Premenstrual Syndrome

Premenstrual syndrome can be defined as the cyclic physical, behavioral, and emotional changes that typically begin the two weeks before you menstrual period and end dramatically within two days after your period begins. If your symptoms occur at any other time during the menstrual cycle, they cannot be ascribed to PMS. As many as 70% to 90% pf American women are affected by PMS, yet there is still little or no agreement as to its cause.

A new theory connects low levels of serotonin (a brain produced chemical) as the underlying cause of PMS. For a variety of reasons, some people do not produce enough serotonin.

Physical symptoms of PMS include breast tenderness, bloating, weight gain, headaches and fatigue. Common emotional symptoms include irritability, mood swings, crying, depression, sensitivity and hostility. Difficulty concentrating, loss of memory and difficulty making decisions are cognitive symptoms women describe. Typical behavioral symptoms include insomnia, withdrawal, abusive behavior and overeating.

To help determine whether your symptoms are those of PMS, a menstrual cycle log must be kept for a minimum of three months. This will give your physician a record of when your symptoms occur and how severe they are. When keeping your log, use code letter chart symptoms as they occur during your menstrual cycle. For example, Headache, Depression, Swelling, Cramps, Menses, Tension, etc. Also, chart whether mild, moderate, or severe.

Two hormonal alterations are seen in women with PMS: 1) A decrease in endorphins or “happy” hormones; and 2) and increase in catecholamines or “stress” hormones. Certain food substances (caffeine, nicotine, proteins) can trigger the production of stress hormones. It has been found when women eliminate these substances from their bodies the 7-10 days prior to menstruation; they will obtain relief from PMS symptoms almost 99% of the time.

BEHAVIORAL MODIFICATION PROGRAM

Dietary changes that may help prevent PMS symptoms

1. Eating more frequently, but smaller amounts, six small meals rather than three a day. Do not skip meals,
hunger will exacerbate PMS symptoms.
2. Monitoring your salt intake, a diet low in sodium will help alleviate selling and bloating. Avoid processed
meats, canned soups, and pickled items, which are usually preserved in salt.
3. Avoid refined sugars found in candy, soft drinks, baked goods, etc.
4. Limit dairy products to two servings per day since calcium inhibits magnesium (important to hormone
synthesis). Women still need 1,000 mg each day to prevent bone loss.
5. Eat foods consisting mostly of complex, unrefined, carbohydrates and fruit to help I-tryptophan enter the
brain (green leafy vegetables, whole grains, cereals, legumes).
6. Limit red meats and saturated fats. Use poultry and fish for protein source.
7. Avoid caffeine (coffee, tea, chocolate, sodas and certain medications), nicotine and alcohol, which interfere
with the normal sleep cycle.
8. Avoid artificial sweeteners because they block the absorption of I-tryptophan.
Vitamin and Mineral Supplementation

Vitamin and mineral supplements may help raise serotonin levels. Especially important are calcium, magnesium and vitamins B6 and E. Magnesium (250 mg orally each day) may help some women. Patients with PMS often crave chocolate, which contains a large amount of magnesium. Although, one serving of instant oatmeal has more magnesium than one ounce of chocolate – you never hear women saying they “crave” oatmeal.

Evening primrose oil, another natural supplement, may help some individuals; 500 mg. should be taken three time a day during the second half of the menstrual cycle (days 14-28). Improvements can take three to nine months.

One particular multi-vitamin/mineral combination, Optivite (generic equivalent Vita-PMS) is marketed for the treatment of PMS. It contains B6, magnesium, calcium, and a variety of other vitamins, minerals and digestive aids. If taken as directed (6 tablets per day during the second half of the menstrual cycle), it is effective in treating PMS.

Exercise

Regular exercise is very important and helps reduce symptoms in many ways. It increases our endorphins, the body’s natural painkiller, which in turn raises our serotonin levels. It is a stress reducer and therefore helps you sleep better. A daily exercise program such as a brisk walking, biking, rollerblading, aerobics, or yoga are all excellent ways to get the endorphins pumping.

PMS will not disappear overnight. Give the diet and lifestyle program four months to work. Since PMS does not lead to death or disability, physicians are primarily concerned with relieving its symptoms and making the patient more comfortable. In some cases, medications are prescribed, but any medications prescribed will have side effects on both the body and your wallet. We believe that women should try to alter their diet and lifestyle first. You may also wish to attend PMS support group, talk with a counselor, or call toll-free:

National PMS Hotline PMS Access Vita PMS
1-800-344-4PMS 1-800-222-4PMS 1-800-255-8025