Scientists have discovered that all three conditions are caused by the same chemical change in a part of the brain which deals with anxiety and stress. Their findings could lead to new treatments for PMS and baby blues, as well as cures for hangovers and aids for addicts trying to conquer their habit.
The common factor is a chemical 'messenger' in the brain called GABA, which dulls circuits responsible for anxiety and stress. GABA is triggered by narcotics and tranquillisers. But researchers found it is also affected by progesterone, the natural steroid produced during pregnancy and when women reach the end of a monthly cycle. The hormone enhances the effect of GABA in the brain, helping it to calm and soothe.
But at the end of pregnancy and just before menstruation, levels of progesterone suddenly drop. At these times GABA is unable to work properly, triggering the symptoms of stress, anxiety and mood swings associated with PMS and postnatal depression. Because drugs act on the same part of the brain, cold turkey has very similar side effects.
Researchers at the Allegheny University of the Health Sciences in Philadelphia investigated the inner workings of the brain by giving rats progesterone for several weeks before then suddenly withdrawing it. They found that GABA immediately lost some of its calming properties and the rats showed symptoms of anxiety. According to the experts, the sudden withdrawal of sedatives such as alcohol and drugs has exactly the same affect.
If science can find drugs to boost the effects of GABA, they could be used to ease the tension, stress and mood swings of PMS and the symptoms of postnatal depression and hangovers.
For two weeks every month, Shelley Machin's life was 'sheer hell.' The mother of two crouched weeping on the sofa, unable to answer the door, make dinner or look after her baby son, Tom. Then her moods would swing so wildly that Shelley would scream and throw things at her husband Tony.
'I was a monster,' says Shelley. 'Every month, before my period, I was convinced I was going mad. I'd repeat sentences over and over again, break crockery and suffer panic attacks that were so bad I thought I was having a heart attack. My body ached so much I thought I would explode. And then, two days after I started bleeding, calm would descend again.'
Shelley is one of the 1.5 million women who have such severe PMS that it affects their health and disrupts life with work, family and friends.
For some of these, a new and controversial medical development could spell the end to their suffering.
Prozac is the first prescription medication to be approved for the treatment of PMS. Professor Shaughn O'Brien, a consultant gynaecologist at North Staffordshire NHS hospital, has been prescribing Prozac for over four years. 'I would say that 80 per cent of my patients with moderate to severe PMS have been helped by Prozac,' he says.
Prozac is one of a class of anti-depressants called SSRI's that work by increasing the amount of serotonin, the 'feel-good hormone' in the brain. The recent studies, conducted in the U.S. and by University College, London, suggest the drug's efficiency in alleviating both emotional and physical symptoms of PMS.
'Traditionally, PMS was thought to be caused by a hormone imbalance,' says Professor O'Brien. 'But it's now been established that hormone levels are normal and don't fluctuate throughout the woman's cycle.
'Basically, the body is reacting in an abnormal way to normal hormone levels. This reaction is thought happen in the brain, rather than the body, and to to involve the neurotransmitter serotonin. This is why Prozac, which inhibits the reuptake of serotonin, is effective.
'The amazing thing about these studies is that even physical symptoms such as bloating and sore breasts are alleviated by SSRIs,' says O'Brien. 'At present the reason is not clear. It's probably to do with our perception and response to pain. Because our nerve impulses are modified by serotonin, it influences the way we feel pain.'
Shelley was started on 20mg of Prozac (the lowest dose) every morning. 'For the first few days, I felt a bit nauseous, but this soon wore off, and within six weeks I noticed an incredible improvement,' she says.
'I now no longer feel the world's coming to an end for two weeks every month. I'm less anxious, so much calmer and, most of all, nicer to my husband and the children. My body doesn't ache the way it used to, and I sleep better. Sure, I still have my off days, but I don't know if these are related to my period or not. Prozac has changed my life.'
However, not all the medical profession holds with this view of Prozac as a 'miracle drug'. There are fears that patients turn to a quick-fix pill too quickly, without dealing with other lifestyle issues.
'We see Prozac as a last resort, not a first remedy,' says Christine Baker of the National Association for Pre-Menstral Syndrome.'There are many other non-prescription treatments that should be pursued first. Women should alter their lifestyle to avoid stress, eat a diet rich in magnesium and low in salt and sugar and take regular exercise. Evening Primrose Oil, to soothe breast pain, can also help.'
Consultant gynaecologist, Dr Katherina Dalton, the first doctor to describe PMS as a syndrome in 1953, is also sceptical. 'In my opinion, an SSRI cannot help physical symptoms. The correct treatment is to treat with the hormone progesterone, combined with a three-hourly diet high in carbohydrate. If there are long gaps between food, the blood sugar falls, and symptoms worsen.'
Dr Dalton also feels that the world of medicine has moved on since Prozac. 'There are now far more effective SSRI's, such as Seroxat, with far fewer side-effects,' she says. ( dailymail.co.uk )
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