(Updated at Mar 22 / 2023)
Premenstrual syndrome causes, non-drug and drug treatment
Premenstrual syndrome abbreviated PMS, is a set of specific psychological, emotional, somatic (physical), and metabolic symptoms that occurs in a woman before the onset of menstruation (period).
Key points about premenstrual syndrome
When does PMS start?
PMS commonly occurs during the luteal phase from 14 to 28 days of the menstrual cycle (i.e. 14 or 28 days after the first day of the previous period not counting spotting). Usually, it coincides with 2-14 days before the next menstruation. The duration and time of onset of premenstrual syndrome are different for every woman.
What is premenstrual syndrome?
Premenstrual syndrome is always a challenge for a woman as it interferes with normal activities and wellbeing to a different extent. Changes in well-being and behavior can be quite uncomfortable.
The symptoms of PMS include:
- Mood swings;
- Cramps, seizures;
- Weight gain;
- Increased anxiety;
- Apathy, melancholy, and even PMS depression;
- Sleep disorders (trouble falling asleep, night awakenings);
- Increased skin oiliness;
- Constipation and/or diarrhea;
- Soreness and engorgement of the mammary glands;
- Increased appetite.
Premenstrual syndrome can be:
- Mild – 2-4 symptoms occur 2-10 days before the onset of regular bleeding;
- Severe – 5-12 symptoms occur 3-14 days before the onset of regular bleeding.
The peculiarity of premenstrual syndrome is that there is no cure for it. The condition can be improved but the therapy should be selected individually for every woman by a gynecologist taking into account the individual features of a particular woman such as hormone levels, number of symptoms and their severity, age, history of other diseases, chronic diseases, and so on.
Therapeutic methods can include lifestyle changes, changes of eating habits, control and regulation of hormone levels, as well as use of medications chosen by a doctor based on the underlying conditions and symptoms.
But what is the best way to cope with PMS? Take medicines, change lifestyle, or follow a certain diet? We have talked to specialists and chosen for you several methods that can relieve PMS.
Premenstrual syndrome causes
The luteal phase is distinguished by the enhanced release of progesterone and a drop of estrogen levels, which causes some of the symptoms of premenstrual syndrome.
The main causes of PMS:
- Hormonal imbalance;
- Chronic or acute stress;
- Genetic disorders.
As you can see, the causes can be different. This is why to treat PMS effectively, it is important to identify the main cause standing behind PMS and treat it. Besides, it is necessary to eliminate the causes that led to the disorders. And the first thing that is recommended to do is to revise your diet, since the use of certain foods can increase negative symptoms before menstruation.
Diet to ease PMS
The main advantage of this method is that you don’t need to undergo multiple tests and take medicines. All you have to do is exclude and add some products to your daily diet for several days before your usual onset of PMS symptoms and during it.
Foods that worsen PMS symptoms:
- Fatty and fried meals. Exclude them for the period of PMS or at least minimize their consumption.
- Alcohol and soda drinks worsen painful sensations during PMS.
- Sweets and pastries increase blood insulin and glucose in the blood which promotes irritability and mood swings.
Foods that ease PMS symptoms:
There is a whole range of products that positively influence a woman’s body during the luteal phase and reduce PMS symptoms. These foods can be divided into several groups:
1. The first group includes products of plant origin with a high content of vitamin B6, which reduce vascular disorders and relieve headaches:
- whole grains;
2. The second group consists of foods rich in vitamin D and calcium, which are found in dairy products and can reduce pain in PMS:
- cottage cheese;
- fermented baked milk.
Mood swings, tearfulness, and melancholy are often the cause of eating disorders, leading to excessive consumption of sweets. This is due to a decrease in the level of the hormone of joy - serotonin. However, fast carbohydrates from baked goods can even worsen mood with added irritability, cause metabolic disturbances and weight gain.
Serotonin can be replenished with products containing the essential amino acid tryptophan, which is involved in the production of the hormone of joy. It can be obtained from:
- Dark chocolate;
- Dried dates;
-Fish of the salmon family (redfish);
- Boiled eggs.
As for the dietary supplements, primrose oil can also help relieve PMS. It has an anti-inflammatory effect, reduces breast and abdominal soreness, neutralizes bloating, relieves swelling, and normalizes mood.
In addition, some gynecologists recommend taking magnesium tablets for PMS, since during menstruation, the amount of this substance in the blood sharply decreases. Magnesium can affect hormones, and its deficiency can lead to painful periods.
Physical activity as a relaxation method
Exercise can help reduce discomfort before and during your period. In no case should they include heavy physical activity, since the main goal is to relax the body, relieve tension, saturate the blood with oxygen and activate metabolic processes. The most suitable physical activity during premenstrual syndrome is:
- Yoga and stretching;
- Breathing exercises;
- Low-intensity aerobic exercises.
