The premenstrual syndrome: moods, headaches and physical symptoms in 133 menstrual cycles

Seven moods and 5 physical symptoms have been observed daily throughout the course of 133 menstrual cycles, in 44 women with the premenstrual syndrome (PMS). The evidence suggests the existence of 2 symptom cyclicities, the first with symptoms appearing early in the luteal phase and reaching a maximum close to the end of the menstrual cycle, and the second with symptoms appearing late in the luteal phase and reaching a maximum on the first or second day of the new cycle. Only headaches followed the second pattern. Headaches, unlike the other PMS symptoms, were symmetrically distributed about day 0 in the menstrual cycle with 53.8% of the peak area occurring in the 10 days before the start of menstruation (95% range, 38.6–68.7%). By comparison, the premenstrual percentages for the 7 moods and for bloating, constipation, food craving and breast discomfort ranged from 77.8 to 93.4% (mean ± S.D., 84.3 ± 6.1%) indicating that these symptoms occur mainly in the premenstruum. It is concluded that headaches are a peri-rather than a pre-menstrual phenomenon in women with PMS and as such are to be distinguished from the other symptoms which were studied.