Photo from womenshealth.gov
PMS manifests itself in a variety of ways, including mood swings, tender breasts, food cravings, fatigue, irritability, and depression. It is estimated that up to three out of every four menstruating women have had some form of premenstrual syndrome.
Symptoms tend to repeat themselves in a predictable pattern. However, the physical and emotional changes associated with premenstrual syndrome can range from barely noticeable to intense.
Nonetheless, you do not have to let these issues rule your life. Treatments and lifestyle changes can help you reduce or manage premenstrual syndrome symptoms.
WHAT ARE THE SYMPTOMS OF PMS?
The list of potential premenstrual syndrome signs and symptoms is lengthy, but most women only experience a few of these issues.
Emotional and behavioural signs and symptoms
- Anxiety or tension
- Depressed state
- Crying spells
- Social isolation
- Inability to concentrate
- Libido fluctuation
- Mood swings, irritability, and anger
- Changes in appetite and food cravings
- Having difficulty falling asleep (insomnia)
Physical signs and symptoms
- Muscle or joint pain
- Headache
- Fatigue
- Acne flare-ups
- Diarrhea or constipation
- Intolerance to alcohol
- Weight gain caused by fluid retention
- Bloating in the abdomen
- Tenderness in the breasts
Physical pain and emotional stress are severe enough for some people to interfere with their daily lives. Regardless of symptom severity, most women's signs and symptoms disappear within four days of the start of their menstrual period.
However, a small percentage of women with premenstrual syndrome experience disabling symptoms every month. This type of PMS is known as premenstrual dysphoric disorder (PMDD).
Depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability, and tension are all PMDD signs and symptoms.
WHAT ARE THE CAUSES OF PMS?
Although it is unknown what causes premenstrual syndrome, several factors may contribute to the condition:
- Cyclic changes in hormones: Premenstrual syndrome symptoms change with hormonal fluctuations and disappear during pregnancy and menopause.
- Chemical changes in the brain: Serotonin fluctuations, a brain chemical (neurotransmitter) thought to play an important role in mood states, could trigger PMS symptoms. Serotonin deficiency may contribute to premenstrual depression, as well as fatigue, food cravings, and sleep issues.
- Depression: Some women with severe PMS have undiagnosed depression, even though depression does not cause all of the symptoms.
HOW IS PMS DIAGNOSED?
There are no distinguishing physical findings or laboratory tests that can positively identify premenstrual syndrome. If a symptom is part of your predictable premenstrual pattern, your doctor may attribute it to PMS.
Your doctor may ask you to record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles to help establish a premenstrual pattern. Take note of when you first notice PMS symptoms and when they go away. Make a note of the days your period begins and ends.
Certain conditions, such as chronic fatigue syndrome, thyroid disorders, and mood disorders such as depression and anxiety, can mimic PMS. To help provide a clear diagnosis, your health care provider may order tests such as a thyroid function test or mood screening tests.
WHAT ARE THE TREATMENTS FOR PMS?
Lifestyle changes can help relieve PMS symptoms in many women. However, depending on the severity of your symptoms, your doctor may recommend one or more premenstrual syndrome medications.
The effectiveness of medications in relieving symptoms varies between women. Premenstrual syndrome medications that are commonly prescribed include:
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and others, have been shown to reduce mood symptoms. For severe PMS or PMDD, SSRIs are the first-line treatment. These medications are typically taken on a daily basis. However, for some women with PMS, the use of antidepressants may be restricted to the two weeks preceding menstruation.
- NSAIDs (nonsteroidal anti-inflammatory drugs): NSAIDs such as ibuprofen (Advil, Motrin IB, and others) or naproxen sodium (Aleve) can relieve cramping and breast discomfort if taken before or at the start of your period.
- Diuretics: When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling, and bloating associated with PMS, taking water pills (diuretics) can assist your body in excreting excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help alleviate some PMS symptoms.
- Hormonal contraceptives: These prescription medications prevent ovulation, which may alleviate PMS symptoms.
HOME REMEDIES FOR PMS
Premenstrual syndrome symptoms can sometimes be managed or reduced by making changes to your diet, exercise routine, and daily routine. Consider the following suggestions:
Change your diet
- Reduce bloating and the sensation of fullness by eating smaller, more frequent meals.
- To reduce bloating and fluid retention, limit your intake of salt and salty foods.
- Choose complex carbohydrates-rich foods such as fruits, vegetables, and whole grains.
- Choose calcium-rich foods. A daily calcium supplement may help if you can't tolerate dairy products or aren't getting enough calcium in your diet.
- Caffeine and alcohol should be avoided.
Include exercise in your daily routine.
Most days of the week, engage in at least 30 minutes of brisk walking, cycling, swimming, or other aerobic activity. Exercise on a daily basis can help improve your overall health and alleviate symptoms such as fatigue and depression.
Reduce your stress.
Get enough sleep.
To relieve headaches, anxiety, or difficulty sleeping, try progressive muscle relaxation or deep breathing exercises (insomnia).
To relax and relieve stress, try yoga or massage.
Keep track of your symptoms for a few months.
Keep a record to help you identify the causes and timing of your symptoms. This enables you to intervene with strategies that may help to mitigate them.
ALTERNATIVE MEDICINES FOR PMS
What is known about the efficacy of complementary remedies used to treat premenstrual syndrome symptoms is as follows:
- Vitamin supplements: Calcium, magnesium, vitamin E, and vitamin B-6 have all been reported to relieve symptoms, but research is limited or non-existent.
- Herbal treatments: Herbs such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil, and St. John's wort have been reported to help relieve PMS symptoms in some women. However, few scientific studies have found that herbs can help relieve PMS symptoms.
Herbal remedies are also not regulated by the FDA, so there is no record of product safety or effectiveness. Before using any herbal products, consult your doctor because they may cause side effects or interact with other medications you're taking. For example, St. John's wort reduces the effectiveness of birth control pills.
- Acupuncture: Acupuncturists use sterilized stainless steel needles to insert into the skin at specific points on the body. Some women report symptom relief following acupuncture treatment.