Many women—and sometimes their families—deal with the effects of premenstrual syndrome (PMS) at some point in their lifetime. Like many women, I typically chalk up occasional PMS symptoms as one of the more unfortunate aspects of being female, take an ibuprofen, and move along. However, PMS symptoms can range from mild to severe, and in a small number of cases, an extreme form of PMS may be diagnosed, which is known as premenstrual dysphoric disorder (PMDD).
Symptoms of PMS and PMDD may be particularly pronounced for teen girls and women in their thirties. Understanding what causes PMS and PMDD is key in preventing and alleviating symptoms that can range from mildly disruptive to downright debilitating.
Defining PMS
Premenstrual syndrome is actually the name of a group of physical and emotional symptoms that begin up to 14 days before menstruation, and generally subside soon after the onset of menses. PMS was first identified in medical literature in 1931 and was described as “a state of unbearable tension,” a description many women can identify with to some extent. An estimated 75 percent of women will experience some form of PMS during their lifetime, and symptoms are most common during adolescence and during a woman’s thirties.
Symptoms may include:
- Acne
- Appetite changes or food cravings
- Back pain
- Bloating
- Breast tenderness
- Crying spells
- Depression
- Fatigue
- Headache
- Heart palpitations
- Hot flashes
- Insomnia
- Irritability
- Mood swings
- Tension or anxiety
While the list of potential symptoms is long, most women only experience a few of these problems. Symptoms may be intense during some cycles and mild during others. For some women, the symptoms may be severe enough to affect their daily activities. A very small percentage of women have PMS symptoms that are completely disabling, and this form of PMS has its own psychiatric diagnosis. Premenstrual dysphoric disorder (PMDD) is characterized by symptoms such as severe depression, anger, anxiety, feelings of hopelessness, and low self-esteem.
Causes and Treatment
The exact cause of PMS is something of a mystery, but it is linked to hormonal changes that occur during the menstrual cycle. Stress and environmental factors likely contribute to the severity of symptoms, and some symptoms have been linked to dietary intake and low levels of vitamins and minerals. The exact cause is difficult to pinpoint because a woman’s response to cyclical changes is extremely individual. Hormonal changes are perhaps the most significant contributor. Edmond pharmacist Lisa Huggins specializes in hormone management and sees many women with complaints of PMS symptoms. “So many women think these symptoms are a given, but they don’t have to be. If a hormone imbalance is the cause, supplementation will usually alleviate most PMS symptoms.”
Huggins goes on to explain that many PMS symptoms are indicative of either too little progesterone or too much estrogen, and the imbalance results in estrogen dominance. “The most common complaints, such as water retention, breast tenderness, mood swings, and headaches are classic signs of estrogen dominance. If this is the case, a little progesterone will go a long way.”
Huggins notes that stress and environmental factors also play a role. “Stress doesn’t cause PMS symptoms, but it can definitely exacerbate them, so it’s important to take time to regroup and get plenty of rest.”
Dietary factors can also affect symptoms. “I always remind patients to reduce their salt intake, especially during this part of their cycle, because that really helps with swelling and water retention. Also, supplements such as calcium, magnesium, B-6, and vitamin E have been shown to alleviate symptoms in many women.”
In certain cases, clinicians may prescribe antidepressants or diuretics for severe PMS or PMDD symptoms. Often, birth control pills are prescribed to regulate a woman’s cycle and help relieve symptoms. According to Huggins, “Many women have side effects to oral contraceptives that they find just as unpleasant as PMS, so it may be a good idea to try other solutions first. An over-the counter pain reliever or anti-inflammatory is also very effective when used correctly.”
Most importantly, Huggins recommends patients become familiar with their cycles. “If you find yourself getting headaches at around the same time every month, make a note of it and mention it next time you visit your doctor. There is so much we can do to help with symptoms of PMS and PMDD, no one really should have to suffer thorough it anymore.”
Shannon Fields is a freelance writer and a Certified Pharmacy Technician at Innovative Pharmacy Solutions.
