Premenstrual syndrome (PMS)

The reality!

Snappy, pimply, tender, fat, teary — most women will notice changes to their body and emotions before the start of their period. This collection of symptoms is known as premenstrual syndrome (sometimes called premenstrual tension or PMT).Symptoms
If you experience some of the following symptoms before the start of your period you are not alone — some studies suggest that 90 percent of women are in the same boat. You might be one of the majority of women who deal with the problems and get on with life. Other women, however, have such severe symptoms that their lives are disrupted for a week or two each and every month. If you fall into the second category you should discuss your problems with a health practitioner.
The most common emotional symptoms of PMS include:

• Irritability
• Anxiety
• Nervous tension
• Mood swings
• Lower coping ability
• Depression
• Aggression
• Difficulty concentrating
• Lower libido or, rarely, increased libido
• Feeling unloved
• Wanting to be alone
• Reduced interest in work and social life

The most common physical symptoms include:

• Fluid retention (swollen fingers or ankles)
• Bloating around the abdomen
• Breast swelling and tenderness
• Headaches ranging from mild to a severe migraine
• Tiredness, lethargy, insomnia
• Increase in weight
• Constipation
• Food cravings especially sweet foods
• Aches and pains, particularly lower back, legs and abdomen
• Poor coordination or clumsiness
• Skin problems such as acne
• Short, intense energy boosts

The main thing about PMS is that it settles completely once the period is over, so that there is always a time in the cycle when a woman has no symptoms at all. If your symptoms continue after your period, then the cause may be something other than PMS, like depression, approaching menopause or thyroid problems. PMS symptoms can often get worse when a woman is in her 30s and may continue to be a problem until into menopause.
Causes
No one knows exactly what causes PMS but the general belief is that it seems to have something to do with the way hormonal changes in the last part of the menstrual cycle affect a woman's body, particularly their nervous systems.
Treating PMS
As long as your symptoms are not too severe, there are many things you can try which may help keep you on track. It may be useful to keep a calendar record of your menstrual cycle. This will help you to know when your symptoms usually start, so you can avoid the things that cause you stress around that time.
A calendar that notes physical, psychological or emotional changes (for at least two months) can also be used by your health practitioner to help detect any problems that might be mistaken for PMS.
Family Planning NSW recommends the following:

• Calcium
  There is good evidence that calcium supplements (take 1200mg daily — preferably last thing at night) reduce PMS.
  
• Chasteberry extract
  There is also good evidence that the natural therapy, Vitex Agnus Castus (Chasteberry extract), which has been used by women for thousands of years, is effective at reducing PMS symptoms.
  
• Healthy lifestyle 
  A healthy lifestyle also seems to help with PMS symptoms. Make sure you eat plenty of fruit, vegetables and whole grains and cut down on salt, coffee, alcohol, sugar and cigarettes. Some women find that eating smaller meals more frequently helps as well. Get some regular aerobic exercise — aim for half an hour every day. And try to get plenty of sleep.
  
• Reduce stress 
  Try to lower your general stress levels. Consider learning relaxation techniques, yoga, meditation or tai chi, or book yourself in for a regular massage.
  
• Over-the-counter medications 
  Anti-inflammatory medications such as Naprogesic, Nurofen or Ponstan are all available from the pharmacist without a prescription. They can be useful where headaches or other aches and pains are the main symptoms of PMS.In the past, high doses of vitamin B, Evening Primrose Oil, and progesterone creams and tablets have all been suggested as treatments for PMS. There is not much clinical evidence that any of these are effective — although some women swear by them.

When to seek professional help
If none of the simple treatments described above help you, or if your symptoms are very severe, you should discuss the other treatments available for premenstrual symptoms with your health practitioner.