Managing Menopause - Premenstrual Syndrome (PMS)

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Premenstrual Syndrome (PMS)

What is Premenstrual Syndrome?

Premenstrual syndrome (PMS) refers to the emotional and physical symptoms that many women experience leading up to their period (menstruation).

The symptoms associated with PMS, can range from very mild to very severe and start approximately four to 10 days before the next period and often stop after bleeding begins.

The exact cause and the differing severity of symptoms, of PMS is not properly understood. PMS is a complex condition involving emotional, physical, hormone and environmental factors.

Stress levels, psychological state, cultural and social environment, and changes in neurotransmitters (brain chemicals), like serotonin, may all influence PMS symptoms.

Symptoms can include:

Emotional symptoms	Physical symptoms
Irritability Anxiety Nervous tension Lower coping ability Difficulty concentrating Wanting to be alone Lower libido Reduced interest in work and social life Mood swings Depression Aggression	Fluid retention (swollen fingers or ankles) Bloating around the abdomen Breast swelling and tenderness Headaches Tiredness, lethargy, insomnia Increase in weight Constipation Food cravings Aches and pains Poor coordination or clumsiness Skin problems such as acne

Premenstrual dysphoric disorder (PMDD)

About five per cent of menstruating women suffer from seriously debilitating PMS, which is sometimes known as premenstrual dysphoric disorder (PMDD). The symptoms are so severe that they interfere with daily life. It is important to speak to your health practitioner if this is the case.

Self management of PMS

Physical activity

Regular physical activity is important, particularly during the premenstrual phase. Choose a form or variety of physical activity you enjoy.

Physical activity increases endorphins (one of the brain’s neurotransmitters or chemicals) and may reduce symptoms. Endorphins also act as natural painkillers and help you feel more relaxed and in control. If possible, exercise should be daily, especially when symptoms are at their peak.

Reduce stress

Make an effort to avoid extra stresses. Take time out to relax and enjoy your own interests.
Talk to your family about your PMS and help them develop strategies to be supportive during this time.
Consider professional councelling - cognitive behavioural relaxation therapy uses one or a variety of relaxation techniques to relieve psychological and / or physical symptoms.

Lifestyle factors

Eat regular, healthy meals including plenty of vegetables, fruit, mixed grains and cereals.
Eat small meals to maintain stable energy levels, this will also significantly reduce food cravings.
Drink less caffeine – particularly if you are suffering breast tenderness. Try drinking water instead (6-8 glasses a day).
Cut down on alcohol..
Cut down salt and salty foods to help reduce fluid retention.
Increase calcium in your diet.
Get enough rest, sleep and exercise.
Don’t smoke.
Wear a well fitting cotton bra if you suffer tense, painful breasts.

Treatment of PMS

If you’re suffering from PMS symptoms, consult your health practitioner. It’s important that other possible causes of the symptoms are excluded and, although no ‘cure’ can be offered, there are many treatments that help reduce and, for some women, completely alleviate PMS symptoms.

Vitamins, minerals and herbs – many supplements have been shown to be helpful for PMS. Some supplements that may be beneficial include vitamin E, magnesium, vitamin B6 and evening primrose oil. Always consult your health practitioner before taking any supplement, as they may have unwanted effects or interact with other medications.

Complimentary therapies – such as acupuncture or naturopathy can be helpful in relieving psychological and/or physical symptoms.

Medications – there are a range of medications available that may help, such as selective serotonin reuptake inhibitors (SSRIs), anti-prostaglandin and anti-inflammatories, and diuretics (fluid pills).

Hormonal treatments – these help to suppress ovulation and reduce the hormones of the premenstrual phase. Hormone therapies can include contraceptive therapies such as the oral contraceptive pill. Consult your health practitioner for further information regarding hormone treatment options.

Things to keep in mind

Premenstrual syndrome (PMS) refers to the range of physical and emotional symptoms that some women experience in the lead-up to their period.
Most PMS symptoms can be managed with lifestyle modifications, exercise, diet and supplements. However if symptoms persist and interfere with daily activities, you may need to seek referral to a gynaecologist with expertise in PMS.
It may be useful to keep a detailed diary of at least three menstrual cycles to see if there is a pattern with your symptoms. It also allows you and your health practitioner to talk about the best treatment options for you.