BENGALURU : Premenstrual syndrome or more commonly known as PMS, can be mild or severe enough to affect the quality of a woman’s life. It’s important to understand what PMS actually means and how best one can manage themselves and also when to seek help. This can trouble as many as three quarters of woman at various times of their reproductive lifetime. In about 1 in 20 women, the symptoms can affect quality of life and cause tension with family and friends.
There are no tests for diagnosing PMS. It is diagnosed by eliciting a thorough history. If the symptoms mentioned here occur two weeks prior to the periods every single month for about six months, PMS is diagnosed. The symptoms usually disappear just after the period. If symptoms are not related to periods, other causes should be ruled out.
Symptoms can be physical or mental. Mental symptoms include tension, irritability, tiredness, anxiety, loss of confidence, feeling emotional. Changes in sleep pattern and libido may be noticed too. Physical symptoms include breast swelling and pain, bloating of abdomen, swelling of feet and hands, weight gain etc. Any pre-existing conditions like asthma and epilepsy may become worse at this time.
The cause of PMS is not completely known but is said to be due to hormonal imbalance or sensitivity to the hormone progesterone which is produced just after ovulation in the middle of the cycle. It is said that this over-sensitivity to progesterone reduces the level of neurotransmitters called serotonin and GABA in the brain.
There are many things one can do to feel better during these days. Just being aware of PMS can help you expect and understand and cope better with the symptoms. Maintaining a diary or an app regarding the cycle and symptoms will help you in scheduling important meetings etc or even warning your husband. Talking about it with your husband, friends and your doctor will help them understand how you are feeling and they can sympathise with you or provide some TLC (tender loving care). Lifestyle changes, in terms of regular exercise and certain yoga postures help in coping with PMS. Avoiding high sugar, refined carbohydrates, high fat foods, caffeine and colas at this time have been shown to have beneficial effects on the symptoms.
Seeing a gynaecologist to talk about your symptoms will certainly help. There are some treatment options that can help. There is no ‘one size fits all’ and the treatment has to be individualised and changed according to the response. Many herbal products, multivitamin tablets are available over the counter for PMS. However, there is no solid evidence that these work.
In severe cases, cognitive behavioural therapy (CBT) may be suggested wherein adaptations to cope with the symptoms are discussed. Medications include antidepressants, combined oral contraceptive pills (also known as birth control pills which have other non-contraceptive benefits), oestrogens etc. However, these are to be prescribed by the gynaecologist after a thorough evaluation of the symptoms and ruling out any risk factors for their use.
PMS symptoms fluctuate and change over time. There may be some bad spells amidst a mostly good reproductive life. A healthy lifestyle, having good family and friends support and avoiding stress will help in managing PMS effectively.The author is a senior consultant obstetrician and gynaecologist, Fortis La Femme Hospital, Richmond Road, Bangalore