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Premenstrual syndrome

What is it?

Premenstrual (pree-men-strull) syndrome (sin-drome) is also known as "PMS." This name is given to symptoms that may begin 1 or 2 weeks before your monthly period. These symptoms usually go away soon after the start of your period. PMS may be worse some months and better others. It can affect the way you act or feel. About half of all women have PMS at some time. It is more common as you get older. There is no cure for PMS but medicines may help your symptoms.

Causes:

Changes in chemicals in the body called hormones cause PMS. Things that may make PMS worse are a poor diet, lack of exercise, or eating and drinking too much caffeine. Symptoms of PMS may be worse if you have stress or mental problems. Caregivers do not know why some women have PMS worse than others.

Signs and Symptoms:

  • Many different changes can occur but most women have only certain ones. You may have changes in how you act or feel. You may feel mad, tense, nervous, sad, or hungry. You may also be moody, have crying spells, or want to be left alone. You may crave foods like chocolate, sugar, or salt. Some women have trouble thinking or focusing. You may feel very tired or have trouble sleeping.
  • You may also have changes in your body. You may gain weight, have swollen breasts, abdomen (belly), ankles, hands, or face. Acne (pimples) and headaches may also occur. Some people feel dizzy or may faint. You may have a hard time having a BM or have diarrhea. You may not pass urine as often as usual. You may not be as interested in sex or get as much pleasure from it.

Wellness Recommendations:

Eat a healthy balanced diet and get 7 1/2 to 8 hours of sleep each night. Exercise daily. Eating less salt may help the swelling in your body.

Medical Care:

There is no cure for PMS. Medicine ("water pills") that helps your body get rid of water can help swelling. Birth control pills or depression medicine may help you feel better. Counseling or joining a PMS support group may help you and your family cope with PMS. You may have a blood test, when you are feeling both good and bad, to measure your estrogen and progesterone hormone levels.

Dietary Measures:

  • Avoid salt (can cause body swelling), caffeine (can cause nervousness and mood changes), and alcohol (can worsen some PMS symptoms).
  • Eat more soy in your diet. Soy is a good source of "phytoestrogens." These are weak estrogen-like compounds found in plants. Phytoestrogens may decrease some of the hormonally-driven PMS symptoms.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat PMS.
      • Your symptoms have not gone away or improved by these self-help measures.
      • You have symptoms that last longer than 2 weeks each month.
      • You have questions about what you have read in this document.

    SEEK CARE IMMEDIATELY IF:

    • You feel out of control or feel that you may hurt yourself or someone else.

    Care Agreement:

    You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

    References:

    1. Amsellem M, Masson JM, Negui B et al: Endotelon in the treatment of venolymphatic problems in premenstrual syndrome-multicenter study on 165 patients. Tempo Med 1987; 282:46-51.

    2. Barr W: Pyridoxine supplements in the premenstrual syndrome. Practitioner 1984; 228(1390):425-427.

    3. Bressa GM: S-adenosyl-l-methionine (SAMe) as antidepressant: meta-analysis of clinical studies. Acta Neurol Scand Suppl 1994; 154:7-14.

    4. Facchinetti F, Borella P, Sances G et al: Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol 1991a; 78:177-181.

    5. Horrobin DF: The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med 1983; 28(7):465-468.

    6. Kim HL, Streltzer J & Goebert D: St. John's wort for depression: a meta-analysis of well-defined clinical trials. J Nerv Ment Dis 1999; 187(9):532-538.

    7. London RS, Murphy L, Kitlowski KE et al: Efficacy of alpha-tocopherol in the treatment of the premenstrual syndrome. J Reprod Med 1987; 32(6):400-404.

    8. London RS, Sundaram GS, Murphy Let al: Evaluation and treatment of breast symptoms in patients with the premenstrual syndrome. J Reprod Med 1983; 28(8):503-508.

    9. Monteil-Seurin J & Ladure Ph: Efficacy of Ruscus extract in the treatment of the premenstrual syndrome. Vanhoutte PM (ed): Return circulation and norepinephrine. John Libbey, Eurotext, Paris, France; 1991:43-53.

    10. Puolakka J, Makarainen L, Viinikka L et al: Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors. J Reprod Med 1985; 30(3):149-153.

    11. Riemann D & Vorderholzer U: Treatment of depression and sleep disorders: significance of serotonin and L-tryptophan in pathophysiology and therapy. Fortschr Med 1998; 116(32):40-42.

    12. Tamborini A & Taurelle R: Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndrome (abstract). Rev Fr Gynecol Obstet 1993; 88(7-9):447-457.

    13. Thys-Jacobs S, Starkey P, Bernstein D et al: Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Am J Obstet Gynecol 1998; 179(2):444-452.

    14. Wyatt KM, Dimmock PW, Jones PWet al: Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ 1999; 318(7195):1375-1381.

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    Last Updated: 11/4/2014

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