Premenstrual syndrome (PMS), is experienced by many women of all ages during their reproductive years. For some women, PMS can be bothersome and relatively mild. However, in more severe cases, it can be life-altering, affecting a woman’s daily life.
PMS is ordinarily experienced 1-2 weeks before a woman’s period, resolving with the initiation of bleeding or subsiding within the first 4 days of bleeding onset.
PMS is described as a compilation of symptoms associated with a woman’s menstrual cycle.
Symptoms associated with PMS vary. Women may experience just a single symptom irregularly during PMS, or multiple symptoms chronically. Symptoms may include:
- tension, anxiety, or depression
- mood swings, irritability, anger, crying, social withdrawal
- food cravings, appetite changes
- difficulty concentrating
- joint or muscle pain and aching
- headache, fatigue, insomnia, abdominal bloating
- weight gain
- breast tenderness or swelling
- gastrointestinal changes such as constipation or diarrhea
The exact causes of PMS are not fully understood. However, it is thought that chemical and hormonal changes in a woman’s body are contributing factors.
While hormonal changes might be the initial cause, other conditions can make symptoms worse. For instance, depression and other emotional problems can make PMS more severe.
Other possible contributing factors include low levels of certain vitamins and minerals, consuming salty foods, and drinking caffeine and alcohol.
It is estimated that approximately 85 percent of all menstruating women will experience at least one symptom of PMS during their menstrual cycle. Symptoms can range from mild to severe, and may be different during different cycles. Some women may regularly experience one particular symptom but then go months without it.
As many as 3 out of 4 women will experience PMS at some point during their menstrual years but those that are most susceptible include women:
- in their late 20s through their early 40s
- who have at least one child
- with a family history of depression
- with a history of postpartum depression or other mood disorders
Because PMS is not fully understood, treatment revolves around alleviating symptoms as opposed to treating the underlying issues.
While not every treatment is as effective for every woman, there are certain things that might alleviate the symptoms of PMS; these include:
Women experiencing PMS may find that the following lifestyle changes can help:
- Regular exercise.
- Eat more fruits, vegetables, and whole grains.
- Eating smaller, more frequent meals.
- Foods high in calcium, such as kale.
- Avoid salt, sugary foods, caffeine, and alcohol during periods of PMS.
- Sleep at least 8 hours per night.
- Avoid smoking.
- Manage stress with things such as yoga, massage, and talking with friends.
- Keep a record of symptoms.
These relatively simple lifestyle changes can help women alleviate symptoms.
Medication options for alleviating PMS include:
- Over-the-counter medications such as ibuprofen, ketoprofen, naproxen, or aspirin may help relieve some of the physical symptoms associated with PMS.
- Birth control pills prevent ovulation.
Medications may provide relief. However, they do not treat the underlying symptoms.
Taking certain vitamins, minerals, or supplements can help with PMS symptoms. However, it is important to speak with a doctor before taking any of these:
- folic acid
- vitamin B-6
- vitamin E
- calcium with vitamin D
- black cohosh
- evening primrose oil
- St. John’s Wort
Women should make sure that these supplements do not interact with any current medications they may be taking.
Premenstrual dysphoric disorder, referred to as PMDD, is a form of PMS in which the symptoms are severe; it affects approximately
Symptoms of PMDD include:
- Tension, anxiety, mood swings, frequent crying, and panic attacks.
- Sadness, feelings of despair, and possible suicidal thoughts.
- Irritability, anger.
- Lack of interest in normal daily activities and/or relationships.
- Difficulty with concentration or focusing.
- Fatigue, low energy, and insomnia.
- Food cravings and binge eating.
- Feelings of being out of control.
- Bloating, breast tenderness, headaches, and joint and muscle pain.
A diagnosis of PMDD is made when a woman experiences five or more of these symptoms.
Treatment of PMDD includes some of the lifestyle changes mentioned above. However, medications such as antidepressants may be necessary in some cases.
Medications approved to treat PMDD include selective serotonin uptake inhibitors (SSRIs) such as sertraline, fluoxetine, and paroxetine HCI. Additionally, the birth control pill, Yaz, may be recommended to treat PMDD. Therapy can also help.
Women concerned about PMS symptoms or who think they may be experiencing symptoms of PMDD, should speak with their doctor for evaluation.