Premenstrual Syndrome (PMS) is the term used to
describe a group of physical or behavioral changes that some women experience
before their menstrual periods every month. PMS can be considered an
abnormal response to normal hormonal changes. Women with PMS have a
specific susceptibility for mood problems triggered by normal monthly cycles.
Symptoms of PMS
Physical symptoms: Abdominal bloating, breast
tenderness, acne, appetite changes and food cravings, swelling of hands
and feet, headache, upset stomach, constipation, clumsiness, and fatigue.
Emotional symptoms: Irritability, mood swings
from sadness to anger, depression, being overly sensitive, crying spells,
social withdrawal, forgetfulness, lack of concentration, a change in sex
drive, and trouble coping with everyday stress.
Most women with PMS have only some of these symptoms.
Some women have more of the physical changes, and others have more of the
emotional symptoms.
*Premenstrual emotional and physical changes occur
in up to 80% of women.
*20-40% of these women experience some
difficulty as a result of these changes.
*3 to 7% of women report mood swings and
physical symptoms that can interfere with work, life style, or relationships.
How to Recognize PMS
PMS tends to follow a pattern of symptoms that
occur at the same time in a woman's cycle. This general pattern occurs
month after month. It may vary somewhat from month to month.
For a woman to be diagnosed with PMS, there must
be a pattern of symptoms:
° Physical or emotional discomfort starting
near the middle of the cycle with the most intense symptoms felt in the
last 7 days before a woman's period starts.
° Rapid relief of symptoms once the period
starts.
° A symptom-free time between days 4 and 12
of the cycle.
At least 25% of women with premenstrual symptoms
will have no such symptom-free interval, suggesting the need for further
evaluation, and consideration of such possible causes as menopause, a thyroid
disorder, depression, or other psychiatric disorders.
Keeping a Monthly Record
There are no tests that can help detect PMS. The
only way to identify it is by keeping a daily record of your symptoms.
This way, you can see if a pattern exists. Keeping a daily record helps
you to be aware of your body and your moods. Once a woman knows when to
expect these changes and how long they last, she may be better able to
manage them.
Treatment
While the cause of PMS is unknown, it can be treated
to some degree in most women. Understanding the symptoms of PMS can help
reduce the anxiety that many women feel about whether their behavior or
feelings are normal. A woman's best defense against PMS is knowledge.
Know what PMS is, know when it occurs, and know what you can do to lessen
its effects.
Life Style Changes
Some of the things that promote a healthy life
style may help improve symptoms and are worth a try. Along with its other
known benefits, exercise enhances well-being and improves ability
to handle stress. Women who exercise regularly report milder PMS symptoms.
Dietary changes have been widely recommended but
are of no proven benefit.
Some studies indicate that taking vitamins and
minerals (such as 50 mg of vitamin B6 daily) can be helpful, but
other studies do not confirm the benefit.
When you can, adjust your schedule to avoid
stress that may be harder to cope with when symptoms of PMS are at their
worst. PMS can affect your relationships with others. Talk about what is
happening to you. If you share your feelings with your family, they may
be more supportive when you are having symptoms. Being aware of symptoms
also may help you avoid conflicts with your family and coworkers.
Medical Treatment
If your symptoms are not relieved through exercise
or stress reduction, your doctor may suggest drug treatment. The medicine
your doctor suggests will depend on your symptoms and how much they affect
you. Diuretics (or "water pills") are sometimes prescribed
to help reduce bloating. They help the body get rid of excess fluids through
the kidneys. You may take pain relievers such as ibuprofen (Advil,
Nuprin, Motrin) or naproxen (Aleve) to relieve the pain of headaches or
cramps. In some women, the use of birth control pills has been helpful
in reducing symptoms.
Alprazolam,
a mild tranquilizer similar to Valium has been reported to have beneficial
effects in some studies, whereas other studies have not been able to demonstrate
any effectiveness. However, this drug can be addictive.
For some women with severe PMS, certain drugs
that alter mood and are used to treat depression or anxiety have been shown
to relieve symptoms. Examples of these mild antidepressants are
Prozac, Zoloft, Paxil, or Luvox. These medications may be taken on a daily
basis, or they may be prescribed to be taken for only for 7-14 days of
the cycle.
Source: American College of Obstetricians
and Gynecologists. |