Premenstrual syndrome (PMS) is the period of 4-6 days before menstruation when a wide variety of symptoms occur, such as mood swings, irritable breasts, increased food cravings, fatigue, nervousness and depression. It is estimated that up to 3 out of 4 menstruating women have experienced some form of premenstrual syndrome during their reproductive period. The symptoms tend to become increasingly recurrent. The physical and emotional changes you experience during premenstrual syndrome can vary from slightly noticeable to severe. However, you don't have to let these problems control your life. Treatments and lifestyle adjustments can help you reduce or manage its signs and symptoms.
Symptoms
- Tension or anxiety
- Depressive mood
- Mood swings, sadness, irritability or anger
- Changes in appetite and greater craving for food
- Difficulty sleeping (insomnia)
- Social isolation
- Poor concentration
- Change in libido
Physical signs and symptoms
- Pain in the joints or muscles
- Headache
- Fatigue
- Weight gain associated with fluid retention
- Abdominal bloating
- Tenderness and chest pain
- Exacerbations of epidermal acne
- Constipation or diarrhea
- Alcohol intolerance
A small number of women with premenstrual syndrome have symptoms almost every month. For some, the physical pain and emotional stress are severe enough to affect their daily lives. This form of PMS is called premenstrual dysphoric disorder (PMDD). The signs and symptoms of PMDD include depression, intense mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.
When you should visit your doctor
If you are unable to manage your premenstrual syndrome with small but significant lifestyle changes and its symptoms are affecting your health and daily activities, see your doctor immediately.
Causes
Exactly what causes PMS is unknown, but several factors may be key contributors:
- Cyclical hormonal changes
The symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
- Chemical changes in the brain
Fluctuations in serotonin, a brain chemical (neurotransmitter) believed to play a key role in mood control, could cause PMS symptoms. Insufficient amounts of serotonin can contribute to premenstrual depression, as well as fatigue, food cravings and sleep problems.
- Depression
Some women with severe premenstrual syndrome have undiagnosed depression, although depression alone does not cause all symptoms
Diagnosis
There are no laboratory tests to confirm premenstrual syndrome. To help you, you may be asked to record your signs and symptoms in a diary for at least two menstrual cycles. Note the day you first notice PMS symptoms, as well as the day they disappear. Be sure to also note the days your period starts and ends. Certain conditions can mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders such as depression and anxiety.
Treatment
For many women, changes in daily lifestyle, diet modification and physical exercise can help relieve PMS symptoms. But depending on the severity and intensity of your symptoms, your doctor may prescribe one or more medications for the syndrome. The success of medications in relieving symptoms varies among women. Medications commonly prescribed for premenstrual syndrome may include:
Antithetical
Selective serotonin reuptake inhibitors (SSRIs) - which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) etc - have been successful in reducing mood symptoms. SSRIs are the first-line treatment for severe PMS or PMDD. These medications are generally taken daily. But for some women with PMS, antidepressant use may be limited to two weeks before the onset of menstruation.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Taken before or at the start of your period, NSAIDs such as ibuprofen or naproxen can relieve cramps and chest discomfort.
Diuretics
When exercise and limiting salt intake are not enough to reduce the weight gain, swelling and bloating of premenstrual syndrome, taking diuretics can help your body eliminate excess fluid retention through urination.
Contraceptives
These medications can provide controlled relief from the symptoms of PMS in younger age groups.
Lifestyle and treatments
Most of the time you can manage or reduce the symptoms of premenstrual syndrome by making changes to your diet, exercise and approach to your daily routine on your own.
Modify your diet
Eat smaller, more frequent meals to reduce bloating and the feeling of fullness. Limit salt and salty foods to reduce bloating and fluid retention. Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains. Choose foods rich in calcium. If you can't tolerate dairy products or don't get enough calcium in your diet, a daily calcium supplement can help. Avoid excessive caffeine and alcohol consumption.
Incorporate exercise into your daily routine
Do at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and relieve certain symptoms, such as fatigue and depression.
Reduce stress
Sleep a lot. Do progressive muscle relaxation or deep breathing exercises to help reduce headaches, anxiety or sleep problems (insomnia). Try yoga or massage to relax and relieve stress.
Record your symptoms systematically and methodically over a few months Keep a record to identify the triggers and the timing of your symptoms. This will allow you to intervene with personalized strategies that may help reduce them.
Vitamin supplements
Taking calcium, magnesium, vitamin E and vitamin B6 supplements to calm the symptoms is an excellent option. Relief of symptoms of premenstrual syndrome has also been reported with the use of herbs such as ginkgo biloba, ginger, chasteberry (Vitex agnus) and primrose oil.
Acupuncture
Many women report relief from symptoms after acupuncture treatment.
Homeopathic alternative therapy has also provided valuable help in PMS.
