Prevalence of premenstrual syndrome

The premenstrual syndrome (PMS) affects 20 to 40% of women of childbearing age, according to the French National Institute for Health and Medical Research (Inserm). It typically occurs five days before menstruation and is characterized by physical and psychological symptoms such as fatigue, irritability, abdominal and breast pain, weight gain, headaches, acne, sadness, anxiety, crying spells, and irritability.

Biological causes of PMS

PMS is linked to the luteal phase of the female cycle, after ovulation, when the follicle becomes the corpus luteum and produces progesterone. If fertilization does not occur, progesterone levels drop, and estrogen takes over, triggering symptoms. Other theories associate the condition with deficiencies in magnesium, calcium, or serotonin.

Distinguishing PMS from other conditions

PMS should not be confused with menstrual pain, although the two can coexist. Symptoms usually disappear with the onset of menstruation, which helps distinguish PMS from chronic depression. However, symptoms can worsen during perimenopause and disappear with menopause, unless a highly estrogen-based hormone treatment is used.

Medical recommendations for PMS

Dr. Geoffroy Robin, secretary general of the French College of Gynecologists and Obstetricians (CNGOF), notes that PMS is underdiagnosed and poorly studied. He recommends the continuous use of combined estrogen-progestin contraceptive pills, which do not affect fertility and may even protect against uterine cancer. He also mentions the use of antidepressants like selective serotonin reuptake inhibitors (fluoxetine and sertraline), which work well during the second half of the menstrual cycle.

Role of pharmacists in managing PMS

Pharmacies are a preferred place to discuss PMS symptoms. Marion Bandel-Bardonnet, a pharmacist in Belleville-en-Beaujolais, recommends lifestyle changes such as physical exercise, meditation, avoiding alcohol, refined sugars, and salt. In cases of severe symptoms, a medical consultation is necessary.

Micronutrition for PMS management

Nathalie Chatel, a pharmacist and micronutrition specialist, recommends intake of fatty acids (omega-3 and 6), minerals (magnesium, zinc), and B-group vitamins. She also emphasizes the importance of probiotics, which affect emotional well-being by aiding serotonin synthesis.

Impact of sexual activity on PMS

A 2020 study involving 486 people menstruating in 18 countries showed that 70% of participants reported a positive effect of regular masturbation on the intensity of menstrual pain. These results may apply to PMS, as orgasm promotes the release of neurotransmitters associated with pleasure and well-being, such as dopamine and serotonin. However, a decrease in libido is one of the symptoms of PMS.

Efforts to recognize PMS in workplace policies

The National Union of Autonomous Syndicates (Unsa) launched a petition to include a menstrual leave covered by the Social Security system in French law, which had over 90,000 signatures by late May. This policy already exists in some companies and local governments, as well as in Japan and Spain, but its expansion in France faces budgetary constraints.