Estrogen and progesterone may cause transitory fluid retention, which seems to explain some PMS symptoms. Production of pregnenolone, which has an opposite effect in the brain, may be increased. The type and intensity of symptoms vary from woman to woman and from cycle to cycle. When menses begins, some women develop dysmenorrhea. Significant dysmenorrhea is more common among teenagers and tends to diminish with age.
Fluid retention causes edema, transient weight gain, oliguria, and breast fullness and pain.
Neurologic and vascular symptoms include headache, vertigo, syncope, paresthesias of the extremities, easy bruising, and cardiac palpitation. Epilepsy may be aggravated. GI symptoms include constipation, nausea, vomiting, and changes in appetite. Pelvic heaviness or pressure and backache may occur. Acne, neurodermatitis, and aggravation of other skin disorders may also occur.