Most women become unstable during the days before periods. One minute they feel fine, quite happy and the next minute they become easily annoyed, irritated, and short-tempered. Women usually feel awkward to discuss their periods or PMS issues clearly, which makes it harder for the experts to find a solution. Hence, PMS remains a medical mystery even today.

According to studies, about 90% of women of reproductive age get PMS and more than 300 different PMS changes were reported1. PMS is common, but it does not mean you need to suffer from it.

Let us have a basic conversation about PMS and its coping strategies.

PMS (Premenstrual syndrome)

PMS is a cluster of physical or psychological symptoms experienced by a woman one to two weeks before the period. These symptoms subside once the period begins.

The exact reason behind PMS is unknown, but researchers believe that hormonal imbalance during a woman’s monthly cycle plays an important role. Additionally, genes and environmental factors contribute to PMS.

The roller coaster of hormones during PMS

Normally, estrogen levels rise during the first half of the menstrual cycle and drop-down during the second half. This drop-down in estrogen levels may result in reduced serotonin levels. Serotonin is a brain chemical that helps in the regulation of mood, appetite, and sleep. This reduced serotonin levels may contribute to PMS.

Progesterone is known to have a calming effect on the body. It helps in relieving symptoms associated with monthly changes. But, in women with PMS, progesterone does not show this calming effect and worsens the symptoms.

Symptoms

PMS symptoms are not the same for everyone. Some women may have mild symptoms and can cope easily. Whereas some women are unable to manage their everyday lives during this time.

The following are the potential symptoms associated with PMS.

Emotional and behavioral symptoms:

  • Anxiety or tension
  • Insecurity
  • Mood swings
  • Depression
  • Change in appetite
  • Sleeplessness
  • Poor concentration
  • Crying spells

Physical signs and symptoms:

  • Back pain
  • Joint or muscle pain
  • Headache
  • Abdominal bloating
  • Acne
  • Diarrhoea or constipation

Coping strategies for PMS:

Most women can manage PMS by following these few measures:

Have a balanced diet: Having a diet with lots of fresh fruits, vegetables, and whole grains throughout the month helps you get adequate nutrients. Thus, it provides enough energy and prevents fatigue.

Cut down junk: Craving for junk foods, especially foods that are rich in salts, sugars, caffeine, and fats comes with PMS. Try to resist them. However, it does not mean to completely cut them out, but try to balance them with healthy foods. This maintains your appetite and prevents the drop-down of blood sugar levels, which is one of the common reasons for irritability and mood swings during PMS.

Stay physically active: Walking, running, swimming, or aerobic exercises are all good ways to stay physically active and healthy. Staying physically active enhance your mood and boosts brain chemicals that help to reduce the pain felt during PMS. Additionally, any form of exercise for at least 30 minutes a day improves blood flow and helps manage stomach cramps.

Get enough sleep: Staying awake for too long will affect your mood, especially if you are a week away from your periods. This is mostly due to hormone imbalance which provokes difficulty in falling asleep during night. According to studies, women with PMS are twice likely to develop insomnia. Sleeplessness during the night results in excessive daytime sleepiness and makes you tired or drowsy around the periods. Maintaining a regular sleep pattern, avoiding caffeine, limiting daytime naps, avoiding heavy meals during nights, and performing relaxing activities, such as reading or meditating may help you achieve you sleep better.

Stay hydrated: Women with PMS likely experience water retention due to imbalance in hormones, which results in bloating and several other digestive issues. You can always avoid these symptoms by drinking sufficient amount of water and staying hydrated. Also, you can flavor water with lime, ginger, mint leaves, or coriander. If you are experiencing water retention every month then consult a doctor.

In some cases, when the above strategies are not working, you need to visit a doctor. Based on the symptoms and its severity the doctor may prescribe you the following medications:

  • Diuretics- These medications are prescribed to eliminate excess fluid from the body to prevent or treat bloating.
  • Antidepressants- These medicines inhibit the action of pain-producing chemicals, thus helps in managing depression and mood swings.
  • Birth control pills- These medications prevent hormone imbalance related to ovulation and help in managing PMS.
  • Painkillers- These medications inhibit the production of a certain chemical that contributes to pain.

Women usually feel PMS to be nothing and do not worry about it. In most of the cases, it is true. But, if something is going out of your control and the physical, emotional, and psychological symptoms of PMS are impacting your day-to-day life, consult a doctor. Track your symptoms, its frequency, and severity to get the best treatment. Also, if you are experiencing deep emotional pain, talk about it with your family, friends, or any trusted individual.

References:
  1. Premenstrual syndrome. https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome. Accessed on 2nd October, 2020.
  2. Read JR, Perz J, Ussher JM. Ways of coping with premenstrual change: development and validation of a premenstrual coping measure. BMC Womens Health. 2014;14:1.
  3. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Premenstrual syndrome: Overview. [Updated 2017 Jun 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279265/
  4. Premenstrual syndrome. https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome. Accessed on 2nd October, 2020.

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