As we are in the midst of PMS Awareness week, I would like to talk to you today about a condition that affects almost every woman at least once in their lifetime – PMS. It is often trivialised as just ‘a bit of a tummy ache’ or mocked as simply an excuse for women to eat more chocolate, when actually it can be a serious and potentially debilitating condition for those who experience severe PMS symptoms every month. For some, a menstrual period is a mild inconvenience but for others, the weeks preceding it can be absolute torture. If you suffer with PMS, please read on for some (hopefully!) useful information about possible ways to manage your condition and how to get help.
What is PMS?
PMS stands for Premenstrual Syndrome and approximately 3 in 4 women suffer with some PMS symptoms. PMS usually occurs in the second half of the menstrual cycle and stops at the arrival of your period. It tends to increase in severity with age and most commonly affects women between the ages of 30-40 years old. It can be mild, moderate or severe.
What is the difference between mild and severe PMS?
Mild PMS causes sufferers some discomfort, but does not interfere with everyday life.
Moderate PMS symptoms interfere with a sufferer’s personal, social and even professional life but they are still able to function as normal, albeit not at their usual level.
Severe PMS symptoms have a severe impact on the quality of the sufferer’s life and relationships. Approximately 1 in 20 women suffer from PMS symptoms severe enough to disrupt their everyday life.
How do I know if I have it?
PMS manifests itself with a variety of different physical and psychological symptoms. Sufferers may experience some or even all of the following in various degrees of severity:
- Mood swings
- A loss of confidence
- Depression, feelings of hopelessness or despair
- Anxiety, feelings of fear or guilt
- Difficulty concentrating
- Anger or aggression
- Feeling emotional
- Changes to sleep pattern
- Changes to sexual feelings
- Changes in appetite or certain food cravings
- Poor self-image
- Feeling bloated
- Abdominal pain
- Constipation or diarrhoea
- Joint pain
- Swollen/tender breasts
- Swelling of the feet or hands
- Weight gain
- Less tolerance to loud noises or bright lights
- Worsening symptoms of migraine, epilepsy, asthma or cold sores, if you suffer from them
These symptoms are, however, not unique to PMS and so you should consult your GP for advice if you are experiencing them. The diagnosis of PMS is usually made in relation to the timing of the symptoms; if you have PMS, you will normally experience these symptoms during the two weeks before your menstrual period. The symptoms will then normally subside once your period has started and return at roughly the same time in your cycle each month.
What causes PMS?
The causes of PMS are not yet completely understood, but there are several theories as to what causes some women to experience PMS and not others. One theory is that PMS occurs in people who are particularly sensitive to varying levels of hormones in their body during their monthly cycle. Another theory suggests that these hormonal fluctuations interact with the production of serotonins; the brain’s mood-controlling chemicals. An alternative hypothesis is that PMS may relate to changes or disturbances in the levels of certain fatty acids within your body.
There are certain lifestyle factors which can increase your likelihood to suffer with PMS. Being obese and not exercising makes you 3 times more likely to experience PMS, whilst smoking doubles the risk.
How is it treated?
There are several options available for treatment, depending on the severity of your symptoms. These include, but are not limited to:
Keep a symptom diary – this way you can plan around your condition to prevent being in stressful situations on key days during your cycle and also pinpoint emotional triggers, which may worsen your symptoms.
Aim to achieve at least 2.5 hours of moderately intensive aerobic exercise every week, such as walking, cycling or swimming. Exercise can help to alleviate feelings of depression and tiredness as well as improving your overall health. Exercises based on stretching and breathing techniques such as yoga and pilates can help to reduce stress levels and improve your quality of sleep.
- Be sure to eat a healthy, balanced diet which is low in saturated fat and sugar.
- Avoid salty foods, which exacerbate bloating.
- Drink plenty of water to prevent dehydration; this will help combat headaches and tiredness.
- Eat lots of complex carbohydrates such as fruit, vegetables and wholegrains – this will provide your body with essential vitamins and minerals, which should help to ease some symptoms of PMS.
- Avoid caffeine and alcohol, which can affect your mood and energy levels. Caffeine may also exacerbate insomnia and irritability.
- Eating calcium-rich food, such as cheese and milk, may improve your PMS symptoms. If you cannot eat dairy, try calcium-fortified soya alternatives.
- Eating smaller meals throughout the day, or having a small carbohydrate-based snack every three hours, can help to keep insulin levels balanced, combating tiredness, and also help with bloating.
- Over-the-counter painkillers such as ibuprofen or aspirin can help with more physical symptoms such as headaches, back pain and joint pain.
- A diuretic (or water tablet) may help to relieve symptoms of bloating and tender breasts.
- A combined contraceptive pill such as Yasmin may be prescribed by your GP to help with PMS symptoms, although these can come with their own unwanted side-effects to tackle. Other hormonal contraceptives such as the implant, contraceptive patch or IUS (coil) should only be used to treat PMS under the guidance of a doctor or gynaecologist.
- SSRIs (antidepressants) such as Fluoxetine and Sertraline may be prescribed to alleviate psychological symptoms such as tiredness, sleep problems, food cravings, anxiety and depression. Like hormonal contraceptives, however, these medicines can have side-effects that potentially outweigh their benefits such as nausea, headaches, dizziness, tiredness, dry mouth, a loss of libido and insomnia.
- In severe cases of PMS, when all other treatments have failed, GnRH (Gonadotrophin-releasing hormone) analogues may be prescribed. These synthetic hormones block the production of oestrogen and progesterone, creating a temporary menopause. This often has unpleasant side effects such as hot flushes, loss of libido and vaginal dryness.
CBT (Cognitive Behavioural Therapy) can be successful in treating anxiety and depression and can be used to treat the psychological symptoms of PMS. A CBT therapist will help you to learn new coping strategies and methods of managing some of your symptoms.
There are several non-prescribed alternative treatments or supplements for PMS that may help to ease symptoms. The research into these treatments has provided conflicting results thus far and so there is little scientific evidence as to their effectiveness. Potentially effective supplements include Vitamin B6, Vitamin E and Magnesium. Those wishing to try complementary medicines should consult a GP or pharmacist for advice before starting treatment.
Non-medicinal pain relief:
Heat therapy products such as heat packs and patches can be used to help alleviate some of the physical symptoms of PMS such as abdominal pain and joint pain. TENS (Transcutaneous Electrical Nerve Stimulation) devices can be also used to relieve pains in the abdomen, muscles and joints. The Beurer EM10 Women TENS minipad has been designed specifically to target abdominal pain in women and is ideal for treating period pains.
I want to learn more about PMS or get help, where should I start?
The National Association for PMS has a wealth of information on its website as well as a forum you can join to get support from other PMS sufferers and professionals:
You can also visit the following page on our website to see our product range for PMS treatments:
If you would like to get more involved in PMS Awareness week, you can become a part of the PMS Awareness Facebook group here:
or join the conversation over on Twitter using the hashtag #pmsawarenessweek!
Until next time, stay healthy and stay happy!