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PMS Predicts Problem Menopause


WebMD Health News

May 5, 2004 -- Women who suffer from premenstrual syndrome (PMS) are likely to have a harder time later in life during the transition to menopause, new research shows.

In a study published in the May issue of the journal Obstetrics and Gynecology, investigators found that PMS suffers were twice as likely to experience hot flashes and mood swings as they approached "the change" as women who did not have PMS.

While it may seem unfair, the link does make sense, Pamela Boggs the North American Menopause Society director of education and development tells WebMD. She says women with PMS tend to be especially sensitive to fluctuating hormones, and fluctuating hormones are also the cause of the symptoms associated with the time prior menopause, known as perimenopause.

"We have known for some time that if a woman has bad PMS in her younger years this is a fairly good predictor of a bad perimenopause," she said. "During this period estrogen levels are high some days and low others, and this is especially troubling for women who are sensitive."

From PMS to Hot Flashes

Most women reach menopause, defined as having a year without a period, in their early 50s. Perimenopause is the period lasting a decade or so before that when menstrual bleeding become erratic and many women experience hot flashes, depression, and other well-known symptoms associated with the end of the reproductive years.

In the newly reported study, researchers followed 436 women approaching perimenopause for five years, in an effort to determine if PMS was predictive of these common symptoms.

All the women were between the ages of 35 and 47 when enrolled in the study, and all reported normal menstrual cycles during the preceding three months.

PMS symptoms declined significantly as menstrual bleeding became less frequent, with the likelihood of having PMS decreasing by 26% among the women considered to be in early perimenopause and by 80% among women who were late in the transition period.

The women with PMS at enrollment were twice as likely to report hot flashes during the study period, and slightly more than twice as likely to report having symptoms of depression. Women with PMS were also 50% more likely to report problems with sexual desire and 72% more likely to report problems sleeping.

Symptoms Similar

Clinicians often have a hard time distinguishing between PMS and perimenopause because many of the symptoms are similar. This study showed that a main defining characteristic of menopausal symptoms is the fact that they can occur at anytime and are not, like PMS, cyclic in nature.

"We concluded that changes in cycle length may, in fact, signify the transition to menopause, and that symptoms occurring frequently throughout the cycle, and not just during the premenstrual period were also predictive," author Ellen W. Freeman, PhD, of the University of Pennsylvania Medical Center tells WebMD.

Freeman also explains that the implications for treatment are not yet clear, but it may be that women with PMS who respond well to treatment with antidepressants may be particularly responsive to similar treatment for the symptoms of menopause.

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