Premenstrual syndrome: A topic of concern

Rubina Acharya (RN)
currently living at Thailand

Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. PMS is a very common concern. Symptoms usually stop once the period starts. It’s thought to be related to the changing hormone levels of the menstrual cycle.

Researchers believe that PMS occurs in the days following ovulation because, if you are not pregnant, your estrogen and progesterone levels start to fall drastically. After a woman’s menstruation begins, PMS symptoms disappear quickly as her hormone levels start to rise.

Some people experience just very mild or no PMS symptoms when they start their period. Others may find it difficult to perform daily tasks like going to work or school because their PMS symptoms are so intense. Premenstrual dysphoric disorder (PMDD) may be indicated by severe PMS symptoms. When we stop having periods, as after menopause, PMS fades gone. The symptoms of PMS after giving birth could change. As we enter our late 30s or early 40s and approach menopause, also known as perimenopause, our PMS symptoms could worsen.

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

• Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause. These hormones naturally fluctuate throughout your menstrual cycle. During the luteal phase, which follows ovulation, hormones reach a peak and then decline rapidly
• Chemical changes in the brain. The neurotransmitters Serotonin and norepinephrine is thought to play a crucial role in mood regulation, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems. For example, a drop in estrogen may prompt the release of norepinephrine, which leads to declining production of dopamnine, acetylcholine, and serotonin. These changes can trigger sleep problems and lead to a low or depressed mood.
• Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms

Symptoms of PMS may be slightly different for each women and can vary from month to

month. The most common symptoms of PMS include:

Emotional and behavioral symptoms:

PMS-related changes in mood, emotions, and behavior might include:

• anxiety, restlessness, or feeling on edge
• unusual anger and irritability
• changes in appetite, including increased food cravings,especially for sweets
• changes in sleep patterns, including fatigue and trouble sleeping
• a sad or low mood, which might involve tearfulness or sudden, uncontrollable crying
• rapid shifts in mood and emotional outbursts
• decreased sex drive
• difficulty concentrating or remembering information
• Social withdrawal

Physical signs and symptoms

• Back and muscle pain
• Cramping
• Headache
• Fatigue
• Weight gain related to fluid retention
• Abdominal bloating
• Breast tenderness
• Acne flare-ups
• Constipation or diarrhea
• Unusual sensitivity to light or sound
• Unusual clumsiness.

Easing the symptoms of PMS:

• Drink plenty of fluids to ease abdominal bloating. This includes herbal teas, like red raspberry leaf or chamomile, which may ease cramping.
• Eat a balanced diet that includes plenty of fruits, vegetables, and whole grains.
• Consider cutting back on sugar, salt, caffeine, and alcohol, especially if you’re particularly sensitive to their effects.
• Ask a healthcare professional about trying supplements like folic acid, vitamin B-6, calcium, and magnesium to help reduce cramps and mood symptoms.
• Try getting more vitamin D via naturalk light, food, or supplements.
• Aim to get 7 to 9 hours of sleep each night to help relieve fatigue and improve overall well-being.
• Try to get at least half an hour of physical activity each day, if you’re able. Exercise can not only help relieve bloating and cramping, but it can also help ease anxiety and depression symptoms.
• Set aside time each day for self-care, which might include exercise, relexation, time to yourself for hobbies, or time for social interaction.

Over-the-counter medications and treatments can also help reduce physical PMS symptoms. Options include:

• pain relievers, like ibuprofen, aspirin, or acetaminophen, for head and muscle aches or stomach cramping
• diuretics to help relieve bloating and sore or tender breasts
• heat wraps or heating pads on your abdomen to relieve cramps

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