Premenstrual syndrome
Premenstrual syndrome (PMS) is a common problem in women at fertility age from menarche to menopause [1]. It appears through a set of physical, psychological, or behavioral symptoms that start at the late luteal phase of menstruation cycle (five to seven days before bleeding) and last for two to four days after bleeding. This cycle happens continuously [2]. Different and many symptoms are reported for PMS. Among the common symptoms are anxiety, irritability, depression, moodiness, sleep disorder, fatigue, breast pain, loss of sexual desire, weight gain, headache, appetite change, general pain, lack of concentration, and isolation [3].
The severe and debilitating form of PMS was described as premenstrual dysphoric disorder (PMDD) in 1994. This form of PMS is featured with stronger mood symptoms and strong function disorders [4].
In a meta-analysis study on the published papers between 1996 and 2011, Dirkvand et al. reported a prevalence rate of 47.7% for PMS. Their study covered 18803 subjects and the highest and lowest prevalence rate of the syndrome were 98% (Iran) and 12% (France) respectively [5]. A study on women at 15-49 yeas age range in Tehran estimated the prevalence of PMS equal to 64.4% [6].
Depression is one of the symptoms of PMS, which appears as a constant depressed mood in the individuals. Loss of desire or happiness, feeling less energy that lasts for at least two weeks, lower self-confidence, self-blame, sense of guilt and suicidal thoughts, loss concentration, change in sensory motor activity, and sleep and appetite disorders are some of the symptoms [7].
Anxiety is another symptom of PMS, which is a mood or feeling of disquietude, restlessness, discomfort, fear, and hesitation that are rooted in expecting a danger or a threat. In many cases, the internal mental factors, which have no clear source, outnumber the external factors [8]. Anxiety might be a form of temporary mental and physical tension (situational anxiety) or a specific trait and part of the permanent characteristics (trait anxiety) [9].