PMS: Symptoms and Treatment

Premenstrual syndrome (PMS) is well-known for making women feel bloated and cranky, but the hormone fluctuations believed to cause it can also trigger nearly two dozen other symptoms.

More than 75 percent of women experience PMS at some point during their childbearing years, with symptoms peaking in their late 20s and early 30s, according to the Mayo Clinic. For most, PMS typically occurs five to 11 days before a new menstrual cycle begins.

The syndrome also occurs more often in women who have given birth to at least one child or have a history of major depression, according to the National Institutes of Health (NIH).

Symptoms

Most women who suffer from PMS don't experience all of its possible symptoms, which can be physical, emotional or behavioral and range from mild to severe. According to the American Academy of Family Physicians (AAFP), they include:

• Bloating, gas and/or constipation
• Weight gain
• Cravings for certain foods
• Feeling irritable, tense or anxious
• Back pain
• Acne
• Depression
• Mood swings and crying spells
• Headache and/or joint pain
• Fatigue
• Swollen, tender breasts
• Low libido
• Trouble concentrating or sleeping
• Swollen hands or feet
• Desire to be alone
• Hot flashes
• Lower tolerance for lights and noise

Diagnosis & Tests

Since PMS is such a common condition, many women who experience it rely on self-diagnosis. Even in a medical setting, however, no tests or physical findings can definitively diagnose the syndrome, according to the NIH.

Those who elect to see a doctor may undergo a physical examination, including a pelvic exam, and be expected to describe their symptoms in detail. Many doctors will recommend keeping a diary of symptoms that spans at least two menstrual cycles, noting the days PMS symptoms and periods begin and end.

Treatments & Medications

Certain over-the-counter and prescription drugs can help relieve specific symptoms of PMS, with varying success. According to the Mayo Clinic, these medications include:

• Diuretics: Also known as water pills, diuretics can alleviate bloat by helping the body shed excess water. These include spironolactone (known by the brand name Aldactone).
• Non-steroidal anti-inflammatory drugs (NSAIDs): Cramps, headaches and breast tenderness can be eased with these over-the-counter drugs, which include ibuprofen (commonly known as Advil or Motrin) and naproxen sodium (Aleve).
• Oral contraceptives: By stabilizing hormone fluctuations, birth control pills can prevent many PMS symptoms.
• Antidepressants: Severe PMS may be targeted with these drugs, which include serotonin reuptake inhibitors such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and others. Antidepressants can reduce fatigue, food cravings, sleep problems and mood swings associated with the syndrome.

The effectiveness of various dietary supplements in treating PMS is in dispute among major medical institutions. But a consensus favors taking about 1,000 mg of calcium each day in the form of chewable calcium carbonate to ease bloating, cramps or back pain. Regardless of its effect on PMS, calcium use lowers the risk of osteoporosis, according to the Mayo Clinic.

Coping Tips

Sometimes simple lifestyle changes can greatly impact the severity of PMS symptoms. According to the NIH and Mayo Clinic, some coping tips include:

• Avoiding excess salt, sugar, caffeine and alcohol
• Drinking plenty of fluids to reduce bloating
• Eating small, frequent meals
• Choosing calcium-rich foods
• Engaging in at least 30 minutes of aerobic activity each day
• Sleeping at least 8 hours nightly
• Practicing yoga or deep-breathing exercises to relieve stress