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Premenstrual syndrome is a term used to describe the chronic physical and psychological symptoms a woman may experience in the weeks before her period (end of phase 3 & phase 4).

It’s estimated up to 30% of women suffer from PMS. These symptoms disappear (or are significantly reduced) by the end of menstruation(phase 1). Symptoms vary from individual to individual and may change each cycle.PMS should not be confused with PMDD which is a clinically diagnosed psychiatric disorder accompanied by a severe manifestation of PMS symptoms.However, severe cases of PMS can still have a debilitating effect on a woman’s life.

The causes of PMS are linked to the body’s response to the cyclical changes of hormones that occur during the menstrual cycle. Women with PMS are thought to be more sensitive to these hormonal changes.

What are the symptoms?
Symptoms vary but often one or two will be dominant. Symptoms can also change each cycle and change in severity. Symptoms may last the entire luteal phase (phase 3& 4), present a week before menstruation or start only 3-4days before.

 

Common symptoms include:

  • Mood swings
  • Insomnia
  • Fatigue
  • Increased anxiety/anger/irritability
  • Bloating
  • Weight gain
  • Abdominal pain
  • Breast tenderness
  • Appetite changes
  • Acne
  • Headaches
  • Reduced coordination
  • Changes to sex drive

  

How can you screen for it?
Keeping a diary of the menstrual cycle with symptoms for 2-3 months can help with diagnosis as it illustrates the timing, frequency, and severity of symptoms alongside the timing of the menstrual cycle.

Using FitrWoman can enable you to do this easily, especially if you use the ‘notes’ function. All symptoms should be tracked but for PMS to be diagnosed, symptoms should be severe enough to affect daily functioning and work/school/sports performance or relationships.

The diary will help a doctor assess if the symptoms are cyclical alongside the menstrual cycle, indicating the presence of PMS. If symptoms are present in the luteal phase, decrease during menstruation and vanish during the follicular phase, it is likely PMS will be diagnosed.

How can you manage it (lifestyle factors):
Regular exercise can help relieve some of the symptoms – moderate intensity aerobic exercise, yoga and pilates have all been shown to help reducePMS symptoms.

 Maintaining a regular sleep pattern and getting at least 7-8 hours per night.

 Eating frequent smaller meals can be more comfortable than eating three larger meals each day – ensuring you have adequate fuel for exercise and your lifestyle and that you’re not in a negative energy balance for long periods of time in the day is important.

 Additionally eating a healthy balanced diet with lots of fruit and vegetables and minimising ultra-processed foods can help reduce symptoms.

 Supplements such as calcium and magnesium, vitamin D, vitamin B6 and evening primrose oil can in some cases help reduce symptoms (although research results on these as treatment are mixed and warrant further investigation). If possible, a food-first approach should be employed before supplementing and always consult a nutritionist, dietician or other relevant medical professional first.

Using methods to manage stress such as yoga, mindfulness and scheduling in some down time each day can help reduce some of the psychological symptoms.

Reducing alcohol and salt intake and stopping smoking are also recommended to help reduce symptoms.

There are mixed findings that acupuncture and reflexology may also help with PMS so for some women this may be a treatment option.

Cognitive Behavioural Therapy (CBT) can be used to treat some of the psychological symptoms associated with PMS. 

Pharmacological treatments for more severe symptoms*: 

Oral contraceptive pills can be successful in reducing symptoms, either by suppressing the cycle completely or shortening the dose free interval.

Selective serotonin reuptake inhibitors (SSRIs) are often used to treatPMS. Like with PMDD, doses can be targeted to when the symptoms occur or a low dose can be taken throughout the month. They can be effective for both somatic and psychological symptoms.

In extreme cases where all other treatment has proved unsuccessful, hysterectomy and bilateral oophorectomy may be recommended. This stops symptoms but also leaves the woman infertile.

 

*Note: we are not medical professionals and this information has been taking from Royal College of Obstetricians & Gynaecologists and the American College of Obstetricians & Gynaecologists. Materials are intended as general information only and should not be substituted for medical advice, diagnosis or treatment.

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