It is thought that most women who have periods have premenstrual symptoms, ranging from mild in 75 per cent of women to severe in 20 to 30 per cent of women. For 8 per cent of women with severe symptoms, PMS is linked to reduced quality of life. Incorrect theories about the causes of PMS have included oestrogen excess, progestogen deficiency, vitamin B6 deficiency, abnormal glucose metabolism and electrolyte imbalances.
Between 3 and 8 per cent of menstruating women suffer from seriously debilitating PMS, which is sometimes known as premenstrual dysphoric disorder PMDD. There are no specific diagnostic tests for PMS, as hormone levels are within the normal range. Diagnosis relies on an examination of your medical history and a description of the symptoms. In most cases, it is recommended that you keep a daily symptoms diary to help identify whether you have PMS. Include the details of your menstrual cycle — for example, the first and last days of your menstrual period.
Keep this daily diary for at least two menstrual cycles. Consult with your doctor or healthcare professional during this trial period. If you experience PMS symptoms you may crave high-fat and high-sugar foods like chocolate, biscuits and ice cream, which can cause weight gain. You can manage your weight and help reduce your PMS symptoms by making a few dietary changes.
You might like to try:. There are different types of medications and hormone treatments available to help you manage your symptoms. Many women feel they benefit from a variety of other therapies, such as cognitive behaviour therapy, and complementary therapies. If you would like to use complementary therapies, it is important to seek advice from a qualified professional.
Let your doctor know about any herbal or complementary therapies you are using. Complementary therapies should be viewed as a medicine and treated with the same respect. Complementary therapies that can help reduce PMS symptoms include calcium, vitamin D and vitex agnus-castus. Many herbal or complementary medicines can have side effects. Make sure you are well informed about them before you and your doctor decide on your treatment.
This page has been produced in consultation with and approved by:. Androgen deficiency in women and its treatment is controversial, and more research is needed. Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder.
Accessed Dec. Kellerman RD, et al. In: Conn's Current Therapy: Philadelphia, Pa. Ferri FF. In: Ferri's Clinical Advisor Accessed Sept. Management of premenstrual syndrome: Green-top guideline No. Casper RF, et al. Treatment of premenstrual syndrome and premenstrual dysmorphic disorder.
Natural medicines in the clinical management of premenstrual syndrome. Natural Medicines. Chiaramonte D, et al. Medical Clinics of North America. Verkaik S, et al.
The treatment of premenstrual syndrome with preparations of Vitex agnus castus: A systematic review and meta-analysis. But there are certain characteristics that health care professionals consider. To qualify as PMS, symptoms must follow this general pattern:.
More than physical and behavioral symptoms may be associated with PMS. Other common symptoms include:. The timing and severity of these symptoms are key to a PMS diagnosis. An average menstrual cycle spans 21 to 35 days. The follicular phase extends from menses to ovulation, and the luteal phase extends from ovulation to menses. PMS occurs during the luteal phase—approximately the last 14 days of your cycle, usually during the five to seven days before you get your period.
A premenstrual symptom chart or checklist also called a menstrual cycle diary is the most common method used to evaluate menstrual cycle symptoms.
With this tool, you and your health care professional can track the type and severity of your symptoms, as well as when they occur, to identify a pattern that may indicate PMS.
In addition to suggesting that you keep a menstrual cycle diary, your health care professional likely will ask about your personal and family medical history and will give you a physical exam. Laboratory tests are not routine but may be obtained to rule out other conditions with similar symptoms, such as low blood sugar hypoglycemia , mania, depression, thyroid disorders, anemia, endometriosis, allergies, fibroids, dysmenorrhea, lupus, endocrine abnormalities, neurological problems such as brain tumors and heart problems.
Menopause and PMS share some of the same symptoms, so depending on your age and health history, your health care professional may want to make sure that you are indeed ovulating and therefore experiencing PMS, not menopausal symptoms. To do this, you will probably be asked to use an over-the-counter ovulation testing kit.
This is a simple test that you can do at home. The results tell you when ovulation is likely. If you are approaching menopause the average age is about 51 for U. However, a single blood test is not informative because hormone levels change often. Many premenstrual syndrome PMS symptoms improve with treatment. Treatment options range from medication therapy to birth control pills to diet modification, including vitamin and mineral supplementation, herbal medicines and exercise.
