Premenstrual Syndrome

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Premenstrual Syndrome

Help for Hell Week

It happens every month. Everything is fine and then--wham!--a week or two before your menstrual period, you become moody, irritable, depressed, tense, headachy, bloated or tired and find it difficult to concentrate. (Or maybe you're blessed with all of the above.)

Only 1 to 5 percent of women experience serious symptoms of premenstrual syndrome, or PMS, severe enough to interfere with their work and social lives or at least get noticed by others. (Even men's magazines are reporting on PMS.) But plenty of women experience symptoms of PMS to a lesser degree, according to Karen J. Carlson, M.D., an instructor at Harvard Medical School and director of Women's Health Associates at Massachusetts General Hospital in Boston.

A PROBLEM YOU CAN LIVE WITHOUT

Rest assured, say women doctors, if you have PMS, it doesn't mean that you're neurotic (or psychotic). Nor are you necessarily suffering from deranged hormone levels. Researchers' best guess is that PMS is triggered by subtle changes in the brain's levels of serotonin, a substance that influences moods--or something similar.

Until science comes up with some kind of explanation, women doctors suggest these remedies for PMS.

Switch to decaf. Coffee--or anything with caffeine--can exacerbate the irritability and tension associated with PMS, says Yvonne S. Thornton, M.D., visiting associate physician at the Rockefeller University Hospital in New York City and director of the perinatal diagnostic testing center at Morristown Memorial Hospital in New Jersey. "Caffeine can also make you sleep less well, which makes you more cranky." So when you feel PMS coming on, Dr. Thornton suggests that you replace caffeine with decaf or herb tea.

Manage your sweet tooth. Many women crave sweets premenstrually, but eating cookies, cake or candy will probably just add to the jitters by dramatically raising your blood sugar levels, says Dr. Thornton. So when the urge strikes, bite into an apple instead of a candy bar.

What Women Doctors Do No Rash Decisions Ann Honebrink, M.D. The co-director of the Center for Women's Health at Allegheny University of the Health Sciences MCP-Hahnemann School of Medicine in Philadelphia doesn't pay too much attention to her own premenstrual syndrome (PMS) symptoms. But Anne Honebrink, M.D., says that hearing about the experiences of the women she counsels, coupled with increased self-awareness, have made her more alert to the existence of PMS. When she does notice premenstrual symptoms like irritability and fatigue, she deals with them by trying to keep them in perspective. "I really do think it helps to just step back and try to recognize PMS for what it is," she says. "You might feel like divorcing your husband or quitting your job. When that happens, I tell myself that maybe I should think about this next week." "It helps to be able to say, 'Okay, I know I'm feeling this way now, but it will go away when my period comes.' It doesn't make PMS go away," she says. "But it can make it easier to deal with."

Eat small, eat often. Smaller, more frequent meals keep your blood sugar levels steady, says Ellen Freeman, Ph.D., director of the University of Pennsylvania Medical Center PMS Program in Philadelphia. This keeps you calmer and also helps cut your craving for sweets.

Have some spaghetti. A PMS diet--heavy on complex carbohydrates such as spaghetti and whole-wheat bread--may help relieve food cravings and mood swings, says Dr. Freeman. Complex carbs play a part in increased levels of the brain chemical tryptophan, necessary for the production of serotonin, the brain chemical that is involved in mood.

Mind your minerals. A daily supplement of 200 milligrams of magnesium premenstrually may also improve your symptoms, says
Dr. Carlson.

And a daily 1,200 milligrams of calcium helps relieve menstrually related headaches and other PMS symptoms, according to a study by Susan Thys-Jacobs, M.D., a physician in the Division of General Internal Medicine at Mount Sinai Medical Center in New York City.

When To See A Doctor Premenstrual syndrome (PMS) is usually considered a minor annoyance--unless it interferes with your on-the-job performance or keeps you from getting to work in the first place. The same goes if you can't manage your children during that time of the month, or if you have blowups with your spouse. If this sounds familiar, see a physician. If you're practicing a form of birth control other than oral contraceptives, your doctor may suggest that you switch to the Pill. Birth control pills suppress the normal cyclic fluctuations in hormone levels and, in some women, can help alleviate symptoms of PMS.

Take your vitamins. Research shows that taking 50 to 100 milligrams a day of vitamin B₆ during PMS can alleviate depression, irritability and other symptoms, say women doctors--perhaps because it plays a part in serotonin metabolism, says Dr. Carlson.

Taking 150 to 200 international units of vitamin E premenstrually also seems to help, says Dr. Carlson, though the exact mechanism is not understood.

Season sans salt. A low-salt diet can relieve premenstrual bloating, says Dr. Thornton. It may also help alleviate headaches and improve mental concentration, because women with PMS may have a degree of edema, or swelling, in their brains.

Exercise for endorphins. Aerobic exercise offers a heightened sense of well-being, because it stimulates your brain's production of the natural feel-good substances called endorphins. Exercising regularly is more important than exercising intensely, says Dr. Freeman. "You don't have to train like an Olympic athlete," she says. "Get out there three or four times a week for a half-hour walk or run."

Increasing your regular exercise levels during PMS can relieve many symptoms, says Dr. Thornton. If you normally walk for 30 minutes three times per week, do so for longer or add extra days when you're feeling premenstrual.

Brighten your mood with bright light. PMS depression may be alleviated by bright lights, according to a study at the Department of Psychiatry at the University of California, San Diego, School of Medicine. Researchers Gabrielle M. Cerda, M.D., and Barbara L. Parry, M.D., asked women who get PMS to sit three feet away from an arrangement of bright lights, gazing at the lights occasionally, between the hours of 6:30 and 8:30 in the morning or 7:00 to 9:00 in the evening seven to ten days before their periods. A significant number of the women reported feeling less depressed after the bright-light sessions. Altered circadian (day-to-day) body rhythms, which appear to be related to mood disorders, or the enhanced production of certain hormones known to have antidepressant effects, may account for the women's improved moods, say the researchers.