Premenstrual syndrome (PMS)

Description

Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, such as mood changes, breast tenderness, food cravings, fatigue, irritability and depression. It is estimated that 3 out of every 4 menstruating women have experienced some form of premenstrual syndrome.

The symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary slightly noticeable all the way to the more intense.

However, you do not have to let these problems control your life. Treatments and adjustments in life style can help to reduce or manage the signs and symptoms of premenstrual syndrome.

Symptoms

The list of potential signs and symptoms of premenstrual syndrome is long, but most women only experience some of these problems.

Emotional and behavioral signs and symptoms

  • Stress or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Changes in appetite and food cravings
  • Sleep problems (insomnia)
  • Social Withdrawal
  • Lack of concentration
  • Changes in libido

Physical signs and symptoms

  • Joint or muscle pain
  • Headache
  • Fatigue
  • The weight gain related to fluid retention
  • Abdominal Swelling
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea
  • Alcohol intolerance

For some, the physical pain and the emotional stress are severe enough to affect your daily life. Regardless of the severity of the symptoms, the signs and the symptoms usually disappear in a period of four days after the start of the menstrual period, for the majority of women.

But a small number of women with premenstrual syndrome have disabling symptoms of each month. This form of premenstrual syndrome (PMS) is called premenstrual dysphoric disorder (PMDD).

premenstrual dysphoric disorder (PMDD) signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.

When to see a doctor

If you have not been able to manage your pms with lifestyle changes and the symptoms of premenstrual syndrome affecting your health and daily activities, see your doctor.

Causes

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the disease:

  • Cyclic changes in hormones. The signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with the pregnancy, and menopause.
  • Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is believed to play a crucial role in mood states, could trigger the symptoms of premenstrual syndrome. Insufficient amounts of serotonin may contribute to depression premenstrual, as well as the fatigue, food cravings and sleep problems.
  • Depression. Some women with severe premenstrual syndrome are diagnosed with depression, despite the fact that depression alone is not the cause of all symptoms

Premenstrual syndrome (PMS)

Diagnosis

There are no unique physical findings or laboratory tests to positively diagnose premenstrual syndrome. Your doctor may attribute a symptom in particular for premenstrual syndrome (PMS) if it is part of your foreseeable premenstrual pattern.

To help establish a premenstrual pattern, your doctor may need to record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you notice the symptoms of premenstrual syndrome, as well as the day to fade away. Also be sure to mark the days of your period begins and ends.

Certain conditions can mimic the symptoms of PMS , including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your doctor may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

Treatment

For many women, lifestyle changes can help relieve the symptoms of premenstrual syndrome. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.

The success of the drugs in the relief of symptoms varies between women. Commonly prescribed medications for premenstrual syndrome include:

  • Antidepressants. Selective serotonin reuptake inhibitors (Ssris), including fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and others — have had success in reducing the symptoms of mood. selective serotonin reuptake inhibitors (Ssris) are the first-line treatment for severe pms or premenstrual dysphoric disorder (PMDD). These medications are usually taken daily. But for some women with premenstrual syndrome , the use of antidepressants may be limited to the two weeks before menstruation begins.
  • Nonsteroidal anti-inflammatory drugs (Nsaids). Taken before or at the onset of your period, non-steroidal anti-inflammatory drugs (Nsaids) such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help relieve the cramps and the discomfort of the chest.
  • Diuretics. When you exercise, and limiting the intake of salt are not enough to reduce weight gain, swelling and bloating of PMS , taking water pills (diuretics) can help your body to shed the excess fluid through the kidneys. Spironolactone (Aldactone) is a diuretic that can help to relieve some of the symptoms of PMS .
  • Hormonal contraceptives. These prescription medications to stop ovulation, which can bring relief from the symptoms of premenstrual syndrome.

Self-care

Sometimes you can manage or reduce the symptoms of premenstrual syndrome, making changes in the way we eat, exercise, and the focus of the daily life. Try these tips:

Modify your diet

  • Eat smaller, more frequent meals to reduce the swelling and the feeling of fullness.
  • Restrict the intake of salt and salty foods to reduce the swelling 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 or are not getting enough calcium in your diet, a daily supplement of calcium can help.
  • Avoid caffeine and alcohol.

Incorporate exercise into your regular routine

Participate in at least 30 minutes of brisk walking, biking, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and to relieve some symptoms, such as fatigue and a depressed mood.

Reduce stress

  • Get enough sleep.
  • The practice of progressive muscle relaxation or deep breathing exercises to help reduce headaches, anxiety or sleep problems (insomnia).
  • Try yoga or a massage to relax and relieve stress.

Record of your symptoms for a couple of months

Keep a record to identify the triggering factors and the time of the symptoms. This will allow you to intervene with strategies that can help reduce them.

Alternative medicine

Here's what we know about the effectiveness of the remedies complementary used to relieve the symptoms of premenstrual syndrome:

  • Supplements of the vitamin. The calcium, magnesium, vitamin E, and vitamin B-6 have been reported to relieve the symptoms, but the evidence is limited or non-existent.
  • Herbal remedies.Some women report relief ofPMSsymptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John's wort. However, few scientific studies have found that herbs are effective for the relief ofPMSsymptoms. Herbal remedies also are not regulated by the Food and Drug Administration, so there is no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interactions with other medications you are taking. St. John's wort, for example, reduces the effectiveness of birth control pills.
  • Acupuncture. An acupuncture practitioner inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience relief of symptoms after acupuncture treatment.

Herbal remedies. Some women report relief of the symptoms of PMS with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John's wort. However, few scientific studies have found that herbs are effective for the relief of symptoms of premenstrual syndrome.

Herbal remedies also are not regulated by the Food and Drug Administration, so there is no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interactions with other medications you are taking. St. John's wort, for example, reduces the effectiveness of birth control pills.

Preparing for your appointment

It is likely to start by seeing your family doctor or primary care physician. However, in some cases, when you call to schedule an appointment, you may be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).

Here's some information to help you prepare for your appointment, and what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time of making the appointment, ask if there is something that you need to do beforehand to prepare.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of your key medical information, including any other condition you are being treated, and the names of the medications, vitamins, or supplements you are taking.
  • Consider the possibility of questions to ask your doctor and write them down. Bring along paper letter and a pen to write down the information like your doctor addresses your questions.

For premenstrual syndrome, some basic questions to ask your doctor include:

  • Is there anything I can do to minimize the symptoms of premenstrual syndrome?
  • My PMS symptoms eventually go away on its own?
  • Could the symptoms I am experiencing indicate a more serious medical condition?
  • What is the recommended treatment for the symptoms of premenstrual syndrome? What treatments are available?
  • Is there a generic alternative to the medicine you're prescribing?
  • Do you have any brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask any questions that occur during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • How severe are the symptoms?
  • On what days during the menstrual cycle your symptoms are at their worst?
  • Do you have symptom-free days during the menstrual cycle?
  • You can anticipate when the symptoms are coming?
  • Nothing seems to make your symptoms better or worse?
  • Do your symptoms interfere with your daily activities?
  • Have you recently been feeling down, depressed or hopeless?
  • Do you or someone in your family has been diagnosed with a psychiatric disorder?
  • What treatments have been tried up to now? How have they worked?
Symptoms and treatment of Premenstrual syndrome (PMS)