Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) involves a multitude of symptoms occurring during the last week of the luteal phase (the weeks before menstruation) in most menstrual cycles. About half of the women who have PMS report only mild symptoms. For the remaining half, the symptoms are more severe. These symptoms usually disappear a few days after menstruation begins. PMS can occur at any time during the woman's reproductive years and seems to remain fairly constant until menopause, although symptoms may vary between cycles. The risk for PMS is usually higher in younger women, and in women who have a mother with PMS. In addition, women who have given birth to several children, those who are sedentary and women under stress have increased risks.

Causes and Symptoms

The exact cause of PMS is still unclear. One theory suggests that some women who experience PMS may be abnormally sensitive to normal amounts of estrogen and progesterone in their bodies - perhaps because of altered hormone receptors in the brain.

The following are some common symptoms :

• Breast tenderness
  
• Fluid retention
• Weight gain
• Acne
• Abdominal bloating
• Irritability
• Depression
• Mood swings
• Increased appetite with specific food cravings, typically sweet and salty foods
• Lethargy and fatigue
• Insomnia

Keep in mind that these symptoms may also be caused by other factors, particularly if they persist or do not follow a pattern consistent with the occurrence of menses.

Suggested Lifestyle Changes

• Keep a sympton diary. This may help you understand the symptoms when they occur, predict them rather than be taken by surprise, and rule out other causes of the symptoms if they are not actually tied to your menstrual cycle.
• Avoid alcohol and caffeine, including chocolate. Both of these can make the symptoms of PMS worse.
• Keep blood sugar levels stable. Eat small, frequent, balanced meals throughout the day.
• Get regular aerobic ecercise.
  
• Practise relaxation. Use breathing exercises daily and make use of a technique like yoga or meditation.

Nutrition and Supplements

The following supplements can be of help in relieving symptoms:

• Calcium. Recent studies have demonstrated that, when used for three months, supplemental calcium can help reduce the severity of PMS symptoms. I recommend supplementing with 500-700 mg daily.
• Magnesium. Magnesium deficiency has been associated with PMS. Supplemental magnesium may help alleviate some of the emotional symptoms, fluid retention and breast tenderness.
• Vitamin B6. Take a good multivitamin or B complex
• Evening primrose oil or black currant oil. These are sources of gamma-linolenic acid (GLA) that can help influence prostaglandin synthesis.
• Dong quai is a readily available Chinese herb used traditionally as a general tonic for women, however this herb should not be taken if a woman is experiencing heavy bleeding. Chaste tree herb (vitex) can also be helpful.
• Raspberry leaf tea is an effective remedy for painful menstrual cramps.

Should I Get Help?
Don’t feel badly if you can’t control PMS on your own. Many women can’t. If you need more help, see your health care provider for further treatment.

Medications sometimes used are : some types of birth control pills, a diuretic to help with bloating, an antidepressant, sometimes taken for only part of the cycle and which can help both the mental and physical symptoms.