PMS

What is premenstrual syndrome?

Premenstrual syndrome, or PMS, is the term used for the physical and emotional symptoms that many women have during the seven to 14 days before their menstrual period begins. Almost every woman will endure bouts of PMS at some point in her life, but for an unlucky few -- between 20 and 40 percent -- PMS is a monthly ordeal.



What are the symptoms?

PMS symptoms are so numerous and varied that looking at a rundown can be a little jarring. The good news is that few people experience all of them. Physical symptoms may include these:



•lack of energy, fatigue
•swollen, tender breasts
•abdominal bloating, cramps, nausea, vomiting, diarrhea, constipation
•headache, back pain, body aches
•appetite changes
•swollen hands, feet, or ankles (due to water retention)
•dizziness, fainting
•joint or muscle pain
•flare-ups of acne, cold sores, genital herpes, yeast infections

Mental and emotional symptoms may include these:



•irritability
•anger
•mood swings
•depression
•crying spells
•forgetfulness, difficulty concentrating
•anxiety
•memory loss or forgetfulness
•confusion

What causes PMS?

Researchers aren't sure. They used to think PMS was related to fluctuations in levels of hormones such as estrogen and progesterone. More recent research favors changes in neurotransmitter levels, including mood-altering endorphins and serotonin, and diet -- especially a lack of calcium. It's also possible that these imbalances are related. A dietary imbalance, for example, might cause your hormone or neurotransmitter levels to get out of whack. You're most likely to suffer PMS symptoms after you've given birth, had a miscarriage or abortion, or experienced another event that involves major hormonal upheaval.



What are the best ways to get relief?

You have a wide range of options, including these:



•Get moving. Studies show that physical activity helps to relieve PMS symptoms, perhaps by triggering the release of brain chemicals, including endorphins, which ease pain, relieve stress, brighten mood, and produce a sense of well-being. Exercise also relaxes muscles, which can ease aches. And it fights fluid retention, which can reduce bloating and breast tenderness.
•Try taking calcium supplements. An exciting new study suggested that women who took two Tums E-X tablets twice a day (which provided a total of 1,200 milligrams of calcium) had a noticeable reduction in PMS symptoms. Calcium's benefits didn't kick in until the third month, though, so don't give up if you don't feel better during the first cycle or two.
•Eat healthfully. Get plenty of complex carbohydrates such as whole grain breads, pasta, and cereal; and load up on fruits and vegetables. Unlike sweets, these foods provide steady energy and are high in fiber, which can curb cravings, since fiber-rich foods take longer to digest. Adding nuts, seeds, and soy products to your meals may also fend off PMS. These foods are rich in phytoestrogens (plant estrogens), which recent studies suggest may help adjust hormonal imbalances. Finally, avoid highly salted foods in the weeks leading up to your period (salt can cause you to retain water and feel bloated), caffeine (it's been found to contribute to breast tenderness and can exacerbate anxiety and irritability), and alcohol (it can trigger cravings and aggravate depression, headache, and fatigue).
•Take over-the-counter pain relievers. Aspirin and ibuprofen can relieve many of the bodily aches and pains that come with PMS.
•Talk to your doctor about taking other medications. If your symptoms are severe, ask your doctor if birth-control pills or antidepressants might be helpful. Oral contraceptives can even out fluctuations in hormone levels that cause symptoms. And studies show that the newer SSRI (selective serotonin reuptake inhibitor) drugs, such as Prozac, can effectively relieve both the emotional and physical symptoms of PMS in 75 percent of women. These medications work by increasing serotonin levels, possibly correcting neurotransmitter imbalances that seem to contribute to PMS.
•Get more sleep. Being stressed out or sleep deprived is likely to exacerbate many PMS symptoms, including aches and pains, moodiness, and irritability. Make sure you get plenty of sleep, and try relaxation techniques -- such as massage, meditation, or simply soaking in long hot baths -- as your period approaches.

When should I see a doctor?

If your symptoms are mild and you're managing fine on your own, there's no need to see a physician. But if you're one of the 5 to 10 percent of women with severe PMS, your doctor can probably suggest treatments that will greatly ease your symptoms. Try keeping a diary of your complaints for a few months. This information can help your doctor determine the best course of treatment.