Take the pain out of PMS

Many women go through monthly torment, but a few steps can help you manage PMS and regain control of your body

Ever find yourself craving sugary treats or shouting at the children for no reason just before your period? More than 80 per cent of women do, as they experience some form of Premenstrual Syndrome (PMS) every month, and for some it can turn their lives upside down. Unfortunately, cases seem to be on the rise – I’m seeing more women with PMS than ever before. Some experts blame our high-fat, high-sugar western diet for the increase but the everyday stress of organising a career, household and family can only add to your chances of experiencing symptoms.

Monthly demon
PMS is experienced by women in the luteal phase of their menstrual cycle – the two-week period between ovulation and menstruation. Symptoms can vary wildly from person to person and are often divided into two categories; physical and behavioural – although these commonly occur together. You may experience bodily changes such as abdominal bloating and pain, excessive sweating, aching legs, tender breasts and vaginal dryness as well as a fluctuation of up to half a stone in weight. And women also report a transformation in their personality, including depression, forgetfulness, mood swings, unpredictable behaviour, clumsiness and increased levels of anger and irritation.
Happily, most of us experience just a day or two of abdominal discomfort or low mood before menstruation and, once our period arrives, life returns to normal. However, for 5-10 per cent of women, PMS is so severe that they suffer an acute level of symptoms throughout the entire two weeks of ovulation, which can have a massive impact on their overall wellbeing. Indeed, these women often find themselves feeling and acting like a completely different person for half of their reproductive life, sometimes too disturbed or unwell to go about their daily routine.

Balancing act
We’re not completely sure why PMS occurs, although most research into the condition points to a hormone imbalance within the body. At the point of ovulation, we experience two significant hormone changes – our oestrogen levels drop and levels of progesterone rise. Experts believe either the decrease in oestrogen or a sensitivity to high levels of progesterone could be the cause of PMS or, in fact, a combination of the two.
PMS does tend to run in families but there isn’t enough strong evidence to say that it’s a genetic condition. Lots of the sufferers I speak to tell me that their mothers showed similar symptoms to their own, but some experts have suggested that the behavioural traits of PMS could be subconsciously learnt from older family members.
It has been proven, however, that women with a tendency towards depression or anxiety often suffer from more severe symptoms of PMS. Those who already battle with low mood often find a decrease in oestrogen levels exacerbates their symptoms to even more extreme levels. I see women who describe the urge to commit suicide or kill in the days leading up to their period, which can have a devastating impact on their family life. In a similar way, stress can act as a trigger for PMS, too.
The foods you eat can also have an impact on your symptoms. Processed sugar is one of the biggest triggers of PMS, as it causes your blood sugar levels to rise and then plummet rapidly, which leaves you feeling confused, angry and irrational. It’s a similar principle to the hyperactivity children experience after eating sweets – an adult sugar high. Alcohol acts in a similar way, stimulating our mind and dulling the immune system.

Taking control
Unfortunately, there’s no one-size-fits-all cure for PMS but making simple changes to your lifestyle could be enough to manage your symptoms. The most important thing you can do is to discuss your condition with your partner, family and close friends. Knowing you have emotional support will not only act as a great comfort, but it will also help them to separate your premenstrual behaviour from the ‘real’ you.
Take notes I always recommend patients keep a diary of their symptoms. Once you’ve established patterns in behaviour, it’s easier to control them. It also means you can forewarn people of when you’re likely to be suffering.
Watch your diet A balanced diet with plenty of protein and vegetables is a great way to boost your immune system and help your body. Soya is a natural source of oestrogen and some women find that introducing soya milk or linseed to their diet helps to relieve symptoms. Cut out processed, sugary foods and make sure you eat complex carbohydrates at every meal to keep your blood sugar levels under control. Try to avoid alcohol during ovulation, too.
Keep hydrated A lot of people think drinking less water is the answer when they feel bloated from fluid retention, but the opposite is true. To stop your body holding excess water, increase your liquid intake to 10 glasses of water a day to flush out and hydrate your system.
Get active Lacing up your trainers for a workout is probably the last thing you feel like doing in the days before your period – our bodies go into comfort mode – but even the smallest amount of low intensity exercise can help reduce stress and aid sleep. Why not try swimming or Pilates to get your endorphins flowing? Plus, research has shown that women who exercise regularly are much less likely to suffer from PMS.
Keep calm Instead of reaching for a slice of cake or glass of wine as a way to de-stress, find a healthy way to relax your mind and body. Some people enjoy a bath with their favourite essential oil while others prefer reading a good book with a calming scented candle. Try to schedule an hour a day for me-time.

When to get help
If your symptoms suggest you’ve got PMS, your GP will make a clinical diagnosis. You may be prescribed an SSRI anti-depressant like Prozac, which acts to increase your body’s levels of the ‘happy hormone’ serotonin. Most women only take this for the two weeks of ovulation.
Oral contraception has also proved helpful for some PMS sufferers. Ask your GP for one of the newer types of contraceptive pill, which tend to be a mix of oestrogen and progesterone rather than just progesterone. But be careful – in women with a sensitivity to progesterone, the pill can make their symptoms worse.
Premenstrual oestrogen therapy (a type of HRT) is also a common treatment for PMS sufferers who are experiencing bad behavioural symptoms, as it helps increase the oestrogen levels within the body and improve your mental state. The connection between oestrogen and mood has been known for some time, and oestrogen therapy can help people with depression.
Applying oestrogen topically may also help women who complain of vaginal dryness or soreness before their period. These creams mimic the function of natural oestrogen which moisturizes and lubricates the vagina, making sex less painful and more enjoyable.
Remember that it could take up to three months for the effects of any medication to show, so continue to keep a record of your symptoms.

Natural Easers
Dr Caroline Longmore, founder of Galen Naturopathic (www.galennaturopathic.com), recommends these natural alternatives to help balance the effects of PMS:

-  Research from the University of Reading found taking vitamin B6 and magnesium decreased anxiety, irritability and mood swings after one month.
-  Black cohosh has antispasmodic properties that help soothe stomach cramps.
-  Evening primrose oil (pictured, right) contains the essential fatty acid GLA to help ease breast tenderness and bloating.
-  Acupuncture stimulates mood-boosting endorphins and has a balancing effect on the body.
-  Research from the British Medical Journal suggested taking agnus castus extract can help balance hormones and help treat PMS-related skin problems.

Expert: Pat Jones
Pat Jones is a nurse specialist in women’s health at a Warwickshire GP surgery, advising patients on PMS and the menopause. She also talks all over the UK on managing PMS symptoms naturally (www.feelwellbewell.com).

Compiled: Victoria Joy