Understanding and managing Premenstrual Syndrome

Dealing with PMS every month is not a walk in the part for most women, even though they make it look like one. Here are some tips and tricks that'll help ease those peskier symptoms.

If misery loves company, premenstrual syndrome sufferers are empathetic supporters of each other. But by taking a proactive approach to this recurring condition — starting with diet and exercise — you may be able to say no the physical and emotional toll that hits every month.

If you're one of the millions of Canadian women who have premenstrual syndrome (PMS), you know it’s hardly the joke that TV comedians make it out to be.

• Every month you really do feel crabby, crave that whole box of chocolates and suffer from breast tenderness, bloating, cramps, weight gain or headaches — and sometimes all at once and sometimes very severely.

The discomfort may last from just a few hours to several days. Or it may begin a week or two before your period and stop abruptly when the bleeding starts. Because PMS can elicit some 150 different symptoms, there’s really no typical case.

• While most women find it annoying rather than disabling, an estimated three percent to eight percent have truly severe symptoms, suffering from a variety of physical problems as well as serious depression — a condition called premenstrual dysphoric disorder, or PMDD.

Research still hesitates to name the cause of PMS. Many experts blame an imbalance of the female hormones estrogen and progesterone, which may interfere with the brain chemicals that control mood and pain.

• Others suspect low levels of serotonin, a brain chemical associated with emotional well-being. Additional culprits may include nutritional deficiencies, fluid and sodium retention, low blood sugar and a heightened stress response.
• Although no theory offers a full explanation for all women, what we do know is that there’s a natural limit to PMS. Symptoms, which usually strike in the mid-20s, generally subside after age 35 and disappear completely with menopause.

• A healthy diet to reduce bloating and curb cravings.
• Stress reduction through regular exercise and mind-soothing techniques like yoga.
• Vitamins and other nutritional supplements to balance body chemistry.
• Analgesics to ease aches and to relieve bloating.
• Antidepressants for PMDD or if PMS-related depression fails to lift with lifestyle measures.

• Keep a symptoms diary
  for at least a few months, charting how you feel and when, as well as dates when your period starts and ends. This will show the cycle of your symptoms and help your doctor eliminate other possibilities. Often problems are due to other ailments, such as pain linked to menstruation (dysmenorrhea) or seasonal affective disorder (SAD).

• Don't eat meat.
  A 2000 study found that women who ate a low-fat vegetarian diet for two menstrual cycles had less pain and bloating than meat eaters. Try replacing red meat with salmon, tuna or other oily fish, which are rich in the omega-3 fatty acids that can help relieve menstrual cramps and possibly related depression.

• Try cognitive-behavioural therapy.
  If you suffer from depression or feelings of hopelessness due to PMS or PMDD, a psychotherapist can help you master techniques for solving problems, managing obstacles and restructuring priorities. The therapist will give you new ways of thinking about your condition so you can overcome pessimistic thoughts and regain a sense of control.

• Be wary of certain PMS clinics.
  If a clinic insists on expensive preliminary lab work, charges high fees payable in advance, pushes one treatment for all patients or offers a fast diagnosis and quick fix, look out. Choose one run by a physician whom you trust and that tailors the treatment specifically to you.

For information and treatment strategies for PMS, log on to www.cfpc.ca, the website of the College of Family Physicans of Canada.

Another great place to compare notes and share ­experiences with other women who have PMS is www.feelgoodcounseling.com.