Understanding premenstrual syndrome

young woman with stomach pain...

Nearly all women of child-bearing age experience premenstrual syndrome (PMS) to some extent in the weeks or days leading up to their period, with women in their late twenties and forties most likely to be severely affected. Read on to discover the typical symptoms, what you can do, and when to see your doctor...
What are the symptoms?
Symptoms can be physical, psychological and behavioural and tend to occur around the same time each month and improve once menstruation starts, to disappear a few days later and return when your cycle starts again.

Physical symptoms include:
Feeling bloated
Tender breasts
Pain or discomfort in your stomach
Trouble sleeping
Feeling sick
Muscle and joint aches and pains
Weight gain

Psychological symptoms include:
Mood swings
Feeling angry or irritable
Forgetfulness and confusion
Problems concentrating
Loss of self esteem
Behavioural symptoms include:
Loss of interest in sex
Food cravings, changes in appetite
What causes PMS

The exact cause of PMS is not fully understood but hormonal and chemical changes are believed to be contributing factors. During the menstrual cycle, levels of oestrogen and progesterone rise and fall. In the same way, the brain experiences fluctuations in certain chemicals, such as serotonin, which helps to regulate mood and feelings of happiness.

What you can do
Research shows that lifestyle factors can have a huge impact on PMS symptoms. One of the most important things you can do is to maintain a healthy weight and exercise regularly. Studies show that you're three times more likely to suffer with PMS if you are obese and don't exercise. Smokers are twice as likely to experience severe symptoms. A healthy diet with plenty of complex carbohydrates and calcium-rich foods, such as cheese and milk, is recommended. Salty food, caffeine and alcohol are best avoided as they may worsen symptoms of fluid retention and tiredness. Some women find that stress can aggravate their symptoms, so breathing exercises, yoga or meditation may help.

When to see your GP
While there isn't a cure for PMS, over-the-counter painkillers for premenstrual headaches, backache or other aches and pains may help relieve symptoms. If you're finding it difficult to cope with PMS or your symptoms are severe, see your GP. A small number of women (around 5 in every 100) suffer with a more severe form of PMS known as premenstrual dysphoric disorder (PMDD), so it's worth getting checked out. Depending on your symptoms, your doctor may prescribe a number of things, such as the combined contraceptive pill to help stabilise hormone levels, a diuretic to relieve symptoms such as tender breasts and bloating, and antidepressants.

In very severe cases, s/he may also suggest gonadotrophin-releasing hormone (GnRH) injections. These create a temporary menopause and stop your periods by blocking the production of oestrogen and progesterone but come with side effects such as hot flushes, vaginal dryness and loss of libido, so is generally only considered.when all other treatments have failed. If anxiety and depression is a particularly problem for you, talking therapies, such as cognitive behavioural therapy (CBT), could also be an option.

Do you suffer with PMS? Leave a comment below...

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