Women who have premenstrual syndrome (PMS) experience a number of physical and emotional symptoms each month from 2 to 14 days before their periods. The symptoms usually go away once their periods begin. PMS may start at any age and ends after menopause. Symptoms vary from woman to woman, and more than 150 symptoms have been linked with the disorder. About 75% of women have some symptoms of PMS, with 20 to 50% finding that symptoms interfere with their daily activities and 3 to 5% becoming unable to function.
Symptoms of PMS include:
While the exact cause of PMS is unknown, the most popular theories include hormonal changes (too much estrogen or not enough progesterone), low levels of vitamin B6 or other nutrients, abnormal metabolism of hormone-like substances called prostaglandins, and low levels of the brain chemical serotonin that affects mood.
Women with a history of the following conditions are at a higher than average risk for having PMS.
If you have symptoms associated with PMS, see your health care provider. Your provider can help make a diagnosis and find a treatment or combination of therapies that may work best for you.
You will need to chart your symptoms and their severity daily for 1 to 2 months. Your provider will take a detailed history of symptoms, do a physical and gynecologic examination to rule out other medical conditions, and perform a psychosocial evaluation. Laboratory and imaging studies may be used to rule out other conditions.
Reducing stress, increasing exercise, and making dietary changes around the time of menstruation may prevent PMS symptoms from worsening. Supplementing the diet with certain vitamins and minerals, including calcium, vitamin B6, vitamin D, Omega-3 fatty acids, and others, may also help. Several studies show that women who exercise report less breast tenderness, fluid retention, personal stress, anxiety, and depression than those who do not exercise.
Preventive measures and, in some cases, drug therapy, are most often used for treating PMS.
Your provider may prescribe the following medications:
A comprehensive treatment plan for PMS may include a range of complementary and alternative therapies (CAM). Work with an experienced provider and always inform every member of your health care team about any CAM therapies you are considering adding to your regimen.
These nutritional tips may help reduce symptoms:
These supplements may also help:
Herbs are generally available as standardized dried extracts (pills, capsules, or tablets), teas, or tinctures or liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with your favorite beverage. Dose for teas is 1 to 2 heaping tsp. per cup of water, steeped for 10 to 15 minutes (roots need longer).
The following herbal remedies may provide relief from symptoms:
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for PMS based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
A low homeopathic dose, such as 30C, as often as every 15 to 30 minutes, may be used for symptoms of PMS, including bloating, pain, irritability, and mood swings.
Acupuncturists treat people with PMS based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of PMS, a qi deficiency is usually detected in the liver and spleen meridians. Many treatments include moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points). Qualified practitioners may also recommend herbal treatment or changes to the diet. Although sceintific evidence for the use of acupuncture for PMS is lacking, acupuncturists often treat PMS.
Castor Oil Packs
For cramping and pain, dampen a cloth with castor oil and apply to the abdomen. Cover with saran wrap, and then apply a heating pad over this pack. Use for 1 to 3 hours, then remove.
Massage, yoga, guided imagery, and bright light therapy may also help relieve PMS symptoms
Some studies suggest that chiropractic spinal manipulation may help women with PMS. Women with PMS have been found to have a higher rate of spine-related problems, such as tenderness and muscle weakness, than those who do not have PMS. In one study, researchers found that women with PMS reported fewer symptoms after receiving spinal manipulation and soft tissue therapy compared to those who did not get chiropractic treatment. The researchers note that these effects may not last long and that monthly chiropractic treatment may be necessary to maintain these results.
Severe PMS can disrupt a woman's life. Women who have PMS may also be at higher risk of developing depression after having a baby. Psychological and emotional support, as well as treatment of the physical symptoms may help.
You may need to see your doctor on a regular basis to treat PMS.
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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