The Truth about PMS © Dr. Eileen Silva 2006

Do any of these symptoms sound familiar? Headaches, depressions, anxiety, uncontrollable crying spells, fatigue, fluid retention, abdominal cramping, heart palpitations, weight gain, irritability, panic attacks, forgetfulness, migraines, backaches, decreased work or social performance, sleep problems, food cravings, breast tenderness, clumsiness, confusion . . . Sounds like a nightmare existence, doesn’t it?

Are you one of the 40-80% of women for whom this scenario, or at least a portion of it, is everyday life for one to two weeks out of every month of their lives from puberty to menopause? What disorder could possibly result in these varied, and often dehabilitating, symptoms for so many women?

Premenstrual Syndrome! That’s right! It’s that old friend, PMS, the subject of so many jokes and putdowns. You know – that “catch-all” phrase that, according to “so-called comedians,” covers all the “imaginary” problems that women “invent” as excuses to spend the day on the couch “watching TV and eating bonbons.”

Let me assure you that, while it is true that doctors and researchers have not found a specific lab test that can identify PMS, this disorder is definitely neither “imaginary” nor is it “invented.” Serious medical research has been going on for years to identify the definitions, diagnosis, causes, and cures for this disorder. Here are two of the resulting definitions:

1. Dr. Ellen Freeman of University of Pennsylvania Health System describes PMS as, “a cluster of emotional, behavioral, and physical symptoms that have a cyclic pattern related to the menstrual cycle, becoming severe in the week or two preceding menses and abating with menstruation.”

2. The American College of Obstetricians and Gynecologists defines PMS as “the cyclic occurrence of symptoms that are sufficiently sever to interfere with some aspects of life, and that appear with consistent and predictable relationship to the menses.”

How do you know if you or a loved one has PMS, if there is no real test for it? Across the board, researchers and doctors agree that the identifying factor overall in this disorder is the fact that the symptoms stop once the menses begin or once a woman becomes pregnant.

You should know that doctors have identified two serious forms of PMS that have effects far beyond those of normal PMS symptoms:

1. “Postpartum Depression” is a severe depression that some women experience after giving birth. Women with this disorder suffer a severe let-down from the high pregnancy-levels of hormones, and, because of the disruption to their nervous systems, they may actually harm themselves or their babies.

2. “Premenstrual Dysphoric Disorder” (PMDD) brings about serious and disabling depression, anxiety, tension, and angry irritability, intense mood changes in the week or two before the onset of menses, and women suffering from this disorder exhibit at least five of PMS’s physical symptoms as well. Like regular PMS, PMDD symptoms disappear with menses.

You may have heard that doctors find it helpful for women to keep a daily diary of symptoms throughout the month when they are attempting to diagnose PMS. What should you look for when keeping a daily diary or considering the possibility that you or a loved one has PMS? Well, PMS carries over 150 possible symptoms that affect women in both the physical and the emotional realms in varying degrees.

Physically, symptoms can range from light, as in headache, fatigue, and slight abdominal swelling, to severe, as in migraines, severe cramping, and an inability to function normally. Emotionally, you may experience symptoms relating to anxiety (irritability, irrational crying, or emotional swings), depression (withdrawn, fearful, or altered libido), cravings (for sweets, dairy, or alcohol), and fluid retention (headache, breast tenderness, abdominal bloating, and weight gain).

I can tell you that although doctors still have not determined the exact cause of PMS, they agree that hormones and neuro-chemical changes within the brain are prime suspects. Estrogen hormones, for example, can contribute to increased brain activity, retention of salt, and drops in blood sugar, because it has a central neurological effect on the brain.

What do you do if you realize that you or a loved one suffers from some level of PMS? Obviously, if the symptoms are severe, you should seek your doctor’s advice. Doctors today may prescribe either psychiatric (psychotropic drugs, tricyclics, tranquilizers, or selective serotonin reuptake inhibitors), medical treatments (anti-estrogenic hormonal medications), or a combination of both for severe cases.

However, if you believe that your symptoms are manageable, or if they are intermittent, here are a few tips that might help you alleviate some symptoms.

Eat six, small, high in complex carbohydrates, low in simple sugars meals at three-hour intervals to help keep energy levels and blood glucose levels steady. Complex carbohydrates are found in foods eaten in their natural states like oatmeal, cornmeal, barley, and wheat germ, or in foods like pastas, brown rice, root vegetables like potatoes, whole grain breads and cereals, etc.

Reduce caffeine, alcohol, salt, fats, and simple sugars to help diminish fatigue, tension, depression and water retention bloating.

Add calcium, controlled levels of B6, B complex, magnesium, and Vitamin E to help maintain normal moods and reduce fluid retention, cramps, and back pain.

Exercise three times a week for at least 20-30 minutes to improve mood, blood circulation, sense of well-being, and alleviate the build-up of tension and stress.

Learn to relax with deep breathing exercises, music, quiet time alone, or yoga, to decrease symptoms and help with coping. In addition, spend time with an understanding friend, get a solid 8 hours of sleep regularly, and keep track of the menstrual cycle on the calendar to prepare for the onslaught of symptoms to help yourself cope.

Adjust your schedule around the menstrual cycle to avoid heavy decisions, stressful appointments or events, or even arguments during PMS to help both your PMS time and your relationships.

Investigate the use of herbs. Much research is going on in the field of herbal remedies for PMS. Evening primrose oil, chaste tree berry, dong qui and other herbs may have an effect on PMS symptoms according to personal testimonies of women who have tried them.

For best results, I recommend a combination of all of these areas. A lifestyle including a balanced diet, proper amounts of necessary vitamins and minerals, plenty of healthy exercise, proper rest and relaxation, good mental attitudes, and appropriate herbs gives you the best defense against PMS symptoms. However, if all else fails, by all means, throw in a couple of bonbons. Women for centuries have insisted that chocolate is a miraculous cure-all!