Posted with permission from Figure Magazine, copyright 2008, by Meredith Corporation and CSPE, LLC. Figure is a registered trademark of CSPE, LLC.
(Excerpted from Figure Magazine. Click here for the article as it originally appeared.)
Prior to the 1970s, few people had heard of Premenstrual Syndrome (PMS). Today, it's hard to browse through a greeting card section without being inundated with dozens of examples of PMS "humor". But for the 50 million women who suffer from monthly premenstrual mood swings, irritability and weight gain, it's no joke. Premenstrual syndrome is different for everyone, but one thing is consistent…women who suffer from PMS experience at least one physical or emotional symptom that starts 5 days before menses, and disappears 4 days after a period starts. If moodiness and bloating come and go throughout the month, PMS is not the problem.
There are more than 150 symptoms that a woman might experience, and seventy to ninety percent of reproductive age women report at least one adverse symptom during the premenstrual phase of their cycle. Up to forty percent feel their symptoms are bothersome enough to qualify as PMS, interfering not only with the ability to think clearly and feel good, but getting in the way of relationships with everyone around them. It's not just the menstruating women who suffer; husbands, kids, friends, and co-workers all feel the impact of PMS.
Premenstrual dysphoric syndrome (PMDD), on the other hand, is, a far more severe and debilitating version of PMS, affecting three to eight percent of reproductive age women. While a diagnosis of premenstrual syndrome requires the presence of only one symptom associated with PMS, women who suffer from PMDD have a minimum of 5 symptoms. At least one of those symptoms must be depression, anxiety, or irritability severe enough to interfere with school, work, or relationships with others. Like PMS, PMDD symptoms are present 5 days before a period and are completely gone within 4 days of the onset of menses.
Since PMS was identified as a specific entity, there have been numerous attempts to control symptoms with progesterone, estrogen, vitamins, exercise and dietary changes. Most women just live with monthly misery either because they think the symptoms are not severe enough to bother talking to a doctor or they don't think anything will help anyway. PMS is often accepted as another "natural" part of being a woman, like menstrual cramps and labor pain.
Until recently there has been little research showing what really works and what doesn't. The data on diet and supplements is inconsistent, but certain things, such as progesterone, evening primrose oil and ginkgo biloba have been definitively proven to be ineffective.
Some, but not all, studies show that Vitamin B6 (100 mg/day), Vitamin E (400mIU/day), calcium and magnesium (200-300 mg/day) reduce PMS symptoms. And chocolate? Well, there is no question that women crave carbs during that time of month, so it's not unexpected that carbohydrate-rich beverages reduce symptoms by boosting serotonin production.
In one small study, just one tablet a day of the fruits of Vitex agnus castus (the chasteberry tree) resulted in a significant decrease in irritability, anger, headache, and breast fullness when compared with placebo. There is also some evidence that exercise, relaxation, and reflexology may help alleviate PMS symptoms. While it is difficult to test the true efficacy of these techniques, experts agree there is never a downside to more exercise and relaxation.
Only two treatments, one an anti-depressant and the other a birth control pill, have been FDA-approved for the treatment of premenstrual symptoms. Three of the selective serotonin reuptake inhibitors (SSRIs), fluoxetine, sertraline, and paroxetine, have been proven to help alleviate symptoms, but many women prefer not to take an antidepressant. Up to 58% of women stop using an SSRI even if it is working due to sexual side effects, fear of growing dependent, or just an unwillingness to take an anti-depressant even if it is not being prescribed for treatment of depression.
Since PMS is hormonally driven, it makes sense that suppressing the normal menstrual cycle by taking birth control pills would eliminate symptoms. Unfortunately, until recently, no traditional oral contraception has been shown to alter the incidence or severity of premenstrual symptoms. In fact, the relatively high estrogen and progesterone in most pills actually increase water retention, breast tenderness and irritability in susceptible women.
Yaz, a recently released birth control pill, is the first non-anti-depressant and the only oral contraceptive to be FDA approved for the treatment of premenstrual symptoms. Unlike other pills, Yaz contains drospirenone, the only progesterone that acts as a diuretic, encouraging water elimination, which in turn reduces bloating and breast tenderness. Yaz is taken 24 days a month rather than the traditional 21 so that the effects are maintained during the short 4-day "off" interval. Studies show that at least 50% of women have reduction in PMS symptoms with Yaz, which is much better than in placebo groups or other remedies.
The important thing to remember is that premenstrual symptoms are not something you have to live with. Life is simply too short to spend 25% percent of the month feeling anything less than your best.
It only takes ONE of these symptoms…
Emotional symptoms
Physical symptoms
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