Premenstrual syndrome (PMS)
PMS has a variety of signs and symptoms, such as mood swings, tender breasts, cravings, fatigue, irritability and depression. It's estimated that as many as three out of every four menstruating women have experienced some form of premenstrual syndrome.
The symptoms of premenstrual syndrome usually recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from barely noticeable to extremely intense.
You don't have to let these problems control your life. Treatments and lifestyle changes can help reduce or manage the signs and symptoms of premenstrual syndrome.
Symptoms
The list of possible signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.
emotional and behavioral signs and symptoms can occur when someone is sick.
- Tension or anxiety
- Depressed mood
- Crying spells
- Mood swings and irritability or anger
- Appetite changes and food cravings
- Trouble falling asleep (insomnia)
- Social withdrawal
- Poor concentration
- Change in libido
Physical signs and symptoms
- Joint or muscle pain
- Headache
- Fatigue
- Weight gain related to fluid retention
- Abdominal bloating
- Breast tenderness
- Acne flare-ups
- Constipation or diarrhea
- Alcohol intolerance
Some women experience severe pain and emotional stress as a result of their menstrual cycle. Regardless of how severe the symptoms are, they usually go away within four days after the start of their menstrual cycle for most women.
Some women with premenstrual syndrome (PMS) have disabling symptoms every month. This is called premenstrual dysphoric disorder (PMDD).
Some signs and symptoms of PMDD may 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 premenstrual syndrome with lifestyle changes and the symptoms of PMS are interfering with your health and daily activities, see your doctor.
Causes
Exactly what causes premenstrual syndrome is unknown, but several factors may contribute:
- Cyclic changes in hormones.The signs and symptoms of premenstrual syndrome (PMS) change with fluctuations in a woman's hormones, and they disappear once a woman becomes pregnant or experiences menopause.
- Chemical changes in the brain.Changes in the level of serotonin in the brain are thought to be responsible for symptoms of premenstrual syndrome. Low levels of serotonin may also lead to premenstrual depression, food cravings, and sleep problems.
- Depression.Some women with severe premenstrual syndrome also have undiagnosed depression. Depression is a condition that can lead to other symptoms. Depression alone does not cause all the symptoms these women experience.
Diagnosis
There is no specific physical or lab test that can confirm that you have premenstrual syndrome. Your doctor may guess that you have the condition based on your usual premenstrual symptoms.
Your doctor may help establish a premenstrual pattern by recording your signs and symptoms on a calendar or in a diary. Note the day you first notice symptoms of PMS as well as the day they disappear. Also note the days your period starts and ends. Finish attaching the end of the strip to the leaf.
If you are experiencing symptoms that may be associated with PMS, your health care provider may order tests to help identify the specific condition. These tests might include a thyroid function test or mood screening test. If the condition is found, treatment may be available.
Treatment
If you are experiencing PMS symptoms, lifestyle changes may help relieve them. But depending on the severity of your symptoms, your doctor may prescribe one or more medications to treat premenstrual syndrome.
Some women find relief from their symptoms with the use of prescribed medications. Commonly recommended medications for premenstrual syndrome may include:
- Antidepressants. SSRI medications, such as fluoxetine (Prozac Sarafem), paroxetine (Paxil Pexeva), sertraline (Zoloft), and others, have been found to be effective in reducing mood symptoms. SSRIs are the first line of treatment for severe PMS or PMDD. Some women generally take antidepressants each day. However, for some women with PMS, antidepressant use may be limited to the two weeks before their menstrual period begins.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that help to reduce inflammation.Taking NSAIDs such as ibuprofen (Advil Motrin IB others) or naproxen sodium (Aleve) before or during your period can lessen cramping and breast pain.
- Diuretics.If exercise and a reduced salt intake aren't enough to reduce the amount of weight you gain during PMS, taking water pills (diuretics) may help the body rid itself of excess fluid through the kidneys. Spironolactone (Aldactone), a diuretic, can help ease some of the symptoms of PMS.