It is necessary to go in for sports, but exclusively in a sparing mode, avoiding hard and exhausting physical loads.
Psychological stabilization: how sleep, rest and calmness affect PMS
Women, whose lifestyle implies adequate rest and sufficient sleep, almost never suffer from premenstrual syndrome symptoms or have very mild symptoms.
Your working day should have multiple short breaks during which you stand up from your table and do a little stretching or walking. It is also necessary to avoid stressful influences and not to enter into conflict situations, since emotional overstrain causes an increase in the spastic activity of the muscles, which increases soreness in the lower abdomen in PMS.
You should sleep at least 8 hours and go to bed early so that you have time to fall asleep before 11:00 PM (23:00). It may seem oddly specific and early for you. But this time is perfect because the maximum volume of the sleep hormone melatonin, ensuring well and refreshing sleep, is produced by the body between 9 PM and 11 PM. After 2 AM, the volume of melatonin starts to lower. Therefore, falling asleep after 11 PM disrupts the functioning of neuroendocrine regulation, reduces the production of melatonin and serotonin, which increases the symptoms of premenstrual syndrome.
Medicines for PMS
To relieve severe premenstrual syndrome, medication may be selected as directed by a gynecologist.
All pills for premenstrual syndrome can be divided into:
1. Pain relievers. NSAIDs (non-steroidal anti-inflammatory drugs), analgesics, antispasmodics.
2. Antidepressants. They are prescribed exclusively by a doctor and only for PMDD (premenstrual dysphoric disorder or premenstrual depression) with hormonal dysregulation and a decrease in serotonin production, which is characteristic of a depressive disorder.
3. Diuretics. They are used for increased swelling if there is a need for to remove excess fluid from the body.
4. Hormonal contraceptives. Hormonal contraception suppresses ovulation and regulates hormones that cause premenstrual symptoms. It can be prescribed by a doctor as a contraceptive method or a method for correcting hormonal levels.
How to deal with PMS, in each specific case, can only be suggested by a gynecologist. The doctor takes into account the individual characteristics of the body and hormonal system, as well as socio-psychological factors. The drugs that can be possibly used for this disorder include Duphaston, Alesse, and others. Please consult your gynecologist if you already use oral birth control and they do not help with PMS. Your doctor can change your medication and chose the optimal drug that will suit your body.
Is it premenstrual syndrome or pregnancy?
Some of the signs of premenstrual syndrome are very similar to the first signs of pregnancy. Therefore, many women confuse these periods and begin to worry in vain. Of course, they have a common nature of occurrence - hormonal changes during pregnancy and in PMS are very similar. But if a symptom lasts longer, for example, engorgement of the mammary glands lasts more than two weeks, then this is probably not PMS, and you need to see a doctor for diagnosis.
The main difference between PMS and pregnancy is the onset of menstruation accompanied by the disappearance of PMS symptoms. However, if the symptoms do not disappear with the onset of menstruation, and the menstrual flow differs from the usual menstruation (scanty or more abundant than usual, resembling bleeding), then this may signal the onset of pregnancy.
Scant bloody discharge is characteristic of the implantation of the ovum (the first days of pregnancy), and profuse bleeding may indicate a miscarriage that has begun.
Common signs of pregnancy and PMS
- Mood swings. During premenstrual syndrome, as in the first trimester of pregnancy, quick mood changes are quite common – it can swing from tearfulness and anger to joy and euphoria in a couple of minutes.
- Breast engorgement and soreness. Before the onset of the menstrual period, many women experience breast pain, swelling, and tenderness. But, if pregnancy has not come, with the first day of menstruation, these sensations disappear.
The simplest advice on how to distinguish pregnancy from PMS is to wait for your period or take a pregnancy test in case of delay.
What not to do with PMS
There are things that are highly undesirable to do during premenstrual syndrome because they increase the symptoms.
Specific actions to refrain from:
- Going to a sauna and taking a hot bath;
- Engaging in enhanced physical activity;
- Following an unhealthy diet with a predominance of spicy, baked, sweet, fried, and salty foods;
- Drinking a lot of coffee and strong tea, alcohol, and soda drinks.
You can work on easing your premenstrual syndrome symptoms following our advice on lifestyle changes, diet, sleep and rest schedule, and moderate physical activity. These recommendations are suitable for all women without serious pathologies that require urgent treatment or certain limitations of activity.
Besides, these tips can help you generally become healthier and avoid gaining weight during premenstrual syndrome cravings and period.
The listed medications are provided for information only. You should not use them without consulting your doctor first. But if your doctor prescribes the drugs we mentioned or other drugs for premenstrual syndrome, you can find them at our online drugstore and buy at an affordable price without a prescription.
Post by Karen Willson, gynecologist at Mother and Baby Centre, London, UK
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