PMS, or premenstrual syndrome, is a term used to describe a very wide range of symptoms that occur during the second half of a woman’s menstrual cycle- approximately 14 or more days after the first day of her last period.
In most cases, these symptoms will disappear 1 to 2 days after her next period begins.
What are the Causes of PMS?
Researchers have been unable to pinpoint a specific cause of PMS. However, it is apparent that some changes in the hormone levels in the brain might play a role in this condition- but this has not yet been proven.
Women with this condition might have different responses to these hormones. Additionally, this condition could have some relation to psychological, social, biological, and even cultural factors.
Approximately 75 percent- or 3 out of every 4 women experience symptoms of premenstrual syndrome during their childbearing years. A woman is more at risk if she has some or all of the following:
- Is between her late 20’s to late 40s.
- Has had at least one child.
- Has a family- or personal- history of major depressive disorder.
- Has had a history of an affective mood disorder or postpartum depression.
In many cases, the symptoms of PMS will become much worse when a woman is in her late 30s to late 40s, as she gets closer to the transition into menopause.
Some of the other factors that can increase a woman’s chance of experiencing premenstrual syndrome are not getting the proper amounts of calcium, B6, or magnesium in her diet, not getting proper exercise, high levels of stress, and consuming too much caffeine.
Symptoms of Premenstrual Syndrome
PMS is characterized by some of the following common physical symptoms:
- Pain in the lower back
- Lowered energy levels/lack of energy
- Tender and swollen breasts
- Little to no tolerance for noise/light
In addition to the above physical symptoms, it is also very common for a woman to experience some of the following mental/emotional symptoms:
- Unexplained sadness
- Difficulty staying alert
- Difficulty focusing
- Becoming withdrawn
- Mood swings
- Poor judgement
- Sleeping too much
- Sleeping too little
- Lowered self-image/self-esteem
Some women will experience very severe PMS symptoms, while others will barely notice theirs. Also, symptoms vary from one woman to the next and can also vary from one month to the next.
Finally, be aware that if a woman notices her symptoms are very severe, she could be suffering from a condition known as premenstrual dysphoric disorder, or PMDD. This is a very rare condition, though, so don’t get too concerned.
Should You Visit Your Physician?
If you have done everything you can do in order to manage your symptoms, and they are still controlling your life by affecting your daily activities as well as your health, you should definitely see a physician.
As I have already said, there is no specific cause that has been found for PMS. However, there are several factors that have been found to contribute to this condition, including:
Changes in hormones: when a woman is going through pregnancy and menopause, the signs and symptoms of PMS are likely to disappear due to the fluctuations in hormones.
Chemical changes: it is possible that fluctuations of the neurotransmitter serotonin could be a trigger for PMS. When you don’t have enough of this neurotransmitter, you are likely to experience depression, food cravings, fatigue, and problems with sleep- too much or not enough.
Depression: in some cases, a woman experiencing severe PMS also has an underlying condition of depression that has not been diagnosed. However, depression by itself will not cause all of the symptoms of PMS.
Getting Ready to See Your Physician
Chances are, you will first turn to your primary care provider. However, sometimes, when you call to make an appointment, they may go ahead and refer you to a gynecologist- a physician who specializes in this area.
Following are some things you can do to get ready for the appointment.
When you make your appointment, be sure to ask if there’s anything you need to do to prepare for it. Make sure that there are no restrictions.
Take a few minutes to record all of the symptoms you have been experiencing- even if you don’t believe they’re related to the reason you made the appointment in the first place. The physician may be able to see a connection that you can’t.
Be sure to write down all of your key medical history, including medications you’re taking such as prescription, OTC, and even vitamins. Also, write down other conditions you are being treated for or have been treated for.
Think about and write down a few questions to ask the doctor. Then, be sure to bring your notebook with you so that you can write down the information as the doctor is answering your questions and concerns. Here are a few questions to consider:
- What can I do to minimize my symptoms of PMS?
- Will these symptoms resolve on their own or will they require treatment?
- Is it possible that these symptoms are pointing to a more serious condition?
