Do I have PMS?
PMS refers to physical and emotional symptoms that affect your life 2 weeks before your period comes. These usually improve when your period starts and generally disappear by the time your period ends. PMS is usually linked to your body’s hormonal changes.
What are the symptoms of PMS?
Symptoms vary vastly depending on the woman. They include:
- Mood changes: depressed, irritable, anxious, upset, emotional
- Feeling tired, insomnia
- Headaches
- Changes in appetite
- Abdominal bloating, water retention
- Breast soreness
You should record your symptoms in a diary for at least 2-3 months to track their pattern, and see a gynaecologist if you find that your symptoms are worsening and/or interferes with your daily life.
What are the treatment for PMS?
There are many good ways to keep your symptoms under control so that your life does not revolve around your period. Some treatment options include:
- Diet and vitamins
Keeping a food diary is important to find out foods that trigger your symptoms. You may need to eliminate the foods that you suspect may be responsible from your diet and try them one at a time to see which one triggers your symptoms. Vitamin B6 has been shown to help with PMS.
- Stress management
Relaxation techniques, meditation, acupuncture, music, regular exercise can help relieve symptoms.
- Psychological support
These can be very useful for women suffering from chronic pelvic pain as this long-term condition can be debilitating and affect one’s relationships and quality of life. Cognitive behavioural therapy (CBT), where you discuss your symptoms with a therapist, can help PMS.
- Non-hormonal medications
These are anti-depressants (selective serotonin reuptake inhibitors (SSRIs) and serotonin–noradrenaline reuptake inhibitors (SNRIs). Your gynaecologist may prescribe these to be taken 2 weeks before your periods, or throughout your cycle.
- Hormonal medications
The first line is usually combined birth control pills (containing both estrogen and progesterone). The newer generation ones containing drospirenone (Yasmin, Yaz) has been shown to help PMS and should be taken continuously for better relief of symptoms. Other forms of hormonal medications include estrogen patches with oral progesterone/Mirena IUD. In severe cases, suppressive hormonal injections with add-back hormone replacement therapy can be considered.
- Surgery
This is reserved for the most severe cases of PMS which do not show improvement with all the above measures. Hormone replacement therapy will be needed after operation if surgery to remove the uterus and ovaries is done before 45 years old.
