What is Premenstrual syndrome: Symptoms, Causes and How to Control Premenstrual syndrome

Premenstrual syndrome (PMS) is a common health problem in women in their reproductive age.  PMS refers to emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. It is the changes in a female’s mood along with certain physical symptoms relating to her menstrual cycle that are significant enough to affect her quality of life. PMS can be clinically recognized as a chronic disorder that impairs relationships, work productivity, and social activities. Symptoms of PMS are common, but vary considerably in how severe they are. Most women can tell that a period is due by the way they feel both physically and mentally. For most, the symptoms are mild and not troublesome. PMS can affect women of any age between puberty and the menopause.

Based on a study 91% of the participants reported at least one symptom, 10.3% had PMS and 3.1% fulfilled the criteria for premenstrual dysphoric disorder (PMDD). Both PMS and PMDD were strongly associated with poor physical health and psychological distress. A survey in Gujarat, India among college students also showed that 91.4% participants had, at least, one premenstrual symptom of any given severity (mild to severe) in at least more than or equal to half of the menstrual cycles during the last 12 months duration. The most commonly reported symptom was fatigue/lack of energy 68.3%, followed by decreased interest in work 60.1% and anger/irritability 59.9%. 

Symptoms of PMS

Each woman’s symptoms are different and can vary from month to month. This includes various physical and emotional symptoms. Some women experience one or two symptoms only and some others see more symptoms also. The most common symptoms of PMS include:

• mood swings, sadness
• feeling upset, anxious or irritable
• tiredness, constant fatigue or trouble sleeping
• changes in appetite or food cravings and sex drive
• trouble with concentration or memory
• bloating or tummy pain
• breast tenderness
• headache, backache
• acne, spotty skin
• greasy hair
• joint or muscle pain
• abdominal pain or cramps
• nausea

How does premenstrual syndrome occur?

It is not clear why PMS symptoms occur, but several factors may be involved. Changes in hormones which can result in chemical changes in the brain, during the menstrual cycle, seem to be an important cause. Hormonal level changes may affect some women more than others. Other issues such as stress and emotional problems, such as depression, may make PMS symptoms worse. Other possible causes can include:

• an unhealthy diet resulting in low vitamins and minerals for the body
• obesity
• heavy smoking or alcohol drinking
• too much of caffeine intake
• leading a sedentary life

These factors can cause PMS symptoms such as anxiety, irritability, fatigue, depression, headache, back pain, food cravings, acne, swollen tender breasts, stomach bloating, constipation or diarrhoea.

How to treat PMS

The syndrome may not require any medical treatment, few lifestyle changes may be sufficient to cope with the syndrome. Pain-relievers and other medication may be used to deal with the physical symptoms. If you haven’t been able to manage your premenstrual syndrome with lifestyle changes and the symptoms of PMS are affecting your health and daily activities, see your doctor.

Medication for PMS

Over-the-counter and prescription medicines can help treat some PMS symptoms. Over-the-counter pain relievers you can buy in most stores may help lessen physical symptoms, such as cramps, headaches, backaches, and breast tenderness. These include Ibuprofen, Naproxen, Aspirin. Some women find that taking an over-the-counter pain reliever right before their period starts lessens the amount of pain and bleeding they have during their period.

Prescription medicines may help if over-the-counter pain medicines don’t work

• Hormonal birth control may help with the physical symptoms of PMS, but it may make other symptoms worse. You may need to try several different types of birth control before you find one that helps your symptoms.
• Antidepressants can help relieve emotional symptoms of PMS for some women when other medicines don’t help. Selective serotonin reuptake inhibitors, or SSRIs, are the most common type of antidepressant used to treat PMS.
• Diuretics (“water pills”) may reduce symptoms of bloating and breast tenderness.
• Anti-anxiety medicine may help reduce feelings of anxiousness.

All medicines have risks. Talk to your doctor or nurse about the benefits and risks.

How to control PMS

The following are some of the tips to control PMS naturally.

• Try to know about PMS, it may help you to understand what is happening with your body and relieve some of the anxiety about symptoms. Keep a chart or diary note down the days you feel irritable, low, anxious, have any other symptom that you feel may be part of PMS  and see how long symptoms last before a period. This helps you to predict when your PMS symptoms are likely to occur and be ready for them. 
• Talk about it with your family, friends or partner. It may help them to understand how you are feeling. It may be best to do this after your period when symptoms have eased.
• Exercising regularly helps in ease the pain, try doing some regular exercise several times a week. People who exercise have less of a problem with PMS.
• Various diets habits can also help to ease the PMS. But there is only little evidence from research trials that it is true. Reducing the amount of sugar, sugary drinks and refined carbohydrates you eat before your period may help to control your symptoms. Carbohydrates with a lower glycaemic index give a slower steadier release of sugar, and may be a better choice for some women with PMS. Smaller, more frequent meals may suit better than infrequent large meals.
• Reducing caffeine and alcohol intake will also help to contorl PMS. based on a survey some women find that alcohol or caffeine found in tea, coffee, cola, etc makes their symptoms worse. So, it may be worth a trial of not having alcohol or caffeine prior to periods to see if this helps.

If PMS symptoms affect your routine and quality of life every month, and home remedies and medications make little difference, it’s always best to connect with a healthcare professional. Severe PMS symptoms may require a more in-depth treatment approach, but they do often improve with treatment. A doctor or clinician can offer more guidance on developing a personalised treatment plan based on your health conditions.