Premenstrual Syndrome
Premenstrual Syndrome
28 Ways to Treat the Symptoms
Think of it as biological warfare, its battles played out on the fields of a woman's body and mind. Once a month, about two weeks before her menstrual period, the opposing armies—estrogen and progesterone—begin to amass. These female hormones, which regulate her menstrual cycle and affect her central nervous system, normally work in tandem. It's only when one tries to outdo the other that trouble looms.
Some women escape the conflict altogether; their hormones strike a peaceful balance before a single sword is drawn. Others are less fortunate. For one women, estrogen levels may soar, leaving her feeling anxious and irritable. Or her progesterone predominates, dragging her into depression and fatigue.
The battles can rage on for days. Maybe you've been there. You might feel bloated and gain weight, have a headache, backache, acne, allergies, or terrible tenderness in your breasts. You may experience all of these symptoms or just a few. You may crave ice cream and potato chips. Your mood may shift without reason, swinging from euphoria to depression. And then, suddenly, the troops clear out and peace of mind returns—you finally get your period.
Premenstrual syndrome, or PMS, is believed to affect to varying degrees between one-third and one-half of all American women between the ages of 20 and 50, says Susan Lark, M.D., director of the PMS Self-Help Center in Los Altos, California. Certain factors, such as bearing several children or being married, seem to increase the risk of having PMS, says Guy Abraham, M.D., a former professor of obstetrics and gynecologic endocrinology at the University of California, Los Angeles, UCLA School of Medicine and researcher who has conducted extensive investigation into the disorder. (PMS is a major cause of divorce, he notes.) The problem may be inherited genetically, says Edward Portman, M.D., a PMS consultant, researcher, and director of the Portman Clinic in Madison, Wisconsin, who is also doing research into PMS.
Not all PMS sufferers have the same symptoms and the same intensity of discomfort, says Dr. Abraham. Nor do all PMS sufferers respond to the same treatments. Finding the best way to handle your PMS may require some trial and error. We talked to physicians who have worked extensively with PMS. They recommend the following coping measures.
Don't worry, be happy. A positive, confident attitude can help you cope and maybe even prevent future episodes of PMS, says Dr. Lark. If you feel PMS getting the best of you, she suggests reciting some positive affirmations. Sit in a comfortable position and repeat the following two or three times: "My body is strong and healthy. My estrogen and progesterone levels are perfectly regulated. I handle stress easily and competently."
Eat a little a lot. Poor nutrition doesn't cause PMS, says Dr. Portman, but certain dietary factors can accentuate the problem. Dr. Abraham agrees. "Poor eating habits can worsen PMS." A number of other physicians recommend a hypoglycemic diet—small meals low in sugar several times a day—to help keep your body and psyche in better balance.
Avoid empty calories. Stay away from low-nutrient foods like soft drinks and sweets containing refined sugar, says Dr. Abraham. Giving in to a craving for sweets will only make you feel worse, contributing to anxiety and mood swings. Try fresh fruit as a substitute, suggests Dr. Lark.
Decrease dairy. Eat no more than one or two portions per day of skimmed or low-fat milk, cottage cheese, or yogurt, Dr. Abraham says. Reason: The lactose in dairy products can block you body's absorption of the mineral magnesium, which helps regulate estrogen levels and increases its excretion.
Ferret out fats. Replace animal fats like butter and shortening with polyunsaturated oils like corn and safflower oils, says Dr. Abraham. Animal fats contribute to the high estrogen levels that may contribute to PMS, he says.
The Alternate Route
The Supplement Solution A number of vitamins, minerals, and even amino acids may help relieve PMS symptoms, some doctors say. Here's the lowdown on nutritional solutions. Vitamin B6. Research into vitamin B6 and PMS has shown that increasing your intake of the nutrient can help alleviate symptoms such as mood swings, fluid retention, breast tenderness, bloating, sugar craving, and fatigue, says Susan Lark, M.D. But, she cautions, don't experiment with the vitamin on your own. B6 is toxic in high doses. Any vitamin therapy, including those mentioned below, should be supervised by your doctor. Vitamins A and D. These two vitamins work in tandem to improve the health of your skin. Because of their importance to the skin, they may play a part in suppressing premenstrual acne and oily skin, according to Dr. Lark. Vitamin C. An antioxidant, vitamin C is believed to play a role in reducing stress. It may help relieve the stress felt during PMS, says Dr. Lark. And there's more. Vitamin C is also know as a natural antihistamine, says Dr. Lark, and can be helpful for women whose allergies worsen before a period. Vitamin E. Another antioxidant, vitamin E may have a powerful effect on the hormonal system, helping to relieve painful breast symptoms, anxiety, and depression, says Guy Abraham, M.D. Calcium and magnesium. These two minerals work together to fight PMS, says Dr. Lark. Calcium helps prevent premenstrual cramps and pain, while magnesium helps the body absorb the calcium. Dr. Lark also believes that magnesium helps control premenstrual food cravings and stabilizes moods. L-tyrosine. This amino acid is required for your brain's production of the chemical dopamine, your own natural antidepressant. Edward Portman, M.D., has found that it helps some of his patients relieve the anxiety and depression associated with PMS. The PMS pill. Your best bet for treating PMS with nutritional supplements is to take a balanced supplement every day, says Dr. Lark. Your drugstore may even sell products specially formulated for PMS symptoms. |
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Restrict salt. "Go on a low-sodium diet for seven to ten days before the onset of your period to offset water retention," suggests Penny Wise Budoff, M.D., director of the Women's Medical Center in Bethpage, New York. "This means no restaurants, processed foods, Chinese food, commercial soup, or bottled salad dressing."
