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Description: A constellation of symptoms characterized by nervousness, irritability, emotional instability, depression, headaches, edema, mastalgia and food cravings, which arise in the 7-14 days before menses starts. Causes: There are four types of PMS, each of which has distinct characteristics, and relationship to hormonal fluctuations: PMS-A: anxiety: mood swings, nervous tension, irritability, anxiety; related to high estrogen, low progesterone. PMS-C: craving: increased appetite, headache, fatigue, dizziness, fainting, palpitations; related to increased carbohydrate tolerance, decreased prostaglandin E1 in some. PMS-D: depression: depression, crying, forgetfulness, confusion, insomnia; related to low estrogen, high progesterone, elevated adrenal androgens if hirsute. PMS-H: hyperhydration: fluid retention, weight gain, swollen extremities, breast tenderness, abdominal bloating; related to excess aldosterone. Most PMS sufferers will experience symptoms from more than one group. The most common is group A. Symptoms: craving foods especially chocolate or sugar abnormal (for the patient) mood swings and hyperirritability edema bloating breast tenderness back pain constipation and diarrhea

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