- Hormonal contraceptives.These prescription medications stop ovulation, which may alleviate PMS symptoms.
Lifestyle and home remedies
There are things you can do to reduce the symptoms of premenstrual syndrome by changing your diet, exercising, and daily life habits. Try these tips:
Modify your diet
- Eat smaller, more-frequent meals to reduce bloating and the feeling of fullness.
- Avoid foods that are salty to reduce bloating and fluid retention.
- Eat foods that are high in complex carbohydrates, such as fruits, vegetables, and whole grains.
- To get the most benefit from foods rich in calcium, try to include dairy products or take a daily calcium supplement. If you can't tolerate dairy products or don't get enough calcium in your diet, some foods may provide more of this important nutrient.
- Avoid caffeine and alcohol.
Make sure to include regular exercise into your routine.
Do aerobic activity for at least 30 minutes each day, on most days. This will help improve your overall health and reduce certain symptoms, such as fatigue and a down mood.
Reduce stress
- Get plenty of sleep.
- Reduce headaches, anxiety, and trouble sleeping by practicing progressive muscle relaxation or deep-breathing exercises.
- Relaxing yoga or massage may help relieve stress.
Record your symptoms for a few months
Make a record of the circumstances that cause your symptoms, so you can better understand what to do to lessen them.
Alternative medicine
Some people believe that complementary remedies can be helpful in reducing symptoms of premenstrual syndrome.
- Vitamin supplements.Many people believe that calcium magnesium vitamin E and vitamin B-6 can soothe symptoms, but the evidence is limited or lacking.
Herbal remedies.Some women report relief of PMS symptoms by using herbs such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil, and St. John's wort. However, there are few scientific studies that have found these herbs to be effective for relief of PMS symptoms.
Herbal remedies are not regulated by the Food and Drug Administration, so there is no record of product safety or effectiveness. Before taking any herbal products, speak with your doctor to make sure they are safe for you and to avoid any possible side effects. St. John's wort may have side effects or interact with other medications you are taking. Some things can reduce the effectiveness of birth control pills.
- Acupuncture.Acupuncturists use sterile stainless steel needles to insert them into the skin at specific points on the body. Some women find relief from symptoms after acupuncture treatments.
Preparing for your appointment
If you need to see a doctor, you may be referred to a doctor who specializes in conditions affecting the female reproductive system (gynecologist).
Here is some information about your appointment and what to expect from your doctor.
What you can do
- Make sure there are no pre-appointment restrictions.When you make the appointment, be sure to ask if there are any preparations you need to do in advance.
- Make a list of the symptoms you're experiencing.Make sure to bring any materials that may be related to the reason for your appointment, such as medication. Also, bring anything that seems unrelated to the appointment, but that you think may be helpful.
- Make a list of your key health information. This will help you remember what to bring to the doctor's appointment.Please list any other conditions for which you are being treated and the names of any medications, vitamins, or supplements that you are taking.
- Consider questions to ask your doctorWhen your doctor is answering your questions, take notes on paper and bring the notes with you.
Some basic questions to ask your doctor if you have premenstrual syndrome include:
- What can I do to reduce my PMS symptoms?
- Will my PMS symptoms go away on their own?
- Are the symptoms I'm experiencing something that I should be concerned about?
- What are the best treatments for PMS symptoms? What treatments are available?
- Can I substitute a different medicine for the one you're recommending?
- Do you have any brochures or other printed material that I can take with me? Can you recommend websites?
If you have any other questions, don't hesitate to ask them during your appointment.
What to expect from your doctor
When your doctor asks you questions, they may include things like:
- How severe are your symptoms?
- What are the days during your menstrual cycle when your symptoms are the worst?
- Do you have menstrual cycles that are free of symptoms?
- Can you predict when your symptoms will begin?
- Do any changes seem to help or worsen your symptoms?
- Can your symptoms limit the activities you are able to do each day?
- Are you feeling down lately?
- Do you or someone in your family have a mental disorder?
- What have you tried so far? What has worked for you?