About 75% Of Women Experience PMS Every Month. Is There a Way To Make It Stop?
We had conversations with women's health experts on this topic to figure out the best way around PMS.
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Sudden mood swings, inexplicable abdominal pain or headaches, crying for no apparent reason, or swollen breasts and limbs that make it hard to move. More than three-quarters of women suffer from premenstrual syndrome (PMS) in one way or another.
It only lasts a few days, but it can throw the work schedule off completely, disrupt plans for a quiet evening and cause mental and physical exhaustion. We found out what causes PMS and whether there's anything that could prevent the reduction of productivity at work and spoiling the mood for the entire day.
We're taking a closer look at reproductive health topics and discussing them in-depth with experts. We also ask sensitive questions to better understand how to take care of our health.
In this article, we're also talking about specific prescription drugs. Take them only after consultation with your doctor.
Why are you like that, are you on your period?
On the one hand, PMS complicates women's lives and, in borderline cases, makes them miserable. On the other hand, different behavior in women, not caused by hormonal changes in the body, is often referred to as manifestations of PMS. This can be easily distinguished, though.
A woman has PMS only during the postovulatory (luteal) phase of the cycle, usually 2-3 days before the start of menstruation. Manifestations of PMS do not include heavy menstrual bleeding or severe cramps and pain.
Thus, if a woman is at a particular stage towards the end of the cycle, she may experience typical PMS symptoms. Many of them are psychological - with the sudden hormonal changes in the body, the mood changes, sadness may appear, a woman can be more vulnerable, even more aggressive at times.
She may have trouble concentrating, get confused, or experience other difficulties that affect her normal functioning. She feels exhausted, and she may have lower self-esteem. Physical manifestations include bloating or swollen breasts, which may become very sensitive to touch, abdominal or back pain, headaches, palpitations, skin problems (usually acne), digestive and sleep problems. PMS is generally accompanied by changes in appetite, whereas most women get a sweet tooth.
This is not a fabrication that women use to get out of work or are sad, as this, this or this study confirms. And it is very difficult to control PMS if a woman doesn't want to artificially interfere with the cycle using hormonal contraception (which replaces natural hormonal changes). After menstruation, all manifestations of PMS disappear and reappear in the next cycle. And it goes like this for decades.
According to gynecologist Denisa Marcisova, premenstrual syndrome is somewhat normal. "Caused by the menstrual cycle itself, it is a normal physiological response to a cycle at a specific stage." According to various sources, approximately 75-90% of women experience it.
However, there's also PMDS (premenstrual dysphoric syndrome or even premenstrual dysphoric disorder, PMDD), which doctors already consider a disease that should be diagnosed and treated. It is a rare form that needs to be analyzed separately.
When PMS gets out of hand
Most women can handle PMS easily. They just have to find their own way around it. Like enjoying their favorite physical activity, indulging in chocolate, fine-tuning their diet, or reaching for their favorite erotic toy. All of the above can improve their mood and calm them down.
However, PMDS already needs to be handled by the doctors. If a woman is unsure which syndrome she has, she must monitor herself for several months before going to the doctor. Specific symptoms must persist for a long time, and the doctor needs to keep track of their appearance and behavior.
"Differential diagnosis is very important - we need to distinguish whether it is PMDS or classic depression, which would require psychiatric treatment. I also had patients who described their syndromes to me, convinced that it was PMDS, but it turned out to be depression. We must also rule out thyroid disorders that strongly affect the psyche, " says the gynecologist.
Associated mental disorders can also get worse shortly before menstruation.
- mood swings
- reduced interest in daily activities
- concentration problems
- changes in appetite, strong appetite for sweets
- sleep problems
- the feeling that the woman is losing control of the situation
- swelling of the breasts
At least 5 of the above must be present in order to be diagnosed with PMDS, with at least one of the first four (highlighted in bold), the gynecologist explained. These symptoms would have to appear about a week before menstruation. Women shouldn't experience them outside of that timeframe.