Fill up with fiber. Fiber helps the body clear out excess estrogens, says Dr. Abraham. Eat plenty of vegetables, beans, and whole grains. Millet, buckwheat, and barley are high not only in fiber but also in magnesium, adds Dr. Lark.
Those Crazy Cravings Did you top off dinner tonight with a giant-size chocolate bar or a quart of ice cream? Don't put yourself down, especially if your menstrual period is around the corner. Chances are, your body made you do it. "A woman doesn't overeat at this time of the month because of a weakness of character. Research shows that she's almost driven to it by the reaction of progesterone on her brain," says Peter Vash, M.D., an endocrinologist and internist on the clinical faculty of UCLA Medical Center in California who also specializes in eating disorders in private practice. What happens, researchers theorize, is that the high levels of progesterone released by the ovaries around the midpoint of a woman's menstrual cycle seem to affect those areas of the brain responsible for carbohydrate cravings. As disturbing as the tendency is, it may actually be a primitive protective mechanism built into a woman's biology, Dr. Vash says. "When a woman is about to have her period, she's going to lose a lot of fluid. Eating high-carbohydrate foods like potato chips and ice cream will cause her to retain fluid and will also give her additional energy." Cravings for chocolate—a common preperiod occurrence—may result because of the brain's need for amino acids contained in that substance, he says. Try to manage your cravings, says Dr. Vash, because giving in to them will only make you feel worse. Here's how he suggests you can help yourself. Be prepared. "Know the cravings will occur for seven to ten days a month and mark your calendar," says Dr. Vash. "And know that they will stop, too. There's a limit. You can rise above them." Put up a fight. Get adequate sleep, drink lots of fluids, and eat fruit and vegetables when your body asks for sweets and starches. |
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Cut the caffeine habit. Consume very limited quantities of coffee, tea, chocolate, and other caffeine-containing substances, says Dr. Abraham. Caffeine has been shown to contribute to painful breast tenderness, anxiety, and irritability.
Abstain from alcohol. The depression that often accompanies PMS will be accentuated by alcohol, says Dr. Portman. Alcohol can also worsen PMS headaches and fatigue and cause sugar cravings, says Dr. Lark.
Say no to diuretics. As a temporary antibloating measure, diuretics are commonly used by many PMS sufferers, says Dr. Lark. But some over-the-counter diuretics draw valuable minerals out of your system along with water, she says. A better approach would be to stay away from substances like salt and alcohol that cause you to retain water in the first place.
Get more active. Moderate exercise increases your blood flow, relaxes your muscles, and fights fluid retention, says Dr. Lark. What's more, says Dr. Portman, exercise increases your brain's production of endorphins, natural opiates that make you feel better all over.
Walk at a fast pace in fresh air, swim, jog, take up ballet or karate—do something you enjoy on a daily basis, Dr. Portman suggests. For best results, increase your level of activity for the week or two before PMS symptoms set in, says Dr. Lark.
De-stress your environment. Women with PMS seem to be particularly sensitive to environmental stress, says Dr. Lark. Surrounding yourself with soothing colors and soft music can contribute to greater calm at this and other times of the month.
Breathe deeply. Shallow breathing, which many of us do unconsciously, decreases your energy level and leaves you feeling tense, making PMS feel even worse, says Dr. Lark. Practice inhaling and exhaling slowly and deeply.
Sink into a tub. Indulge yourself in a mineral bath to relax muscles from head to toe, Dr. Lark suggests. Add 1 cup of sea salt and 1 cup of baking soda to warm bathwater. Soak for 20 minutes.
Try a little romance. The aching muscles and sluggish circulation that often accompany PMS can be relieved by having sex with orgasm, says Dr. Lark. The stimulation will help move blood and other fluids away from congested organs.
Get an advance from your sleep bank. If insomnia is part of your PMS, prepare for it by going to bed a few hours earlier for a few days before the problem generally sets in, says Dr. Lark. It may help alleviate the tiredness and irritability that go hand in hand with insomnia.
Stick to a schedule. Set reasonable goals and schedules for each day to avoid feeling overwhelmed, even if this means cutting back in your routine, Dr. Lark suggests.
Save social obligations for another time. Postpone big plans like holding a dinner party until a time when you feel you can handle it better. It'll only frazzle an already frazzled situation, says Dr. Lark.
Don't hide the truth. Talking about your PMS problems with your spouse, friends, or coworkers helps, says Dr. Lark. And it can be especially beneficial. You may even find a PMS self-help group in which to share your experiences with fellow sufferers. To see if one exists in your area, ask your doctor or call a local women's center.
PANEL OF ADVISERS
Guy Abraham, M.D., is a former professor of obstetrics and gynecologic endocrinology at the University of California, Los Angeles, UCLA School of Medicine and has conduced extensive research on PMS.
Penny Wise Budoff, M.D., is director of the Women's Medical Center in Bethpage, New York, and author of No More Menstrual Cramps and Other Good News, No More Hot Flashes and Other Good News, and other related books.
Susan Lark, M.D., is director of the PMS Self-Help Center in Los Altos, California, and author of Dr. Susan Lark's Premenstrual Syndrome Self-Help Book.
Edward Portman, M.D., is a PMS consultant, a researcher, and director of the Portman Clinic in Madison, Wisconsin.
Peter Vash, M.D., is an endocrinologist and internist on the clinical faculty of the UCLA Medical Center in California and a specialist in eating disorders. He also holds a master's degree in public health.
