Premenstrual syndrome

As many as 1 in 3 women experiences symptoms of premenstrual syndrome (PMS) as her period approaches. In up to 1 in 20 women, these symptoms may be severe enough to disrupt activities.

The cause of PMS is disrupted, but it is thought that the symptoms are triggered by the action of the female sex hormones oestrogen and progesterone before menstruation. Stress may make the symptoms worse, as may excessive consumption of chocolate and caffeine containing drinks, such as coffee and cola. A women is more likely to have severe symptoms of PMS if close relatives have experienced similar problems, although no specific genetic factors have as yet been identified.

What are the symptoms?

The symptoms of PMS vary between women, and some women find that the symptoms also differ from month to month. Symptoms may appear just a few hours before a period begins, but they can start up to 14 days beforehand. In most affected women, the symptoms disappear by the time menstruation has finished or a few days afterwards.

The symptoms of PMS may include:

- Tenderness or generalized lumpiness of the breasts.
- A feeling of bloating caused by the retention of fluid.
- Mood changes, including feelings of tension, irritability, depression, anxiety, and tiredness.
- Difficulty concentrating and making everyday decisions.
- Headaches, including migraine.
- Backache and muscle stiffness.
- Disruption of normal sleep patterns.
- Unusual food cravings.

Less commonly, nausea, vomiting, cold sweats, dizziness, and hot flushes may also be experienced.

What may be done?

The diagnosis of PMS is usually easily made from the timing of your symptoms. Your doctor may ask you to keep a record of symptoms to confirm that they are related to menstruation.

There are a number of self-help measures you can take to try to prevent PMS. If there are not effective or your symptoms are severe, you should seek medical advice. Certain painkillers, such as ibuprofen, can help to relieve headaches and muscle stiffness. If you experience mood swings, your doctor may prescribe antidepressant drugs, which may be more effective if taken throughout the menstrual cycle. Diuretic drugs may help to relieve fluid retention. Your doctor may also prescribe treatment with the hormone progesterone. No treatment is consistently successful, but the symptoms can usually be relieved.

PREVENTING PREMENSTRUAL SYNDROME

The following self-help measures may help either to prevent or to relieve premenstrual syndrome. If these measures do not help and you have persistent symptoms, visit your doctor for advice.

- Relax as much as possible and try to avoid stress.
- Try taking up a light, relaxing exercise, such as yoga.
- Take warm baths.
- Eat little and often, making sure your diet includes plenty of carbohydrates and fibre.
- Try to reduce your salt intake.
- Avoid eating excessive amounts of chocolate.
- Avoid drinks containing large amounts of caffeine, such as coffee, tea, and cola.
- A vitamin B6 supplement may be helpful, although very high doses can be harmful.
- Evening primrose oil capsules are often effective, especially in relieving breast tenderness.