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PMS: Signs and Symptoms


WebMD Feature

If the sadness and mood swings don't get you, the cramps and headaches just might. In fact, premenstrual syndrome (PMS) affects almost all women to some degree during their reproductive years.

In 30 percent to 40 percent of cases, symptoms are so severe that they interfere with normal day-to-day functioning. Once passed off as simply an unpleasant-but-inevitable part of being a woman, the symptoms many experience in conjunction with their monthly period are finally being seen as what they are -- signs of a legitimate medical problem.

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PMS, a catch-all name for a myriad of physical and psychological symptoms, is thought to be caused by hormonal changes during the menstrual cycle. The exact cause, however, remains a mystery. Symptoms generally strike five-to-10 days before the period and dissipate with its start or soon after. But it's not "all in your head," as you've probably been told. Research has determined that women aren't imagining anything -- and, thankfully, there's help.

What Are the Signs?

Researchers have pinpointed more than 150 PMS symptoms

Some Common PMS Symptoms

  • moodiness
  • depression
  • abdominal cramping
  • bloating
  • food cravings
  • headaches
  • muscle aches
  • breast tenderness
  • fatigue
  • acne

Should You See a Doctor?

It's not always easy to decide if the symptoms warrant a trip to the doctor.

"If you have to give up an aerobics class, that's one thing," says Dr. Michelle Warren, professor of obstetrics and gynecology at Columbia University. "But if symptoms interfere with your normal activities, if you can't concentrate, if you have to stay home and lie down, that's abnormal."

The good news is that many of the symptoms can be treated, and, in some instances, even prevented. Talking to a doctor is an important first step. While no diagnostic tests exist for PMS, a diagnosis can be made through tracking monthly symptoms to find patterns and discussing them with a doctor accustomed to treating the disorder.

Help Is Here

There's no one-size-fits-all treatment. Rather, what will help depends on a woman's symptoms.

The Following Are a Number of Treatment Options:

  • Calcium -- One of the latest findings for treating PMS is regularly taking calcium carbonate -- found in Tums and certain calcium supplements -- twice a day, for a total of 1500 mg. Studies show that this significantly reduces symptoms of moodiness, depression, food craving and pain in many women. The dose of calcium provides a bonus of protecting against bone loss.
  • A wholesome diet -- Eating fruits, vegetables and whole grains is a good idea. Cutting down on salt and increasing fluids will help to prevent bloating. Staying away from caffeine can reduce breast swelling and pain. Reducing sugar and alcohol intake lessens food cravings.
  • Pain relievers -- Over-the-counter remedies like aspirin, ibuprofen (in such brand names as Motrin, Advil, Nuprin and others) and naproxen (in Aleve) can reduce cramps, headaches and muscle pain. If that's not enough, stronger prescription medications are available. Warren recommends taking the medication three times a day for the three to five days before the period starts to reduce swelling and prevent pain. Continue the medication during your period as needed.
  • Stress reducers -- Stress can make symptoms worse. Exercise and relaxation techniques like yoga, meditation and biofeedback can help. Exercise offers a possible bonus in the form of endorphins, natural painkillers produced in the brain and released during physical activity.
  • Antidepressants -- Research has found that women suffering from premenstrual dysphoric disorder respond well to low doses of antidepressants, according to Dr. Margaret Spinelli, assistant professor of psychiatry at Columbia University. This disorder is characterized by severe mood and behavioral symptoms such as depression, irritability, fatigue and disturbed sleep, during the two weeks prior to a woman's period. Symptoms are greatly reduced with the onset of the period. While such drug therapy acts primarily on psychological symptoms, "the fact is, sometimes when women feel better psychologically, the physical symptoms don't seem to bother them," Spinelli says.
  • Other options -- Progesterone suppositories, iron supplements, diuretics and the vitamins B6 and E offer additional treatment options. However, much controversy surrounds the safety and efficacy of such therapies. Consult with your doctor to see whether any of these options might help.

Whether or not you do go for treatment, it is important to be aware of your cycles and to recognize symptoms as they occur. Knowing when PMS may rear its ugly head and planning accordingly can make a big difference in your life.

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