Premenstrual Syndrome (PMS)

Whether you call it PMS (Premenstrual Syndrome) or PMT (Premenstrual Tension), if you suffer from it, it doesn't matter what it's called. It can vary from annoying to down right unfair. Unfortunately two thirds of women will be effected by it during their lifetime, although it is more common in women over the age of thirty. Nevertheless these statistics do not make it go away for those who suffer from it.

Sadly, there is no actual diagnosis to justify this condition. There are a variety of symptoms that appear before you start your period. The best way to diagnose PMS is to be aware of the symptoms and to keep a monthly diary based around your cycle, ensure you document physical and emotional changes within that time. If you find they are occurring at the later stages of the month, then it is likely that it is to do with PMS.

What is it?

It is a condition affecting women from around a few days, to two weeks prior to their period starting, displaying various symptoms such as:
Tender breasts
Bloating
Migraine
Menstrual pain
Constipation
Sugar cravings
Poor concentration
Nervous tension
Fatigue

Causes

The causes of PMS are actually unclear, although there are various theories as to why it occurs. One possibility is that it is caused by hormonal changes, which although are normal throughout the month of your cycle, they can disrupt all sorts of things in your body - especially the mind. Some medical conditions completely unrelated to your period may worsen whilst you are premenstrual, doctors are still unclear as to why this may occur.

Another reason PMS is thought to cause problems is due to low blood sugar. For unknown reasons when a woman is premenstrual her blood sugar levels are thought to drop more easily after a meal. Usually blood sugar levels stay steady for up to 5 hours after a meal, however during the premenstrual phase of a women's cycle, blood sugar levels can drop sooner (around three hours after eating). Low blood sugar can cause symptoms of poor concentration, tiredness, and sugar (carbohydrate) cravings. This is often why you find yourself craving chocolate!

Another change in the body when you are premenstrual, is an increase in hormones called prostaglandins. These hormones are directly related to inflammation processes within the body. They can cause such problems such as breast tenderness, and may relate to any increase in headaches. Prostaglandins can also decrease your pain tolerance, so don't try waxing your legs during this time, as it's likely to hurt more. It also may increase the intensity of menstrual pain suffered.

Any nervous tension suffered, is related to the hormonal changes that occur in the body as it prepares to menstruate. Some of you may be thinking "what, your only calling it nervous tension?" Some women experience the most horrific mood swings a week before their period. These women I'm sure, will have the backing of their families and boyfriends, that this condition can exist to this extreme. Sometimes for those living with a female who experiences PMT to this degree, they will say it is like living around a complete, (almost) psychotic stranger.

How can I reduce the symptoms?

For mild PMS there are various lifestyle changes that you can incorporate in to your day to day living to reduce the symptoms.

These include:

Increasing your complex carbohydrate intake, and eat them more frequently prior to your period coming (brown rice, wholemeal bread & pasta etc), this will help to reduce sugar cravings. It has been found that often the body uses more energy prior to menstruating, so the extra food eaten should not make you gain more weight.

Decrease your salt intake, as it will decrease any water retention suffered. And although you may feel full, increase the amount of water you drink, as this will actually reduce bloating also.

Eat foods high in fibre to reduce constipation (e.g. wholegrain cereals, vegetables).

Exercise regularly, as it will help to reduce pain. Exercise helps to release endorphin's (the body's natural painkillers).

For breast tenderness try evening primrose oil (this must be taken every day for any beneficial effects) as it reduces levels of prostaglandin hormones.

Try relaxation techniques, such as mediation or yoga for nervous tension.

For those who find their PMS symptoms unbearable, you need to discuss your symptoms with your doctor. You may find the need to commence some kind of hormonal treatment, this may be as simple as going on the contraceptive pill (however the pill for some, can make PMS worse, therefore if you are on it, this will also need to be evaluated). For serious symptoms, the use of SSRI antidepressants are sometimes used, however this is usually a last resort.

For most women, they should find some definite improvements in their symptoms if they follow the suggestions I have already discussed. If this is not the case please visit your doctor, as you shouldn't have to suffer from this condition throughout your childbearing years.

- Louise Ganey (RN)

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