Some women experience certain premenstrual symptoms called premenstrual tension about 7-10 days before the start of menstrual bleeding. These premenstrual symptoms include irritability, malaise, lassitude, headache, gastrointestinal upset like constipation and spasm of colon, feeling of fullness of the breasts and abdomen, frequency of urination etc. There may also be feeling of congestion in the feet and face. In some women these symptoms become exaggerated and form a well marked psychosomatic disorder.
In some of the cases of premenstrual tension water retention can be demonstrated by an increase of body weight up to 5 kilos which is accompanied by pedal edema. This is more marked if the patient has history of phlebothrombosis. The fullness of breasts can be prominent symptom and can be accompanied by breast tenderness. On examination of breasts, there is hardness and lumpy feeling and there is also tenderness. Some women with premenstrual tension suffer from migraine headache which disappear if the woman become pregnant.
The cause or etiology of premenstrual tension is not clear. It is suggested (but not proved) that premenstrual tension may be due to excess production of estrogen and abnormal or disturbance in adrenal function, because there is always an increase of extra-cellular water throughout the body. This is because estrogen is recognized to cause water and sodium retention as seen in carcinoma of prostate, where there is excess production of estrogen. But presence of large amount of estrogen does not always produce water retention as seen in granulosa cell tumor. Adrenal cortical steroids and progesterone (progesterone containing oral contraceptive pills may are well known for their water retention properties) can also cause water retention, so it may not be always due to estrogen excess.