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The truth about PMS

Do any of these symptoms sound familiar? Headaches, depression, anxiety, uncontrollable crying episodes, fatigue, fluid retention, abdominal cramps, palpitations, weight gain, irritability, panic attacks, forgetfulness, migraines, back pain, decreased work or social performance, sleep problems, food cravings, breast tenderness, clumsiness, confusion. . . Sounds like a nightmarish existence, doesn’t it?

Are you one of the 40-80% of women for whom this scenario, or at least a part of it, is everyday life for one to two weeks out of every month of their lives from puberty to menopause? What disorder could result in these varied and often disabling symptoms for so many women?

Premenstrual syndrome! That’s how it is! It’s that old friend, PMS, the subject of so many jokes and criticisms. You know, that “mixed bag” phrase that “so-called comedians” say covers all the “imaginary” problems women “invent” as excuses to spend the day on the couch “watching TV and eating sweets.”

Let me assure you that while it is true that doctors and researchers have not found a specific laboratory test that can identify PMS, this disorder is definitely not “imaginary” or “made up.” Serious medical research has been done for years to identify the definitions, diagnosis, causes, and cures for this disorder. Here are two of the resulting definitions:

1. Dr. Ellen Freeman of the University of Pennsylvania Health System describes PMS as a “cluster of emotional, behavioral, and physical symptoms that have a cyclical pattern related to the menstrual cycle, that become severe in the week or two before menses and subside with menses.”

2. The American College of Obstetricians and Gynecologists defines PMS as “the cyclical occurrence of symptoms that are severe enough to interfere with some aspect of life and that occur in a consistent and predictable relationship with menstruation.”

How do you know if you or a loved one has PMS if there is no real test to detect it? In general, researchers and physicians agree that the general identifying factor for this disorder is the fact that the symptoms disappear once menstruation begins or once the woman becomes pregnant.

You should know that doctors have identified two serious forms of PMS that have effects far beyond the normal symptoms of PMS:

1. “Postpartum blues” is a severe depression that some women experience after giving birth. Women with this disorder experience a severe comedown due to the high levels of hormones during pregnancy, and because of the disruption to their nervous systems, they may actually harm themselves or their babies.

2. “Premenstrual dysphoric disorder” (PMDD) causes severe and disabling depression, anxiety, tension and irritability, intense mood swings in the week or two before the onset of menstruation, and women with this disorder also have at least five of the physical symptoms of PMS. Like normal PMS, PMDD symptoms go away with menstruation.

You may have heard that doctors find it helpful for women to keep a symptom diary for the entire month when trying to diagnose PMS. What should you look for when journaling or considering the possibility that you or a loved one has PMS? Well, PMS carries over 150 possible symptoms that affect women both physically and emotionally to varying degrees.

Physically, symptoms can range from mild, such as headache, fatigue, and mild abdominal swelling, to severe, such as migraines, severe cramps, and the inability to function normally. Emotionally, you may experience symptoms related to anxiety (irritability, irrational crying, or emotional swings), depression (withdrawn, fearful, or altered libido), cravings (for sweets, dairy, or alcohol), and fluid retention (headache, breast tenderness, bloating, and weight gain).

I can tell you that while doctors have yet to determine the exact cause of PMS, they agree that hormones and neurochemical changes within the brain are prime suspects. Estrogen hormones, for example, can contribute to increased brain activity, salt retention, and a drop in blood sugar, because it has a central neurological effect on the brain.

What do you do if you realize that you or a loved one is suffering from some level of PMS? Obviously, if the symptoms are severe, you should seek the advice of your doctor. Currently, doctors may prescribe psychiatric treatments (psychotropic drugs, tricyclics, tranquilizers, or selective serotonin reuptake inhibitors), medical treatments (anti-estrogenic hormone drugs), or a combination of both for severe cases.

However, if you think your symptoms are manageable or come and go, here are some tips that may help you alleviate some symptoms.

– Eat six small meals, high in complex carbohydrates, low in simple sugars in three hour intervals to help keep energy levels and blood glucose levels stable. Complex carbohydrates are found in foods that are eaten in their natural state, such as oatmeal, cornmeal, barley, and wheat germ, or in foods such as pasta, brown rice, root vegetables such as potatoes, whole grain breads and cereals, etc.

– Reduce caffeine, alcohol, salt, fats and simple sugars to help reduce fatigue, tension, depression and swelling from fluid retention.

– Add calcium, controlled levels of B6, B complex, magnesium and vitamin E to help maintain a normal mood and reduce fluid retention, cramps and back pain.

– Exercise three times a week for at least 20-30 minutes to improve mood, blood circulation, sense of well-being, and relieve tension and stress buildup.

– Learn to relax with deep breathing exercises, music, quiet time alone, or yoga to lessen symptoms and help you cope. Also, spend time with a supportive friend, get a solid 8 hours of sleep regularly, and track your menstrual cycle on your calendar to prepare for the onslaught of symptoms and help yourself cope.

– Adjust your schedule according to the menstrual cycle to avoid difficult decisions, stressful appointments or events, or even arguments during PMS to help both your PMS time and your relationships.

– Investigate the use of herbs. A lot of research is being done in the field of herbal remedies for PMS. Evening primrose oil, chaste tree berry, dong qui, and other herbs may have an effect on PMS symptoms according to personal testimonials from women who have tried them.

For best results, I recommend a combination of all of these areas. A lifestyle that includes a balanced diet, adequate amounts of necessary vitamins and minerals, plenty of healthy exercise, adequate rest and relaxation, good mental attitudes, and appropriate herbs gives you the best defense against PMS symptoms. However, if all else fails, by all means add a couple of sweets. Women for centuries have insisted that chocolate is a miracle cure-all!

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