Premenstrual Syndrome (PMS)

What are the common symptoms of "premenstrual syndrome"?

Ninety percent of women have some type of premenstrual syndrome, a symptom before their menses. Sometimes a little bit of cramping, sometimes a little bit of mood change, sometimes a little bit of insomnia maybe. premenstrual syndrome is different in everybody. So that's the changes that a person feels in a cyclical manner before their period we call premenstrual syndrome.

What causes premenstrual syndrome?

We really don't know. There has been many theories. Some feel that it's emotionally related, some feel that it's hormonally related. There have been many treatments have been offered from oral treatments and anti-anxiety medications and so on and so forth. None has worked for everybody. Premenstrual syndrome has responded to some anxiety medications better than hormonal treatments, but there are a lot of birth control pills now that we use that have been approved for premenstrual syndrome of certain kinds of symptoms also. So there are many different possible ideologies or causes but it's not clear and most likely, again, every -- depending on the symptom, the cause is different and eventually once we learn more about it then we're better.

What is "premenstrual dysphoric disorder" or "PMDD"?

Premenstrual dysphoric disorder or PMDD is a severe form of PMS, or premenstrual syndrome. This is when a person has to alter their life because of the symptoms that they are experiencing emotionally. So a person gets extremely depressed, can't go to work, they spend the day in bed. They cry a lot and this is related to their menses. That's what we diagnose as the dysphoric syndrome.

How will my doctor treat premenstrual syndrome?

Depending on your symptom. Let's say you have cramps that occur a couple days before, and you've had these cyclically for a long time. Well, a doctor may say since your cycles are so regular why don't you just take some Advil a day before they come. This way Advil or Motrin or any of these anti-inflammatory medications suppress some of the hormonal changes prior to the menstruation and make the pain much more manageable, as opposed to waiting for the pain to start and then taking the medications. If the problem is a mood change, then maybe some of these anti-anxiety medications are helpful. Also some of these birth control pills, new birth control pills that are out there have been approved for these mood changes. In patients that this problem is very severe, we can stop their menses, we can basically get rid of that cyclical event that brings on these premenstrual symptoms and there's many ways of doing that, but the treatment should fit the symptoms.

What can I do to alleviate the problems caused by premenstrual syndrome?

I think everybody should look for signs and symptoms of it, and see what helps them and what doesn't help them. For example, some women with premenstrual syndrome feel bloatedness, or fluid retention, well it's very important at this time then to cut back on the salt intake and the fluid intake to alleviate this symptom of premenstrual syndrome. Some women feel headaches coming when suffering premenstrual syndrome before their periods and alleviating this symptom of premenstrual syndrome may involve taking the anti-inflammatory medication or even tylenol prior to the day that they see this problem coming. So everybody should look for their symptoms of premenstrual syndrome and then of course try to help themselves in terms of the different opportunities for treatment of premenstrual syndrome. Also discuss relieving symptoms of premenstrual syndrome with their physician. Exercise is also very important in alleviating the symptoms of premenstrual syndrome, diet is very important, fluid intake is very important. These are all things that can be altered by a person to make the symptoms of premenstrual syndrome more manageable.

Are there alternative treatments that will help premenstrual syndrome?

Alternative treatments for management of premenstrual syndrome have been a big market for a long, long time. Turn of the century was the snake oil and many different things came after that for treatment of premenstrual syndrome. Ninety percent of women have this. None of them have really panned out, unfortunately. None of them have been the miracle cure that they profess to be. Some have used saint john's wart, those women with maybe emotional symptoms, mood changes, and that has helped some women. But nothing really up til now has shown any significant promise to alleviate these symptoms in general.