PMS: All You Need to Know

What is PMS (Premenstrual Syndrome)?

What is PMS? PMS is a cluster of symptoms linked to a woman's menstruation. Symptoms start appearing 10 to 15 days before menstruation. They are related to physical, mental, and behaviour. PMS symptoms usually disappear when the period starts or after one or two days. 

PMS can affect menstruating women of any age, and each woman gets affected differently.

Although PMS is a prevalent health condition, its intensity will differ in different women; for some, PMS is just a monthly difficulty. For others, it may be a severe psycho-somatic issue that makes it hard to even get through the day and can also be challenging. 

Causes of PMS

Even though it is a common issue, doctors have not identified the exact causes of PMS. 

The following are the causes of PMS:

• Variation in the levels of oestrogen and progesterone hormones at the middle period of the menstrual cycle.
• Lack of serotonin (a chemical that helps transmit brain signals) synthesis.
• Lack of endorphins (chemicals produced by the body which help in relieving pain and elevating mood) 
• Depression is also said to be the cause of PMS, though depression alone does not cause all the symptoms.

Hormonal Fluctuations

According to many experts, PMS is caused by changing levels of the hormones oestrogen and progesterone. These hormones fluctuate throughout the menstrual cycle. During the luteal phase (a phase in the second half of the menstrual cycle, which happens after ovulation), hormones reach a peak level and then decline rapidly. This leads to anxiety, irritability, and other mood changes.

Other Potential Triggers

• Smoking
• Mental stress
• Existing mental health conditions like anxiety and depression
• Lack of sleep
• Lack of exercise
• Alcohol
• Excessive intake of fat, salt, sugar, red meat, etc.

Common Symptoms of PMS

Symptoms differ in everyone. But most of them get a few of the following symptoms:

• Irritability or mood swings
• Muscle cramps and backache
• Headache
• Depression
• Breast swelling and tenderness
• Digestive issues, including constipation, diarrhoea, bloating, and gas
• Appetite changes and food cravings
• Too much or too little sleep (insomnia)
• Memory or concentration issue
• Sleep issues like insomnia or difficulty sleeping
• Lack of sex drive
• Flaring up of acne

How is PMS Diagnosed?

There are no specific diagnostic tests that can detect PMS. Any kind of laboratory test or medical imaging technique (MRI, CT scan, USG, X-ray, etc.) can confirm PMS. Even a set of specific symptoms cannot authenticate the presence of PMS. 

If specific symptoms appear regularly before menstruation, it will help doctors to affirm the diagnosis. 

Therefore, to make an accurate diagnosis, the following factors are necessary: 

• Personal and family history of PMS
• Mood and mental health conditions
• Keeping a record of symptoms experienced before menstruation 

A few health conditions mimic the symptoms of PMS. Chronic fatigue syndrome, thyroid disorders, and mood disorders like anxiety and depression can have similar sets of symptoms, which can imitate PMS. Your doctor will suggest specific diagnostic tests to rule out other health conditions in such cases.

Treatment and Management Options

For PMS disorder treatment​, healthcare experts prescribe certain medications like antidepressants, NSAIDs (non-steroidal anti-inflammatory drugs), Diuretics, and Hormonal contraceptives to treat PMS. But for many women, just lifestyle changes can help relieve symptoms of PMS. Requirements of medicines may flare up only in severe conditions which do not respond to lifestyle changes.

Before exploring lifestyle changes, we shall look at other options to eliminate PMS. 

Counselling therapy can help maintain emotional well-being, by which one can effectively manage the emotional and psychological symptoms associated with PMS.

One more similar therapy is CBT or cognitive behavioural therapy, which can help you replace your negative thoughts with healthier and positive ways of thinking. 

1. Lifestyle Changes

Even though there are different options for managing PMS, lifestyle changes can be very valuable for coping with the discomfort of PMS. 

