Most women have some symptoms, whether physical or emotional, related to their periods. Symptoms are present during the five days before a woman gets her period and then disappear within a day or two of the period starting.
For a woman to have premenstrual syndrome (PMS), the symptoms must be severe enough to interfere with her social or work life. Severe cases of PMS are diagnosed as premenstrual dysphoric disorder (PMDD). Symptoms of PMS and PMDD include those for depression as well as breast tenderness, headaches and joint and muscle pain.
Women who have a family or personal history of depression or postpartum depression are at higher risk for developing PMS or PMDD. PMDD affects five percent of menstruating women.
Keeping a calendar of when symptoms and menstruation occur will help a woman and her doctor decide if she has PMS or PMDD.
If symptoms of PMS are mild, simple changes in lifestyle can alleviate symptoms:
- Reduce caffeine intake
- Limit salt and sugar during the second half of your cycle
- Eat several small meals daily and do not skip meals
- Eat complex carbohydrates (example: grains, fruits, vegetables)
- Eat low-protein, low-fat meals
- Avoid bingeing
- Consume adequate calcium. It is recommended that adult women get 1,200 mg of calcium daily, the equivalent of three glasses of milk, which is found in dairy products, fortified orange juice and breakfast cereals, some deep-green leafy vegetables, fish with edible bones, such as canned salmon, and vitamin supplements.
- Increase in aerobic exercise (example: dancing, jogging)
- Over-the-counter pain medicines (example: aspirin)
- Nutritional supplements. Several scientific studies are looking at evening primrose oil and vitamin B6 (pyridoxine). Some women get relief from these things. If you try the vitamin B6, you must be careful because it can be toxic in high doses. Be sure to consult your physician before taking any nutritional supplements.
For more severe symptoms of PMS or PMDD, you may want to talk to your doctor about whether any of the following prescription medications may be right for you:
- Estrogen-containing birth control pills regulate menstrual cycles and often alleviate severity of PMS symptoms.
- Antidepressants such as Celexa, Prozac, Zoloft, and Paxil make many women with more severe PMS feel better. Some women take these medications during the second half of their cycle and others need to take it every day of the month. Your doctor will help you decide the course of therapy best for you.
- Hormone therapy. In the most severe cases, in which a woman is incapacitated by depressions around her periods, it may be necessary to stop her cycle completely with hormones.
Michael Herkov, Ph.D., and Wayne Goodman, M.D. contributed to this article.