Your health with Pharmacist Advice

Women's Health - Premenstrual Syndrome

DEFINITION

Premenstrual Syndrome (PMS) is the name given to a complex set of psychological behavioural and physical symptoms which occur one to two weeks before menstruation and last until menstruation begins.

DESCRIPTION

PMS is a common disorder in women. Although many women experience symptoms that are linked to their menstrual cycles, the diagnosis of PMS requires that these symptoms are severe enough to affect a woman's ability to function at home or in the workplace or in her relationships with others(1). The symptoms occur monthly and may worsen as menstruation approaches and improve when menstruation commences, with a symptom-free phase following menstruation(2). PMS is distinct from Premenstrual Dysphoria (PMD). PMD is a severe form of PMS with extreme psychological symptoms such as depression, anxiety and irritability and it involves a different method of treatment from PMS(3).


Symptoms may include nervous tension and mood swings, depression, water retention, headache, food cravings and breast tenderness(4).
Menstrual cramps are not considered to be a symptom of PMS, but a woman can experience cramps while suffering PMS(5).

PMS can occur at any stage of a woman's menstrual life, but is most frequently experienced by women in their late 20s and 30s. There are a number of proposed causes for PMS, but the exact cause is yet to be established.

HEALTH MANAGEMENT

As with all conditions your Doctor should be consulted to diagnose and treat this condition. Treatment strategies include either eliminating the hormonal cycle that causes ovulation or treating a woman's symptoms as they occur(6).

It is a good idea to be examined properly to exclude any pathological or disease process that may be a causative factor. Any bleeding between periods should be investigated for possible fibroids or cervical lesions. Hypoglycaemia (low blood sugar), nutritional anaemia, iodine deficiency and hypothyroidism can be associated with PMT.

PHARMACIST

Ask your Pharmacist for advice.

  • Follow the Diet Hints.
  • If there is any pain ask your Pharmacist for the correct brand of painkiller for you.
  • Sometimes using a hot water bottle on the stomach will ease the pain.
  • Relax as much as possible. A massage to relax is sometimes beneficial. Consider using some aromatherapy oils such as geranium or lavender.
  • Develop a healthy lifestyle.
  • Avoid certain major activities or decisions the week before menstruation.
  • Keep the bowels regular. Your Pharmacist might suggest some special fibre supplements such as Metamucil or Nucolax.
  • Ask your Pharmacist for some anti-inflammatory tablets if the Pharmacist suggests they are necessary whenever there is pelvic pain with depression.
  • Exercise may decrease breast pain and fluid retention(7).
  • If the diet is inadequate consider the supplements suggested in this topic.

DIET HINTS

See the Premenstrual Syndrome Diet topic on the Healthpoint.

  • Avoid sugar and caffeine.
  • Reduce intake of salt, dairy products, margarine and meat.
  • Magnesium containing foods such as green vegetables nuts and seeds are recommended(8).
  • Try to consume easily digested foods.
  • Have everything as fresh as possible.
  • Have smaller meals more often. This will lower the desire to eat to excess.
  • Chromium rich foods are generally suggested. Chromium can help reduce sugar cravings and help to regulate blood sugar levels. These include oysters, mushrooms, raisins, asparagus, prunes and nuts.
  • Have plenty of fluid during the day. Filtered water is the best.

VITAMINS/MINERALS/HERBS

  • Vitamin E may be of benefit for tender breasts.
  • Evening Primrose Oil is anti-inflammatory and may be useful in reducing the painful symptoms.
  • Vitamin B complex may help with energy levels, sugar cravings and stress levels.
  • Magnesium may help relieve period pain. If periods are heavy, then an iron supplement is necessary.
  • Vitamin D helps regulate oestrogen action(9).
  • Vitex agnus-castus may reduce symptoms of PMS by restoring the balance of oestrogen during the second half of the menstrual cycle(10).
  • Dong quai is considered a uterine tonic(11).