Premenstrual syndrome, also known as the notorious PMS, is a recurrent, yet variable cluster of uncomfortable physical and emotional symptoms that occur 1-2 weeks prior to the onset of the menstrual period. Fortunately, many symptoms of PMS typically subside when menstrual bleeding begins. There are many potential symptoms and the symptoms of the premenstrual syndrome experienced by one woman may be completely different than the symptoms experienced by another. PMS is most common in women between the ages of 25 and 40 years of age. It can range in severity from mild, annoying symptoms to severe, life-altering symptoms in up to 10% of women.
Common symptoms include:
breast pain
ankle or hand swelling
backache
abdominal pain/cramps
bloating
headaches
skin problems
irritability
muscle spasms
acne flares
aggression
depression
concentration difficulties
forgetfulness
poor judgment
anxiety
hostility
paranoia
low self-esteem
fatigue
food cravings
weight gain
a change in libido
nausea
constipation or diarrhea
While it is not entirely clear what causes PMS, certain medications and lifestyle modifications can dramatically decrease the frequency and severity of symptoms.
Several studies have demonstrated that regular exercise has been demonstrated to be of benefit in decreasing depression, anxiety, and fluid retention when a woman is premenstrual.
Serotonin reuptake inhibitors (SSRIs), such as Prozac (yes, Prozac), have been shown to be very effective in treating PMS, and have relatively few side effects. The benefit seen with SSRIs does not mean that those who benefit from these drugs are clinically depression or have an anxiety disorder. The chemical imbalance seen with these conditions is similar to the one seen with PMS, so dont be deterred by any perceived stigma of taking this medication. It can be life-changing if you have severe PMS.
Oral contraceptives help some with PMS, but make others worse.
Treatment with a medication called Danazol on cycle days 14-28 can decrease breast pain encountered with PMS.
Spironolactone, a diuretic (fluid pill) can not only reduce bloating, it can also diminish breast tenderness.
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and naproxen, have been shown to be effective in minimizing some PMS symptoms.
Eating a healthy diet with plenty of whole grains, fruits and veggies, and decreasing your intake of salt, sugar, alcohol, and caffeine may help.
Nutritional supplements, such Vitamin B6, magnesium, and calcium may be of benefit.
While there is no physical exam finding or diagnostic test that can diagnose PMS, you can help your doctor diagnose you by keeping a diary of your symptoms for at least 3 months. This will help correlate your symptoms with your menstrual cycle and expedite your diagnosis.
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