMS symptoms, especially PMDD, have had suicidal thoughts. One study suggested that women who attempt suicide are more likely to do so during the premenstrual phase or in the first week of the period.

Risk for Major Depression

Depression and PMS often coincide, and may in some cases be due to common factors. Some studies suggest that PMDD may lead to or predict major depression in some women.

Substance Abuse and Eating Disorders

Women who abuse alcohol or have close relatives who are alcoholics, have a much higher risk for drinking during the premenstrual period. Alcohol worsens PMS symptoms and may increase the risk for prolonged cramping (dysmenorrhea) during menstruation.

Studies also have found a higher incidence of smoking in women with premenstrual dysphoric disorder than in women without PMDD.

One study showed a strong association between PMDD and eating disorders.

Magnification of Other Medical Conditions

A number of conditions worsen during the premenstrual or menstrual phase of the cycle, a phenomenon sometimes referred to as menstrual magnification.

Migraines. Although half of women with migraines report they are related to menstruation, experts believe that true menstrual migraines are less common than originally thought. Typical menstrual migraines are usually without auras and regularly occur during the first 3 days of menstruation, but not during ovulation or right before a period. Although researchers are not certain what causes menstrual migraines, some evidence suggests that progesterone may be protective. Menstrual migraines have also been associated with magnesium deficiencies. (Magnesium levels drop during the premenstrual period.)

Diabetes. The menstrual cycle may also affect diabetes, a disease that is defined by low levels of insulin or resistance to this hormone that is critical for efficient use of sugar (glucose) in the body. High estrogen and progesterone levels, which occur in the luteal phase, affect insulin, although their effects vary widely among individuals. In one study of women with insulin-dependent diabetes, 27% experienced higher blood sugar levels and 12% lower levels in the week before their period than at other times in the cycle. Some experts argue, however, that these blood sugar changes are due to cravings and dietary responses to PMS, not to insulin changes.

Islets of Langerhans contain beta cells and are located within the pancreas. Beta cells produce insulin which is needed to metabolize glucose within the body.

Asthma. It has long been known that asthma often worsens during the premenstrual period, with one study estimating that 40% of women with asthma are affected at that time. Some research suggests that during the premenstrual period there is increased activity of a combination of asthma-inducing effects, including lower resistance to stress and infections and increased hyperreactivity in the airways of the lungs.

Other Disorders. Many other chronic disorders may be exacerbated during the premenstrual phase, including epilepsy, multiple sclerosis, systemic lupus erythematosus, inflammatory bowel disease, and irritable bowel syndrome. Women are also more prone to seasickness in the premenstrual phase.