Introduction
Premenstrual syndrome is the combination of psychological and physical symptoms caused by hormonal fluctuations before menstruation. It is a multifactorial disorder, which consists of psyche, nervous system and hormonal balance. Usually the contraceptive pill is used to control the hormones in the cycle and a premenstrual syndrome should not occur. However, this is different with the mini-pill and a low-dose pill, as the body’s own hormones maintain an almost normal cycle.
Why can a premenstrual syndrome occur despite the pill?
Since the exact cause of the premenstrual syndrome is not yet clear, various options are discussed. One possibility why a premenstrual syndrome occurs despite the pill is simply that the pill is underdosed. Not every woman needs the same amount of hormones in her cycle and especially at the beginning of taking the pill gynaecologists try low-dose preparations first, which is not always sufficient.
The body is therefore still subject to fluctuations in the hormone balance. The pill break, which many women take after three weeks, also causes cyclical hormone fluctuations and can therefore also trigger symptoms. Since psychological factors also seem to play a role in the development of a premenstrual syndrome, knowledge about the pill break and the coming abortion bleeding can already cause symptoms.
Another reason for a premenstrual syndrome is taking the mini-pill. This is a pure progestin preparation which only prevents the sperm from entering the uterus and does not prevent the egg from maturing. The minipill therefore allows the body to have an almost natural cycle and cannot prevent premenstrual syndrome.
Since the cause of premenstrual syndrome is at least partly to be found in the hormone balance of the woman, an artificial supply of hormones with a pill break can also cause symptoms that did not occur before taking the pill. As a cause it is also discussed that some women do not tolerate the breakdown products of the progestins and these are contained in all pill preparations. If this theory is true, the pill is also a possible cause of premenstrual syndrome.
After discontinuing the contraceptive pill the body returns relatively quickly to a natural cycle, including the hormonal fluctuations that are at least partly responsible for the premenstrual syndrome. Stopping the pill is a major change in the body’s hormone balance and can trigger premenstrual syndrome even in women who have never had any symptoms. In addition, most of those affected do not develop premenstrual syndrome until after the age of 30, and this is often the period in which the pill is discontinued due to the desire to have children.
Many girls today take a pill in early adolescence and do not even know about their natural physical reactions within their monthly cycle. These girls and women then sometimes perceive even mild symptoms as premenstrual syndrome. However, if the symptoms after stopping the pill mean restrictions in everyday life, it is possible to consider taking the pill again. For some people, discontinuing the pill can also lead to an improvement in symptoms, as the mood is often improved by the elimination of systemic hormones.