Antidepressant drugs called selective serotonin reuptake inhibitors SSRIs are typically recommended to women with severe mood-related symptoms such as anxiety, depression or mood swings. In addition, there's some evidence that some nutritional supplements such as vitamin E, magnesium and vitamin B-6 may help ease symptoms of PMS. Discuss these and other strategies with your health care professional before taking any dietary supplement.
There is no single treatment that works well for every woman who experiences PMS. Typically, it's wise to try the most conservative treatment options first, which include lifestyle changes such as modifying your diet and exercising more. Discuss your symptoms with your health care professional if strategies you've tried don't work, so he or she can recommend other treatment options.
Can premenstrual syndrome PMS be prevented? Many women report benefits from a variety of lifestyle change including dietary changes, exercise and stress management. Dietary changes may include:. Ironically, some PMS symptoms, such as mood swings, irritability, bloating, hunger, carbohydrate cravings and fatigue, may lead you to consume foods that aggravate the condition. Premenstrually, you may crave either refined sugar usually combined with chocolate or fat combined with salt.
Generally, foods high in refined sugars and fat temporarily raise energy levels. But within several hours or less, as your body metabolizes these foods, you may "crash," meaning you'll feel worse than before you ate them.
Foods high in sugar content can also leave you feeling jittery. To alleviate mood swings and fatigue, try adding more high-quality, complex carbohydrates to your diet such as:. These complex carbohydrates help keep blood sugar levels even while providing your body with a long-lasting source of energy.
It's not uncommon for your appetite to increase just before your period begins. To combat the munchies and extra weight gain, try eating smaller, low-fat healthful meals using the food choices listed above. Make sure you include adequate calcium in your diet; calcium may help prevent irritability, anxiety and other PMS symptoms.
Good sources of calcium include:. Another good way to prevent PMS symptoms is through regular exercise in the form of aerobic activities such as brisk walking, jogging, biking or swimming. You will get the greatest benefits from exercise if you do it for at least 30 minutes, five or more days a week. But even taking a to minute walk three times a week can:. Review the following Questions to Ask about premenstrual syndrome PMS so you're prepared to discuss this important health issue with your health care professional.
For information and support on coping with Premenstrual Syndrome, please see the recommended organizations, books and Spanish-language resources listed below. The most lead-contaminated neighborhoods in cities are often the poorest and home to the highest percentage of nonwhite children.
Your Health. Your Wellness. Your Care. Real Women, Real Stories. Home pms. Premenstrual Syndrome PMS.
Medically Reviewed. Overview What Is It? Premenstrual Dysphoric Disorder Approximately three to eight percent of women experience premenstrual dysphoric disorder PMDD , a condition that, like PMS, is associated with the menstrual cycle. Diagnosis There is no specific laboratory test to determine if you suffer from PMS, and diagnosis can take some time because symptoms are so varied.
To qualify as PMS, symptoms must follow this general pattern: They tend to increase in severity as your cycle progresses.
They improve within a few days of your menstrual period starting. They are present for at least two to three consecutive menstrual cycles. Other common symptoms include: Sudden mood swings Depression Headaches Joint and muscle aches Food cravings Fluid retention Forgetfulness Clumsiness Sleep disturbances Breast swelling and tenderness The timing and severity of these symptoms are key to a PMS diagnosis.
Follow these simple steps to determine if your symptoms fit the PMS pattern: Track your symptoms using the first day of menstrual flow as Day 1. Note: Don't be surprised if you do not have any symptoms to record before day 18 or so. Have a person close to you your partner, roommate, friend chart his or her impression of your symptoms, when they occur and their severity. Chart your symptoms for at least three consecutive months to help you and your health care professional identify a pattern that may indicate PMS.
Different diaries use different rating systems, with point values to record severity ranging from 1 to 6. You can find an example here. Treatment Many premenstrual syndrome PMS symptoms improve with treatment. These medications are used to relieve premenstrual headache and other menstrual-cycle related pain. They usually cost less and have fewer side effects than other treatments.
As a result, the FDA has issued a "black box" warning highlighting this risk, as well as the risk of potentially life-threatening stomach bleeding. Contraceptive hormones. Other women, however, feel worse on birth control pills.
The combination birth control pills Yaz containing 3 mg of drospirenone, a progestin, and 20 mcg ethinyl estradiol, a form of estrogen and Beyaz and Safyral containing 3 mg of drospirenone, 20 mcg ethinyl estradiol and a daily dose of folic acid are FDA approved for the treatment of PMDD.
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