Your Questions Answered
Is “PMS” a real thing? If I have it, what can I do about it?
Yes. PMS, or premenstrual syndrome, is real and is a common condition occurring in 75% of regularly menstruating women. PMS is a combination of physical and mood changes that occur in the luteal (or last half) of the menstrual cycle. For the diagnosis to be correct, these cyclic changes must adversely affect the individual’s life and daily functioning. PMS and premenstrual dysphonic disorder (PMDD, which is a severe case of PMS with specific criteria) are diagnosed by a licensed practitioner. The most common symptoms of PMS are abdominal bloating and fatigue but commonly include breast tenderness, headaches, irritability, labile mood, depressed mood, and decreased ability to concentrate. Some patients also report bouts of anger and crying, nausea, heart palpitations, and dizziness. The use of a diary to document these symptoms as they occur is often helpful as you and your practitioner can survey the occurrences and judge whether or not they are associated with PMS.
The causes of PMS are controversial but involve the interaction of normally cycling hormones with brain neurotransmitters and other symptoms. The most commonly implicated neurotransmitter is serotonin which affects mood. Some women are more susceptible to these normal cyclic changes but the reason some women are more susceptible than others remains unclear.
The treatment of PMS includes modifying the most bothersome of symptoms. In some patients, simply modifying the cycle hormonally with oral contraceptives is beneficial. In other patients, the use of laxatives and/or diuretics to combat constipation and bloating can be helpful.
The most commonly effective treatment of mood symptoms of anxiety, irritability, and depression are the antidepressants Paxil, Zoloft, and Prozac which increase serotonin levels. Non-medical treatments include chasteberry, St. John’s Wort, biofeedback, hypnosis, and regular exercise which can all increase serotonin levels.
For questions or concerns about you and your body’s reaction to your cycle, please seek consultation with any of the practitioners at Harbour Women’s Health.
Anja B. Crider, MD
Harbour Women’s Health