Premenstrual Symptoms (PMS)  

Premenstrual Symptoms (PMS): Causes, Symptoms, and Management

Premenstrual symptoms are a group of symptoms that women undergo before their periods. The symptoms include tender breasts, mood swings, irritability, food cravings, fatigue and depression. 

Premenstrual symptoms are usually predictable and will experience physical and emotional changes. In some cases, these symptoms can be intense. PMS can affect the quality of life. However, it will not cause any drastic changes or symptoms. 

Symptoms 

The premenstrual symptoms will vary from one woman to another. Some of the common symptoms of premenstrual symptoms include 

• Cravings for food 
• Mood swings 
• Breast tenderness 
• Anxious 
• Acne flare-up 
• Trouble sleeping 
• Easily irritable 
• Fatigue 
• Spotty skin 
• Headache 
• Diarrhoea 
• Crying spells 
• Bloating 
• Fluid retention and weight gain 
• Tummy pain 
• Change in appetite 
• Poor concentration 
• Reduced or increased sex drive 
• Constipation 
• Joint and muscle pain 

Things that can be done and should be avoided

PMS is common as women get their menstrual cycle monthly. So there is a list of things that can be done and avoided to prevent PMS. 

Things that can help are 

• Consume a healthy and balanced meal. If you have a loss of appetite, try consuming meals in smaller quantities than a large three-day meal. 
• Get adequate sleep. At least 8-9 hours of sleep is recommended. 
• Do yoga and meditation to reduce stress. 
• If the pain is unbearable, take painkillers. 
• Note down your symptoms for 2-3 days. 

Things to avoid 

• Avoid smoking and alcohol consumption. 

Causes of PMS

The cause of PMS is not known. However, scientists guess it occurs due to hormonal changes during and before the monthly cycle. Some women may get affected more by this syndrome than others. 

Cyclic changes in hormones 

Cyclic changes lead to symptoms. Women tend to undergo hormonal changes every month, which leads to these changes. These symptoms cease after menopause and pregnancy. 

Premenstrual dysphoric disorder (PMDD) 

Some women may experience intense symptoms and pain called premenstrual dysphoric disorder. The symptoms of premenstrual dysphoric disorder are the same as premenstrual symptoms. However, PMDD symptoms will be severe. 

The PMDD will be more intense and can a cause negative impact on daily activities and can affect the quality of life. 

Symptoms of PMDD include 

• Behavioural changes like insomnia and binge eating. 
• Physical symptoms like headaches, cramps and muscle and joint pain. 
• Emotional and mental symptoms include depression, anxiety and anger. 

Chemical changes in the brain 

Chemical changes in the brain occur due to fluctuations in serotonin in the brain. Serotonin plays a major role in mood states and can trigger PMS symptoms.  

If there is a deficiency in serotonin, it can lead to premenstrual depression like fatigue, sleep problems and food cravings. 

Depression 

Premenstrual symptoms can cause depression. However, depression alone will not lead to premenstrual symptoms. 

Diagnosis of PMS

Medically, there is no unique lab test to diagnose premenstrual syndrome. The doctor will diagnose premenstrual syndrome by its symptoms, which are predictable. 

The doctor will ask you to record the premenstrual pattern for at least two cycles—Mark the start and end of your cycle and when the symptoms set in. Sometimes, certain health conditions like chronic fatigue syndrome, mood disorders and thyroid disorders will be the same. 

So it is important to note your symptoms and consult your doctor for any undesirable symptoms. 

Treatment for PMS 

There is no specific treatment for PMS. However, the symptoms may vary depending on the severity of the symptoms. If the symptoms do not settle, the doctor might suggest certain medications. 

Medications success will vary depending on the symptoms, and some of the medications prescribed are 

Antidepressants 

Serotonin-selective reuptake inhibitors have been successful in reducing mood disorders and symptoms. They are suggested as a first-line treatment for PMDD and PMS.  

These medications should be taken daily and limited to about two weeks before the menstrual cycle begins. 

• Diuretics 
• Nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Hormonal  contraceptives 

Lifestyle and home remedies for PMS

PMS can be managed with certain lifestyle changes. However, the symptoms cannot be prevented fully.  

• Consume small meals at frequent intervals. If you consume food three times, break it and consume it five times. 
• Lessen your salt and sugar intake. This will reduce bloating and prevent fluid retention. 
• Consume foods rich in complex carbohydrates like whole grains, fruits and vegetables. 
• Try to consume calcium-rich foods. However, if you are lactose intolerant, get a calcium supplement. 
• Try to avoid caffeine, alcohol and tobacco. 
• Engage in physical activity and exercise. Brisk walking for 30 minutes will help with the symptoms. Other exercises like cycling, swimming and aerobic activity will also help. 
• Adequate sleep is important. Try to get 8-9 hours of sleep. 
• Practise meditation, which will help you to relax. 
• If you are not able to sleep, try yoga. This will relieve stress and help you to sleep well. 

Alternative medicine to treat PMS

Complementary medicine can be effective and can soothe premenstrual symptoms. 

Herbal remedies 

There are reports that herbal medicine can help soothe the symptoms. Herbs like ginger, chasteberry, ginkgo, St. John's wort and evening primrose oil are used to reduce the symptoms. However, herbal remedies are not FDA regulated and there is no product safety. 

Vitamin supplements like vitamin B6 and E, magnesium and calcium. However, scientific evidence that these supplements will reduce the pain are limited. 

Acupuncture can help relieve symptoms. A professional will insert sterilised needle into the skin at specified points in the body.  

Conclusion 

Premenstrual symptoms are common and are usually manageable. If you have PMS, drink plenty of water, get adequate sleep, do some exercise and consume a balanced meal. This will help with the symptoms. 

However, some women may face severe symptoms. In such cases, it is advised to consult a doctor and get proper medication. Try to reduce stress and avoid alcohol and tobacco. This will reduce the severity of the premenstrual symptoms.