• Fluid Intake: Drink plenty of fluids to ease the symptoms of PMS. Staying hydrated plays an important role in coping with the symptoms by flushing out the toxins from the body. Fluid intake includes herbal teas, fresh fruit juice, coconut water, etc.
• Exercise: Incorporate exercise into your regular routine. Engage in at least 30 minutes of physical activity. Practice brisk walking, cycling, swimming, or other aerobic activity throughout the week. Regular daily exercise can help improve your overall health and relieve fatigue and depression. It helps ease the cramps and pain and improves sleep quality.
• Diet: Eat smaller meals to avoid bloating and indigestion. Reduce salt intake, which can prevent fluid retention. Choose foods high in complex carbohydrates, such as fruits, vegetables, and whole grains. Carbohydrates can help produce serotonin and, in turn, elevate mood.
• Calcium Intake: Consume foods rich in calcium. If you don't consume dairy products or have a calcium deficiency in your diet, try to include calcium-rich foods like leafy green vegetables, broccoli, sardines, salmon, almonds, sesame, figs, lentils, chickpeas, beans, etc. Calcium helps to regulate hormone levels and improves mood.
• Stress relief: Try to live a stress-free life. A stress-free life can offer you sound sleep and relief from anxiety and headaches. Practice relaxation techniques like breathing exercises, meditation, mindfulness, etc., to overcome the burden of stress. 
• Sleep: A person's overall health depends on the quality of their sleep. It has a major role in managing the physical, mental, and emotional symptoms of PMS. Maintaining a sleep schedule by maintaining the same bedtime and waking up time, as well as going to bed early and waking up early, makes a significant difference in managing PMS. 
• Yoga and Pranayama: Yoga can be a very effective way to manage PMS; it addresses both mental and physical issues. Yoga postures should be very simple and gentle, not strenuous and difficult.

2. Over-the-Counter Medications

For many women, PMS could be unbearable, and in such instances, one cannot manage with lifestyle changes or simple remedies. Therefore, resorting to some over-the-counter medicines becomes mandatory.

• You can manage menstrual cramps, headaches, body aches and back pain with NSAIDs (Non-steroidal anti-inflammatory drugs) like ibuprofen, aspirin, or acetaminophen. 
• Diuretics, which increase urine output, can help relieve water retention and, in turn, give relief from sore and tender breasts. (Taking NSAIDs and diuretics at the same time can damage your kidneys).
• Magnesium supplements can help relieve bloating and water retention and elevate the mood. It would help if you take it a few days before the menstrual period.
• Vitamin B6 supplements help correct your mood and reduce irritability. 
• Low iron is standard if you have heavy menstrual flow. Low iron can lead to fatigue. 

Always be careful when taking any medicine without a doctor's guidance. Because long-term use of some medicines, especially NSAIDs, can even result in kidney failure.

When to See a Doctor?

If you are not able to manage your PMS symptoms with lifestyle changes and simple remedies, and when it affects your day-to-day life activities and prevents you from doing necessary work, then you are supposed to consult your doctor.

Natural Remedies for PMS Relief

There are several natural remedies that can help you manage PMS on your own. Proper diet, hydration, stress management, sleep hygiene, regular physical exercise, herbal remedies, yoga, and breathing exercise can help you manage the PMS symptoms. 

Staying hydrated is very much necessary to flush out the toxins.'

1. Diet and Nutrition

• Include a lot of fibre, less fried foods, and foods rich in Calcium, Magnesium, omega-3 fatty acids, and iron. 
• Also include whole grains, lean protein, fruits, and vegetables.
• Reduce the intake of salt, sugar and caffeine.
• Instead of eating three full meals daily, consume four to five small meals. This prevents the release of large quantities of sugar into your bloodstream at once.
• Don't skip food; remaining hungry will make you more irritable as blood sugar levels decrease.

2. Exercise and Relaxation Techniques

• A daily dose of exercise is necessary to maintain a healthy body weight. More accessible modes of exercise include walking and light jogging.
• Practice exercise at least four hours a week. Weight-bearing and muscle-strengthening exercises help maintain normal oestrogen levels.

Myths and Facts About PMS

There are numerous myths about PMS, as it is not understood correctly. Here, you can read the most common myths and the related facts: 

Myth #1: Every woman suffers from PMS

• Truth: No, because not everyone experiences PMS. Many women manage to go through without experiencing any mental or physical discomforts.  

Myth #2: PMS is not a real issue related to the menstrual cycle; some women just get an excuse for their bad moods.

• Truth: PMS is a health issue which manifests as a cluster of symptoms because of hormonal variation during the menstrual cycle.

Myth #3: You have to avoid exercising when you experience PMS symptoms.

• Truth: Gentle physical activities help ease PMS symptoms and elevate your mood if you're feeling down. 

Myth #4: There is no remedy for managing PMS

• Truth: Several natural remedies, including dietary changes, lifestyle adjustments, and a healthy sleep schedule, can help ease PMS symptoms. Also, medicines can help relieve the symptoms.

Conclusion

PMS is a common health condition affecting women, which makes it difficult for sufferers to cope with day-to-day life activities during their menstrual period. There is great difficulty in socialising with others, both at home and at work. It affects a woman's physical, mental and emotional well-being. However, it is not difficult to find a solution to this problem through some simple and effective natural remedies.

But if you are unable to find a solution to this problem through such remedies, please do not hesitate to consult your doctor. Though PMS can be uncomfortable, it is not an unbeatable issue, and with the right approach, you can manage it effectively.