Premenstrual Syndrome(PMS)

What is this condition?

Premenstrual syndrome (PMS) refers to a complex of various symptoms that appear 7 to 14 days before a menstrual period starts and usually subside with its onset. The effects of PMS range from minimal discomfort to severe, disruptive symptoms. These may include nervousness, irritability, depression, and multiple physical complaints. Researchers believe that 70% to 90% of women experience PMS at some time during their childbearing years, usually between ages 25 and 45.

What causes it?

Many theories have been offered to explain the cause of PMS, including vitamin deficiencies and a progesterone deficiency during a certain phase of the menstrual cycle. But so far, no one knows for sure. This suggests that PMS represents a variety of symptoms triggered by normal hormonal changes.

What are its symptoms?

The symptoms of PMS vary widely among women and may include any combination of the following -

• Behavioral- mild-to-severe personality changes, nervousness, hostility, irritability, agitation, sleep disturbances, fatigue, sluggishness, and depression

• Physical- breast tenderness or swelling, a bloated or tender abdomen, joint pain, headache, swelling, diarrhea or constipation, worsening of skin problems (such as acne or rashes), respiratory problems (such as asthma), or seizures.

How is it diagnosed?

The woman's history shows typical symptoms related to the menstrual cycle. Before diagnosing PMS, the doctor or nurse may ask her to record her menstrual symptoms and body temperature on a calendar for 2 to 3 months. Evaluating estrogen and progesterone levels helps to rule out hormonal imbalance. A psychological evaluation may be done to rule out or detect an underlying psychiatric disorder.

How is it treated?

The woman is taught about PMS and reassured that it's a real physical problem. Because treatment focuses mainly on relieving symptoms, each woman must learn to cope with her own set of symptoms.

Treatment may include diuretics to reduce excess fluid buildup, antidepressants, vitamins such as B complex, progestins, prostaglandin inhibitors, and nonsteroidal anti-inflammatory drugs. For treatment to be effective, a woman may have to eat a diet low in simple sugars, caffeine, and salt.

What can a woman with PMS do?

. Get a good night's sleep. If you're tired during the day, set aside time for regular breaks .

. Engage in regular exercise, such as walking, bicycling, or swimming. Try to work out three to five times a week, 20 to 30 minutes per session.

. Eat a well-balanced diet, and don't skip meals. Drink 6 to 8 glasses of fluid daily. Avoid caffeine-containing foods and beverages, and limit or avoid alcohol.

. Use stress-reduction techniques. If you have emotional problems you can't resolve on you own, seek a qualified counselor.

.  See your doctor to rule out other possible causes of your symptoms.

. Ask your doctor or nurse for the names of local self-help groups for women with PMS.