I Need Help With PMS…What Can I Do?

by Mona Saint MD

I am in my 30’s and my PMS symptoms seem to have gotten worse over the past few years — is this common?  What’s the deal and what can I do?

It is hard to tell what exact symptoms you’re having from the email, but I’ll assume that you have premenstrual syndrome (PMS).  And it often does seem to get worse with age and especially with our hectic lives.   PMS specifically occurs anytime up to about a week or two before your period starts and the symptoms are usually gone by the fourth day of your period.  Many women have experienced crying at the drop of a hat, and partners usually are wise enough to steer clear, especially if we bait them with a question like, “do I look fat?”  The kids probably also sense that mommy’s on edge and why is she crying over American Idol?  PMS symptoms are really quite common, and below I’ll cover some options to help provide some much needed relief. To make sure we’re all on the same page let’s look at the most common symptoms from most frequent to least: fatigue, irritability, bloating, anxiety/tension, breast tenderness, bad mood, depression, change in appetite, acne, oversensitivity, swelling, anger, crying easily, feeling of isolation, headache, forgetfulness, gastrointestinal symptoms, poor concentration, and uncommonly hot flashes and heart palpitations.  As a gynecologist  who treats patients day in and day out for this kind of stuff, I can’t tell you how many times I suddenly I have one of those worst days for no apparent reason, and then — boom! —my cycle starts.  When this happens, I laugh to myself that after all these years, some months I just don’t recognize it as PMS until it is literally declares itself.  I think this shows how profound the mood effects can be and even overcome some of our rational thinking.

What if you’re not sure if it’s really PMS or something else like depression/anxiety, thyroid disorder, anemia, perimenopause or a conditions like irritable bowel, chronic fatigue, or migraines?  It is worth jotting down your main symptoms in relationship to your cycle.  If you have a 28 day cycle, these symptoms should not be there from about day 4-12 (day 1 is the first day of your period).  In any case, you could see your doctor to evaluate all of this.

So now you’re even more sure it is PMS—what to do for relief?  Some treatments that have been shown scientifically to help are: exercise (even just taking a daily walk), relaxation techniques including meditation, yoga, self-hypnosis, muscle relaxation, biofeedback, and reflexology. Also the agnus castus fruit extract from the chasteberry tree in one study helped when taken once a day (herbals are not regulated by the FDA in terms of safety—see (http://nccam.nih.gov/health/chasteberry/). Certain vitamins have also been shown to help in some studies. Calcium 600mg twice a day, Vitamin D, Vitamin B6 up to 100mg/day, Vitamin E 400IU per day, and Magnesium 200mg up to three times/day can provide some relief for some patients.  Some medical options that work well include birth control pills and mild antianxiety or antidepressant medicines.  Some of the newer birth control pills work well and some of the antidepressants medicines can be dosed for just the last 14 days of your cycle.  Of course, consult your physician first, and you may need work up for thyroid, anemia, depression, menopause, etc. if it is unclear what is causing your symptoms. Good luck!

References: Up to Date 2008

Got a PMS story? What works well for you?

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PMS, Depression, Thyroid Disease, and Perimenpause | What Women Want to Know
06.09.09 at 5:09 pm

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