The symptoms of premenstrual syndrome can affect many women and members of their entire family. These monthly symptoms can vary in severity and, if not adequately managed, can have serious consequences.
What is Premenstrual Syndrome?
Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. An estimated 3 of every 4 menstruating women experience some form of premenstrual syndrome. Symptoms tend to recur in a predictable pattern. The physical and emotional changes that a woman experiences with premenstrual syndrome may be particularly intense in some months and only slightly noticeable in others. A few women have more severe symptoms, that disrupt work or personal relationships, known as premenstrual dysphoric disorder (PMDD).
Who Gets PMS?
Any woman who has a period can get PMS, but PMS is more likely in the late 20s to mid-40s.Older teens tend to have more severe PMS than younger teens.Women who have had at least one pregnancy are more prone to PMS.Women with a history of depression or other mood disorder may have more PMS symptoms.
What are the symptoms of PMS?
There are many symptoms associated with PMS but the following are very common:
Cravings – Many women get specific cravings when PMS strikes, often for sweet or salty foods like chocolate cake. The reasons for this are not really clear. Other women may lose their appetite or get an upset stomach. Bloating and constipation are also common.
Mood swings – Unpredictable mood swings are common. Irritability, anger, crying spells, depression, and anxiety may come and go in the days leading up to the woman’s period. Some women even have trouble with memory and concentration during this time.
Other symptoms include:
Acne flare-ups
Trouble falling asleep (insomnia)
Social withdrawal
PMS can trigger a wide range of aches and pains, including:
• Back pain
• Headaches
• Tender breasts
• Joint pain
What Causes PMS?
The exact cause of PMS is not clear, but we do know that levels of oestrogen and progesterone drop during the week before a woman’s menstrual period. Many doctors believe this decline in hormone levels triggers the symptoms of PMS. Changes in brain chemicals or deficiencies in certain vitamins and minerals may also play a role. Too many salty foods, alcohol, or caffeine may make symptoms worse as well.
PMS and similar disorders
The symptoms of PMS can be similar to or overlap with other conditions, including:
• Perimenopause
• Depression or anxiety
• Chronic fatigue syndrome
• Thyroid disease
• Irritable bowel disease
The key difference is that PMS symptoms come and go in a distinct pattern, month after month.
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) follows the same pattern as PMS, but the symptoms are more disruptive. Women with PMDD may experience panic attacks, crying spells, suicidal thoughts, insomnia, or other problems that interfere with daily life. Fortunately, many of the same strategies that relieve PMS can be effective against PMDD.
Risk factors for PMDD include a personal or family history of depression, mood disorders, or trauma.
Treatment for PMS
Treatment will vary from one individual to another. Some individuals have found relief by having moderate physical activity, while others have benefited by using vitamin B and complex carbohydrates. Avoidance of certain foods is also beneficial. These include cutting back on:
• Salt, which can increase bloating
• Caffeine, which can cause irritability
• Sugar, which can make cravings worse
• Alcohol, which can affect mood
Stress
There is no doubt that PMS can cause tension, anxiety, and irritability. It is important to find healthy ways to cope with stress. Different strategies work for different women. You may want to try yoga, meditation, massage, writing in a diary, or simply talking with friends. Getting at least seven to eight hours of sleep is also important.
Medications
Over-the-counter pain relievers can ease some of the physical symptoms of PMS such as breast tenderness, headaches, back pain, or cramps.
Hormone Treatments
Birth control pills prevent ovulation by regulating hormones. This usually leads to lighter periods and may reduce the symptoms of PMS. Other hormonal and non-hormonal medicationsare also beneficial. Talk to your gynaecologist about these medications.
Herbal Extracts
Herbal remedies for PMS have not been well studied, but some women get relief from chasteberry, black cohosh, and evening primrose oil. Check with your doctor before trying these herbs. They may interact with medications or be harmful for people with certain chronic conditions.
When to see a doctor
If you find it very difficult to manage your premenstrual syndrome with lifestyle changes, and signs and symptoms of PMS are seriously affecting your health and daily activities, see your gynaecologist.
Conclusion
The symptoms of PMS can be very intense at times, but you do not have to let these problems control your life. Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome. Have a visit to your gynaecologist if the symptoms of PMS are proving unbearable.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the JohnsonBuilding in The Valley.