"I've had patients who couldn't go to work, nor even get out of bed," the doctor recalls of the PMDS cases she was treating. "This syndrome is already affecting a woman's quality of life. It's not just about feeling sadder or more sensitive." If you don't think it's that serious, and you've found a way to deal with PMS, you don't need to report it to the doctor. It's considered completely normal during the menstrual cycle and can evolve and change over time, like the cycle itself.
PMDS is also treated with various prescription drugs, she continues. "The first group is hormonal contraception containing drospirenone. We have enough research about this, proving that it is effective in PMDS. If a woman doesn't want or cannot use hormonal contraception, antidepressants are prescribed. The effect of active substances escitalopram or sertraline has been confirmed by studies."
While contraception should be used continuously by a woman if she wants to treat premenstrual dysphoric syndrome, the antidepressants are sufficient to be used one or two weeks a month.
"Classic antidepressants have an onset of action within two weeks in the treatment of depression. But research has shown that in PMDS, the first effects appear after 24 hours. I've also observed this on my patients, " says Dr. Marcisova.
The third group of medicines that helps with PMDS contains the active substance spironolactone, a diuretic (increases urine production). It is also a drug that only needs to be taken when the patient is feeling ill.
Can we „turn off“ PMS?
Zuzana Kopacikova, who focuses on the women's cycle and helps women with fertility problems, says that PMS doesn't have to be part of the cycle at all. Although it's common, she does not consider premenstrual syndrome normal. "Change is part of the cycle and also the fact that a woman feels slightly different - like having mild lower abdominal pain or getting tired. But this is not PMS. PMS is a disorder, something that should not happen. It can be alleviated by adjusting the diet and lifestyle," she says. In some cases, a lifestyle change will lead to the disappearance of symptoms.
According to her, adjusting to the cycle and awareness of hormonal changes is essential for a woman. "We shouldn't try to turn it off, but learn how to work with it."
According to her, strong symptoms that prevent women from functioning should be addressed with a doctor. But most women do not have PMDS (according to Harvard Health Publishing, only 5 - 8% of women experience PMDS), and in these cases, Kopacikova advises aligning lifestyle with cycle.
Although the manifestations of PMS do not disappear completely, the female cycle expert says that by adjusting the lifestyle in the right way (diet, exercise, sleep, and well-being), they will alleviate. The woman will be able to function without any major problems. "Certain types of foods are better or worse during certain stages of the cycle," she continues. According to her, the body is very sensitive to changes and the woman's body "calculates" her entire lifestyle during the cycle. "It won't be so annoying and devastating."
After helping her clients set up their diets, most reported that PMS manifestations had eased considerably over time. Her advice on proper diet is met by extended and general advice from other experts: a diet rich in healthy fats, complex sugars, quality protein, lots of vegetables and fruits combined with good sleep and regular exercise.
The effect of diet on premenstrual syndrome was examined, for example, in this study in Cambridge, where they followed hundreds of women aged 20-46. Or this one, which looked at the lifestyle of college students.
"Many women omit carbohydrates or fats, but they are part of a good diet. They need to find resources they enjoy. It helps to reduce or eliminate the consumption of red meat, highly processed foods, alcohol, or cow's milk," Kopacikova advises.
You may also come across many nutritional supplements, "women's teas," or various pills on the market to help with the symptoms of PMS. Kopacikova advises including magnesium, zinc, vitamin B6, and omega-3 fatty acids in your diet.
"Nutritional supplements have not undergone any clinical research, so we don't know if they help or what effect exactly they have," says the gynecologist. In addition, she points out that the active substances in herbs can be very powerful, and their dosage is hard to measure. But if they help someone, it shouldn't prevent them from taking them.
"However, as a doctor, I won't recommend them, because these are not substances that have undergone the EBM process, which is evidence-based medicine." Be careful when choosing them, and make sure to reevaluate your lifestyle before setting out on a miracle tea adventure.
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