- Do you think that PMS symptoms should be treated and which ones are available?
- (If he/she is prescribing a medication) Is there a generic alternative to that medication?
- Are there any brochures that I can have to read more about this or are there some websites that I can take a look at to educate myself?
In addition to these, feel free to ask any other questions that come up during your appointment.
What Your Physician will Do
Be prepared because the physician is likely going to be asking you a few questions as well.
If you’re prepared for these questions, it’s possible that you may open up some time to further discuss some of the points you need or want to spend more time on.
Following are some of the questions that he/she may ask:
- What is the severity of your PMS symptoms?
- Which days during your cycle do you notice the symptoms to be worst?
- Are there any days during your cycle that are free of symptoms?
- Do you have any warning of when the symptoms are coming on?
- Is there anything that makes these symptoms better?
- Is there anything that makes these symptoms worse?
- Do these symptoms cause any interference with your normal, daily activities?
- Have you recently been feeling hopeless, depressed, or down?
- Have you ever been diagnosed with a psychiatric disorder?
- Has anyone in your family been diagnosed with a psychiatric disorder?
- Have you tried any treatments for your PMS?
- How have these treatments worked?
Unfortunately, there are no lab tests or examinations that can diagnose this condition.
However, a woman can visit her physician to rule out other possible conditions. The physician will perform the following:
- Complete medical exam, including a pelvic exam
- Collect a complete medical history
- Collect a complete family history
There are many different symptom trackers available that can help a woman identify the symptoms that give her the most trouble and will help her physician come up with an official diagnosis.
In order to obtain effective treatment for your PMS symptoms, you’ll need to keep a diary/record of your symptoms for at least three months.
You’ll want to make sure to record what the symptoms are, how long they last, and the severity of them.
This information will be extremely helpful for your healthcare provider to find the treatment that will work best for you.
Of course, as with many other conditions, a healthy lifestyle is the very first step for managing this condition.
Most women will find that making a few changes in their lifestyle will get their symptoms under control. Be aware though, the success of these changes in lifestyle varies from one woman to the next.
In some cases, you may find that they don’t work for you. In that case, you’ll need to speak with your physician about medications for treating your symptoms of premenstrual syndrome.
First of all, you should make sure that you’re drinking plenty of water or juice. Try to avoid caffeinated beverages, alcohol, and soft drinks- or if you must have them, only do so in moderation.
This will help to reduce fluid retention and bloating, as well as a few of the other symptoms of PMS.
Instead of sitting down for three full meals every day, try eating smaller, more frequent meals.
Avoid eating too much and try not to go more than three hours between eating something.
Make sure that you are consuming a balanced diet, with lots of fruits and veggies as well as whole grains. Try to avoid or limit sugar and salt.
In some cases, your healthcare provider will suggest that you take some nutritional supplements such as calcium, magnesium, and B6.
Another one that might be helpful in controlling symptoms is tryptophan, which is found in dairy products.
Make some time throughout the month to get in some aerobic exercise- this has been proven to reduce the severity and occurrence of symptoms of PMS.
During the weeks that you are experiencing the symptoms of PMS, exercise more often and harder.
Instead of taking something for your insomnia, try to make some changes in your nighttime sleep habits.
This includes, only using your bed for sleeping- don’t work, watch TV, read, or other activities that keep your brain going.
Don’t play on your phone when lying in bed. Make sure your room is dark and quiet- all of these will wire your brain to sleep at night instead of having you lie awake.
Your physician may recommend that you take OTC pain relievers for menstrual cramps, breast tenderness, backaches, and headaches. However, make sure that you take them as instructed.
In addition, some physicians recommend birth control pills- but these could decrease or they could increase symptoms of PMS.
If you are experiencing very severe symptoms, your physician may recommend medications to treat depression.
In some cases, SSRIs- or selective serotonin reuptake inhibitors- have been prescribed first and have been proven to help.
In many cases, these have proven to stabilize mood symptoms. These are the first line of treatment for PMS and PMDD.
They are usually taken daily- but in some cases, your physician may only recommend that you take them for the two weeks before menstruation.
