Introduction
Many women experience bloating, food cravings, cramps, muscle aches, breast tenderness, headaches and mood swings before their period. Collectively, these symptoms are known as premenstrual syndrome (PMS). Women sometimes get PMS for the first time in their teenage years or early 20s. Others get it later in their 30s. Symptoms can intensify with the approach of menopause.
For most women, menstruation is, at worst, a minor inconvenience. However, intense PMS symptoms or excessive pain and bleeding should not be ignored.
Symptoms
PMS generally appears about one or two weeks before the menstrual period and disappears once the period begins. The symptoms vary widely according to the individual. Some women experience purely emotional changes, while others feel physical discomfort, or a combination of both. Many women don't experience any problems at all.
The most common symptoms of PMS are mood swings, irritability, and bloating. Water retention can cause tender and swollen breasts, hands and feet, and marginal weight gain. Food cravings and strong appetite are common. Skin problems, especially acne, also tend to surface at this time. Other problems include headaches, abdominal cramps, back pain, physical exhaustion, dizziness and fainting spells.
In some cases, the emotional symptoms associated with PMS can be quite disruptive. These include mental fatigue, forgetfulness, insomnia, depression, withdrawing from other people and acting in forceful or hostile ways.
Causes/Risk Factors
While hormonal changes are normal throughout the menstrual cycle, recurring symptoms of PMS occur when these changes are extreme and unbalanced. These hormonal imbalances are brought about by a complex set of factors. The most important is poor nutrition, usually as a result of a diet rich in meat and meat products, and lacking in cold-pressed oils containing essential fatty acids.
A deficiency in vitamin B6, calcium, or magnesium elevates your risk of getting PMS. A sluggish liver often leads to an imbalance of hormones, since this organ is responsible for the breakdown and detoxification of hormones. This is also caused by improper diet and eating habits.
Too much sugar, salt, coffee, alcohol and refined white-flour products can aggravate symptoms, as can lack of sleep, stress and lack of exercise. Other health conditions, such as hypoglycemia, an under-active thyroid, metal poisoning and food allergies, will also exacerbate PMS.
What You Can Do
Engage in 30-60 minutes of physical activity daily. Regularly exercising elevates endorphin levels, a natural brain chemicals that alleviates pain and increases a sense of well-being.
Reduce your stress levels by practising time management, relaxation and meditation techniques. Make sure you get enough rest.
Don't smoke and avoid secondhand smoke. If you do smoke, take steps to quit immediately.
To relieve cramping, apply heat in the form of a heating pad or hot water bottle, or take a warm bath. You can also lie down on your side and bring your knees up to your chest.
If you practise or are interested in yoga, learn to perform the menstrual cramp pose. It's specifically aimed at relieving cramping.
If you bleed excessively, bleed between periods, feel sick after using tampons or experience severe pain during your period, contact your doctor. Although it's an extremely rare condition, you may have premenstrual dysphoric disorder (PMDD).
What You Can Take
Choose foods that correct the imbalance in neurotransmitters caused by excess estrogen in the body prior to menstruation. Eat a healthy, balanced diet high in fruits and vegetables.
Meat contains arachidonic acid, which inhibits the formation of the prostaglandin PGE1, an anti-inflammatory hormone-like fatty acid which prevents PMS. The body manufactures PGE1 from linoleic acid, which it must get from dietary sources. Unrefined, cold-pressed nut and seed oils such as sunflower, flax or sesame seed oil contain this essential fatty acid.
Vitamin B6 and magnesium effectively relieve PMS symptoms. Wheat germ is an excellent source of both these nutrients and is also rich in vitamin E, which helps reduce breast tenderness. Other good sources of vitamin B6 are nutritional yeast, cabbage, cantaloupe and alfalfa. Magnesium, vital to enzyme activity, is found in figs, nuts, lemons and grapefruit. Daily doses of calcium may also help with moderate to severe symptoms.
Another food helpful in relieving PMS is plain, unsweetened yogurt containing live culture. The friendly bacteria in yogurt help to prevent the conversion of estrogen to a toxic form in the intestine.
If your symptoms are severe, anti-inflammatory medicine can also help. Consult your health-care provider to see if supplementation or medication might be beneficial for you.
To ease menstrual pain, you can take ASA, ibuprofen (such as Advil or Motrin), or another anti-inflammatory medicine. Among the prescription medications used to treat severe PMS symptoms are selective serotonin reuptake inhibitors (SSRIs), which can help to ease physical and emotional symptoms. Most women feel relief after taking a low dose every day or just on premenstrual days. Another medication sometimes prescribed for moderate to severe symptoms is Yasmin, a birth-control pill.
If you're planning on becoming pregnant, consult your doctor before taking any medications. Some drugs used to treat PMS can result in birth defects if taken while pregnant.
Additional Resources
Visit the College of Family Physicians of Canada's Web page on PMS at www.cfpc.ca/English/cfpc/programs/patient%20education/pms/default.asp?s=1.
