PRE-MENSTRUAL SYNDROME
70
to 90% of women in their reproductive years experience some physical,
emotional or behaviour symptoms 2-14 days before their periods. Premenstrual
Syndrome (PMS) is a term used to describe the collection of symptoms
which occur before a period starts and ends shortly after the arrival
of the period. The same set of symptoms occur at the same time each
month. Symptoms can begin as a teenager when the periods start (menarche)
and may worsen with age, after pregnancy or at times of stress. It
may occur in women who have had a hysterectomy if the ovaries still
function. It is most common in women between the ages of 30 - 39 years.
Other illnesses such as depression, anxiety, eating disorders, migraine
and asthma can worsen around the pre-menstrual or menstrual time
SYMPTOMS
Over 100 symptoms have been described. Many experience minor symptoms,
but a few women suffer from severe symptoms which may affect daily
functioning. The common symptoms are:
- Depression, anxiety, irritability, anger
- Cravings for salty/sweet food
- Breast tenderness/swelling, weight gain, fluid retention
- Fatigue, headache, sleep disturbances
- Feeling out of control, overwhelmed, tense or on edge
PREMENSTRUAL DYSPHORIC DISORDER
Sometimes the emotional symptoms premenstrually can be very severe
and this is called Pre-menstrual Dysphoric Disorder. This occurs
in 3-8% of women, more often in women whom have a past history of
depression, have a family history of PMDD or who have had mood changes
with the oral contraceptive pill
CAUSE
This is unknown at present. There is no evidence of high or low levels
of hormones. There may be an abnormal response to normal levels of
hormones and this may involve a chemical in the brain called serotonin
DIAGNOSIS
There is no laboratory test to make the diagnosis of PMS or PMDD. The
diagnosis comes from the cyclical nature of the symptoms, in other
words they start just before a period and stop once a period begins.
Your doctor may ask you to chart your symptoms for at least 2 months
MANAGEMENT
There is no one single treatment that will cure PMS or PMDD. However
a number of different things may help to reduce or prevent the symptoms.
Often this means changing aspects of your lifestyle
DIET
Don't go on a diet but try to change your eating pattern. Eat frequently
and never go without food for more than 5 hours:
Increase:
- the amount of water
- the amount of green vegetables and salad
- the amount of fruit and nuts
- the amount of pasta, brown rice, and dried beans
- the amount of chicken and fish
Reduce:
- intake of sugar including honey, additives with '-ose' at the end and sweeteners
- intake of junk food - fast foods, burgers, crisps
- intake of salt since this may reduce bloating
- amount of tea and coffee since caffeine causes irritability
- intake of cigarettes and alcohol
EXERCISE
Exercise will reduce physical and emotional symptoms. It releases built
up stress and enhances your sense of well being. If you do no exercise
at the moment, then do some gentle exercise such as going for a short
walk. Start exercising slowly, don't push yourself and listen to
your body. Try to exercise for 20-30 min 3 times a week. Remember
exercise should be fun. As well as exercising, make sure you get
enough rest each day
STRESS REDUCTION
Think about your life at home and at work. Identify things that cause
you stress. Often it is not possible to eliminate all stress but
try reducing it if possible. You may find anxiety management and
relaxation techniques useful. Take time to care for yourself. Make
space for yourself. Enjoy a warm bath or a massage. Try using aromatherapy
oils
MEDICATION
- Vitamins - Some women find vitamin B complex and evening primrose
oil useful. If you want to try them check with your doctor that this
is all right
- Oral Contraceptive Pill - Often your GP may prescribe the pill
for PMS. The pill stops the periods and therefore should stop symptoms
of PMS
- Antidepressants - These can be used if depressive symptoms are
common. Sometimes some tablets have side effects. You may wish to
discuss this with a member of staff at your surgery
HELP AND SUPPORT
- National Association for Premenstrual Syndrome, 08707 772177 www.pms.org.uk
Source text: Leeds Mental Health Trust and Leeds Primary
Care Trusts
Image source: Insulite Laboratories
The original version of this leaflet was written by Ardsley Community
Mental Health Team, East Ardsley Health Centre, Wakefield WF3 2DN
NHS
Direct 0845 46 47 www.nhsdirect.nhs.uk
