PMS

General Information

Most researchers today agree that PMS is a real physical condition with a real physiological basis. Beyond that, a precise definition is difficult. In general terms, it is a "syndrome" or a series of symptoms, which appear each month in a pattern related to the menstrual cycle. Symptoms can occur as a combination of physical, psychological or behavioral changes. The range and severity of symptoms differ from woman to woman. They can also differ in one woman from month to month. But the timing of PMS symptoms is cyclical, corresponding to the menstrual cycle.

TIMING

The symptoms of PMS appear in the time between ovulation (about 14 days before your next period) and menstruation. Occasionally symptoms begin during ovulation and continue until your period ends.

PMS symptoms most often begin 1-10 days before your period and stop when your period begins. Unlike dysmenorrhea, or "painful menstruation", true PMS symptoms appear before your period. This is why PMS is sometimes called "the period before your period". Just like your period, these symptoms usually occur almost the same time each month. Thats important to know, because it means that once you know your PMS pattern, you can be prepared for it.

Symptoms

Much of the confusion surrounding PMS can be explained with this simple fact: 180 different symptoms have been linked to PMS. The most common symptoms break down into the three different groups, or discomfort clusters, indicated In the boxes below. Fortunately, most women suffer only a few symptoms of mild-to-moderate severity.

WHO HAS PMS?

If you think you have PMS, you are not alone. Estimates show that PMS affects from 70% to 90% of women at some time during their childbearing years. Though this can appear in menstruating women of any age, it is most common between the ages of 25-45. Some women first experience PMS after pregnancy, or after they stop taking birth control pills.

For most women, the effects of PMS will be minimal. They may experience any combination of the physical, emotional or behavioral symptoms weve talked about. One of the most common - and frightening - complaints is a feeling of being out of control or a fear of losing control. During this time, even women with mild PMS symptoms may experience difficulties in personal, social and professional relationships.

In severe cases, PMS can be devastating and violent. While cases like these are the ones that make headlines, they are not typical. In reality, they represent only a very small percentage of cases.

WHAT CAUSES PMS?

We dont really know. There arent any objective standards like lab tests or x-rays, for its diagnosis. Because of that, researchers are often dependent on subjective standards such as a womans own assessment of her symptoms and how they impact her life.

HOW IS PMS DIAGNOSED?

If you suffer from any of the symptoms described here, you should discuss them with your doctor.

The single best diagnostic tool you and your doctor can use is a daily diary or calendar noting the timing and pattern of your symptoms for at least one month, and preferably three months.

If you see a cyclical pattern, you probably do have PMS. Remember that "cyclical" means no matter how intense your symptoms, you will experience at least a few symptom-free days each month. If you do not see a cyclical pattern, be aware you could have one of many other medical problems. Most symptoms of PMS are not unique to PMS, and could be something else that should be investigated.

Continue your diary for a month or so after you begin treatment. That way you can see if the treatment youve chosen is effective.

Treatment

Just as there is no single cause, there is no single treatment. With some planning and forethought, you can be as prepared for "the period before your period" as you are for your period itself.

INITIAL TREATMENTS
As with any health condition, identifying your symptoms, as well as their intensity and pattern, is the essential first step in choosing effective treatment.

PLANNING
Use your daily diary to exercise control over your life. When you discover the approximate days you experience PMS, plan ahead: avoid stressful social or work situations, assure yourself time to relax, and schedule time for adequate sleep and healthy meals. When you identify your personal symptoms you can start modifying your lifestyle in order to reduce stress and enhance coping.

DIET
A well-balanced diet is essential to overall good health, as well as to the management of PMS. Cut down on sodium to reduce water retention and on sugar and caffeine to alleviate tension and irritability. Some women find that eating six small meals a day instead of three larger meals (in other words, regulating blood sugar levels) can make a tremendous difference. Others find it helpful to eat between-meal snacks rich in protein during the second half of their cycles. If you drink alcohol, be aware some women experience an increased desire for alcohol during their premenstrual cycle.

EXERCISE
Regular, daily exercise may help symptoms such as depression, tension, anxiety, fatigue and irritability. If you dont currently have an exercise program, a brisk walk is a good place to start.

VITAMIN SUPPLEMENTS
Many women gain relief from PMS symptoms by taking supplements of vitamin B6. Some physicians recommend B6 supplements of 50mg. to 200mg. per day to relieve irritability, fatigue, and depression. A word of caution though: B6 has been reported to be toxic in high doses and should be used carefully.

NON PRESCRIPTION MEDICINES

Non prescription medicines can be very effective in the treatment of mild-to-moderate PMS. To relieve cramping, bloating and irritability, a multi-symptom premenstrual syndrome medication has been formulated.

You can make an appointment at the SHS Women's Clinic by calling (858) 534-8089.

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