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    Winning the War on PMS

    Got PMS?

    Look at Your Lifestyle continued...

    In addition, you can find specially formulated dietary supplements designed to combat PMS. Judith Wurtman, PhD, developed PMS Escape, a powdered drink mix containing a mixture of carbohydrates and vitamins.

    "We know the changes in mood and appetite that characterize PMS are related to changes in the amount of serotonin in the brain, says Wurtman, a researcher at the Massachusetts Institute of Technology and director of the TRIAD Weight Management Center at McLean Hospital in Boston. "PMS Escape helps raise serotonin levels in the brain for about four to five hours. It works faster than food, and you only use it on the days you have symptoms."

    Suppose you try diet and lifestyle changes but nothing seems to help? First, take a closer look at your personal pattern of symptoms. If you have classic PMS, you'll notice that you start to feel better as soon as your period begins. If you fit that definition, this means your symptoms are clearly cycle-related. In that case, Goldstein says, cycle suppression using birth control pills will alleviate many if not all of your symptoms.

    What About Sarafem?

    If you watch TV an average amount, you've already seen the ads for Sarafem, those pink and lavender capsules designed to ease premenstrual depression and mood swings. Sarafem is actually a low dose of the antidepressant Prozac, repackaged with a new look and name. It's not supposed to be used for garden-variety PMS. Sarafem is prescribed only for premenstrual dysphoric disorder (PMDD).

    "This condition was only recently included in the DSM-IV, the manual of psychiatric disorders," says Shifrin. "This is a huge advance."

    "In this syndrome the patient's primary complaint is severe depression, anxiety, irritability, and mood swings, while PMS is characterized by more physical symptoms," says Jean Endicott, PhD, director of the Premenstrual Evaluation Unit at Columbia Presbyterian Medical Center, in New York City. "The second diagnostic criteria for PMDD is the presence of severe symptoms leading to psychosocial impairment."

    She estimates 3% to 8% of women with regular menstrual cycles have clinically significant symptoms that meet the criteria for PMDD, while about 60% have PMS.

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