In addition to these, you might want to consider seeing a therapist or counselor- especially if you do have depression as an underlying condition.
Some of the selective serotonin reuptake inhibitors used include the following:
Other medications used to control the symptoms of PMS include the following:
- Antianxiety medications: for treating severe anxiety
- NSAIDs: as already mentioned, these OTS pain relievers can help relieve breast tenderness, headaches, cramps, and backaches.
- Diuretics: these will help your body to shed excess water weight through your kidneys- especially when lifestyle changes such as exercise and avoiding too much salt don’t help.
- Contraceptives: as stated earlier, these may or may not be helpful for controlling the symptoms of PMS. They do stop your body from ovulating, which may be helpful.
Lifestyle Changes to Control Symptoms of PMS
As said earlier, in some cases, your symptoms of PMS can be managed by making a few very simple changes in your lifestyle. Following is some more detail on these:
In some cases, it is your diet that is either triggering your symptoms or aggravating them. By simply making a few very minor changes, you may be able to get these under control.
- Eat small meals often. This will help reduce that full sensation and bloating.
- Avoid (or limit) the amount of salty and sugary foods that you’re consuming- this will help to reduce retention of fluids and bloating
- Try to select foods such as whole grains, fruits, and veggies that are high in complex carbohydrates.
- Try to select foods that contain lots of calcium– such as dairy products. On the other hand, if you can’t tolerate dairy products and you’re not getting the proper amount of calcium in your diet, consider taking a supplement.
- Avoid (or limit) alcohol and caffeine consumption.
Get Plenty of Exercise
On most days of the week- all month long- make sure that you’re getting at least 30 minutes of aerobic activity such as swimming, walking, or cycling.
Getting plenty of exercise on a regular basis will help to improve your health overall as well as relieve specific symptoms of PMS such as depression and fatigue.
Reduce Your Stress Level
It’s no secret- stress makes everything worse, right? If you want to relieve your symptoms of PMS, make sure that you are doing things to reduce your stress levels whenever possible.
Make sure that you’re getting plenty of sleep- adults should be getting 7 to 8 hours of sleep every night.
Practice yoga and meditation, including deep-breathing exercises and progressive muscle relaxation to reduce your anxiety, difficulty sleeping, and headaches. In addition, consider visiting a massage therapist to help alleviate symptoms.
Observe/Record Symptoms of PMS for a Few Months
Instead of relying on yourself to remember these things, just as you would do if you were preparing for a doctor’s appointment, make a record of your symptoms over the course of a few months.
This will help you to learn what your triggers are and how you can tell when the symptoms are coming on- therefore, you can intervene before they become unbearable.
Following are some complementary remedies that are possibly able to soothe your PMS symptoms:
Calcium: taking in 1200 milligrams of calcium either through your diet or by taking a calcium supplement might help to reduce both the psychological and physical symptoms of PMS.
Magnesium: taking in 360 milligrams of magnesium via magnesium supplement can help reduce the symptoms of fluid retention, bloating, and breast tenderness
Vitamin E: taking in 400 IUs, or international units, daily could help the symptoms of PMS because prostaglandin production is reduced- prostaglandins cause breast tenderness and cramping
Herbal Remedies: some women have reported that they found relief of the symptoms of PMS by using herbal remedies such as chasteberry, St. John’s wort, evening primrose oil, ginger, and gingko.
However, scientific studies do not back this information. Since herbal remedies are not regulated by the FDA, there is no record of effectiveness or safety- so speak with your physician before taking any of these because they could have some harmful interactions or reduce the effectiveness of your birth control pills
Acupuncture: some women have said that they experience relief of the symptoms of PMS after acupuncture or acupressure treatments.
Acupuncture is where sterilized stainless steel needles are inserted into your skin and acupressure is where pressure is applied at pressure points.
Prognosis of Women with PMS
The good news is, that no matter how bad your symptoms are, most women who are treated for this condition do get relief.
However, keep in mind that it is possible for the symptoms to become severe enough that you will be unable to function normally.
Additionally, the rate of suicide in women is much higher during the second part of their menstrual cycle.