Q: What is PMS?

     A woman's body is a very complex domain. Many chemical changes are happening inside a woman's body especially before having their period. Premenstrual syndrome (PMS) is a symptom or collection of physical and emotional symptoms that usually occurs in relation with the menstrual cycle which starts 5 to 11 days before menstruation with the symptoms gradually diminishing on the onset of menstruation or shortly thereafter.

Q: What causes PMS?

     There is no exact cause of PMS identified yet although it can be related with social, cultural, biological and psychological factors. Theories range from hormonal and chemical to nutritional and psychological. Women whose mother or sisters have PMS are more likely to have it, so there may be a genetic component.

Q: Is it true that PMS is caused by hormones?

     Although there is still no proof of that claim, The PMS Project theorizes that PMS can be caused by a combination of hormone imbalance (progesterone deficiency, estrogen excess), biochemical factors, vitamin and mineral deficiency, prolactin excess, stress, nutrition and lifestyle factors.

Q: Do all women suffer from PMS?

     No, but the incidence is higher in women between their late 20s and early 40s, those with at least one child, those with a family history of a major depression disorder, or women with a past medical history of either postpartum depression or an affective mood disorder.

Q: How will I know if I have PMS?

     There is a wide range of physical and emotional symptoms that have been related with PMS. The most common symptoms include:

A. Physical symptoms: " headache or dizziness " backache " swelling of ankles, hands, feet " abdominal cramps or heaviness " abdominal pain " abdominal fullness, gaseous " muscle spasms " breast tenderness " weight gain " acne flare-up " recurrent cold sores (herpes labialis) " nausea " bloating " changes in bowel either constipation or diarrhea " decreased coordination " food cravings " night sweats " decreased tolerance to sensory input (ex. noise, light) " painful menstruation " heavy menstrual flow

B. Emotional symptoms: " anxiety or panic " mood swings " confusion and tension " difficulty in concentrating " forgetfulness " nervousness " insomia " poor judgment " depression " irritability, hostility or aggressive behavior " increased guilt feelings " fatigue or lethargy " decreased self-image " libido (sex drive) changes " paranoia or increases fears " slow, sluggish, lethargic movements " low self-esteem " loss of libido (sex drive) " overreaction to sensory stimulus (ex. noise, light) " paranoid (unfounded feeling of persecution)

Q: Are all symptoms present and the same for all women?

     Not all these symptoms will be present, however many women may experience a series of symptoms, both physical and emotional. The symptoms, duration and severity can also vary among individuals. For some women, the symptoms may be mild or moderate, and for others, they may be so severe as to be incapacitating.

     The most devastating symptoms that can have far-reaching repercussions are mostly emotional symptoms. Ten days is the typical duration for women with severe PMS, while a smaller percentage of women report symptoms lasting approximately four days. The intensity is generally similar for both groups, however, women with the longer PMS cycle also exhibit increased symptom range.

Q: Are there tests for diagnosing PMS?

     PMS is difficult to diagnose because there is not a clear cause and the symptoms are varied and are found in other disorders. The cyclical pattern is crucial for a diagnosis: symptoms appear prior to menstruation and resolve when bleeding begins.

     There are still no physical findings or lab tests that can diagnose if a woman has PMS. But a complete history, physical examination (including pelvic exam), and in some instances a psychiatric evaluation should be conducted to rule out other potential causes for symptoms that may be attributed to PMS.

     A symptom calendar or menstrual diary can help women identify the most troublesome symptoms and to confirm the diagnosis of PMS.

Q: If I am diagnosed to have PMS, is there a treatment for it?

     There is really no absolute treatment that could cure PMS. The treatment for PMS focuses only on relieving symptoms that involves exercise, dietary changes, and medication. Exercise has a profound effect on hormones, including those involved in the menstrual cycle. Women, especially those who experience PMS, are encouraged to exercise regularly, 20-45 minutes, 3 times a week. A professional nutritionist or dietician can advise women on dietary changes that may relieve symptoms. When exercise, diet, and other lifestyle changes have not helped, medication may be effective.

     If your daily activities are really affected with your PMS, you can take over the counter medications such as Midol PMS and Pamprin PMS to relieve cramps. But it is best if you visit your doctor or a gynecologist. Prostaglandin inhibitors (aspirin, ibuprofen, other NSAIDS) may be prescribed for women with significant pain, including headache, backache, menstrual cramping and breast tenderness. Diuretics may be prescribed for women found to have significant weight gain due to fluid retention. Your doctor can also prescribe psychiatric medications and or therapy may be used for women who exhibit a moderate to severe degree of anxiety, irritability, or depression. You could also consider hormonal therapy which may either decrease or increase PMS symptoms. The use of progesterone vaginal suppositories during the second half of the menstrual cycle is still controversial. There are also many prescription drugs that your doctor can give you such as Effexor, Elavil, Wellbutrin, Zoloft, Paxil, Prozac and Sarafem that are said to relieve PMS but be cautious in taking them for they are known to have side effects. Nutritional supplements may also be recommended such as Vitamin B6 , calcium, and magnesium.

     Although there are many medications out in the market that promises to relieve PMS, prevention is the best course of action to be taken.

Q: What can I do to prevent having PMS?

     Drinking plenty of water, regular exercise, eating a balanced diet and adequate sleep are not just good for the over all health but they are also believed to help prevent women from having PMS.

Q: I already have PMS but I don't want to take medications, how will I minimize the symptoms of PMS?

     A change in lifestyle is often recommended to help prevent the occurrence of symptoms and to not make the symptoms worse. The self care method mentioned above like regular exercise, eating a balanced diet, adequate sleep and stress reduction are proven to be beneficial for women with PMS. Exercise can alleviate both the physical and emotional symptoms. The endorphins released during exercise can reduce menstrual cramps and lift you out of the PMS blues. Drinking 8 glasses of water everyday can also help reduce bloating and fluid retention. Some foods should also be avoided during the onset of PMS such as salt, sugar, caffeine, alcohol, dairy products and red meat. Avoid processed foods, fast food and convenience foods. Complex carbohydrates, turkey, specific fruits and vegetables are a healthy and satisfying alternative.

     It is also advisable for women with PMS to have a "symptom diary" that should be kept for a minimum of 3 months in order to correlate symptoms with the menstrual cycle. If you plan to visit your doctor, the diary will greatly assist your doctor not only in the accurate diagnosis of PMS, but also with the proposed treatment methods.

     If PMS symptoms does not improve with the self treatment measures mentioned above, or if symptoms that occur are severe enough to limit functional ability you must go see your doctor. A bad case of PMS might need treatment by taking medications or therapy mentioned above.

Q: What would happen if PMS is left untreated?

     For some women, complications may occur if PMS is not treated. PMS symptoms may become severe enough to prevent women from maintaining normal function. It can lead to severe depression which may require associated medication adjustments. The incidence of suicide in women with depression is significantly higher during the latter half of the menstrual cycle.

     PMS if left untreated can also lead to Premenstrual Dysphoric Disorder (PMDD). PMDD is considered a mental illness and have more pronounced emotional symptoms that can impair the ability of a woman to function in her daily activities in home, work, social and relationship interactions. It is usually marked by severe depression, irritability and tension that are more severe than symptoms experienced in PMS.

     For more information on PMS, PMDD and other women's health issues, you can visit the following websites:

• http://health.yahoo.com/health/encyclopedia
• http://www.conquerpms.com
• http:// www.womenshealthchannel.com