Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is a complex condition involving emotional, physical, hormonal and environmental factors.  It is not a state of hormonal imbalance.  Stress levels, psychological state, cultural and social environment, and changes in neurotransmitters (brain chemicals) like serotonin may influence premenstrual symptoms.

Physical Symptoms:

• bloated stomach  
• swollen hands and feet  
• tender or enlarged breasts  
• lower-abdominal pain/cramps
• weight gain  
• headache  
• nausea 
• vomiting 
• diarrhoea 
• constipation  
• appetite changes  
• joint or muscle aches 
• acne or other skin problems

Emotional Symptoms:

• irritability  
• anger  
• depression  
• anxiety  
• tension 
• fatigue, lack of energy  
• difficulty concentrating  
• crying spells  
• feeling overwhelmed or out of control

Treatment

Research into PMS has shown that there are generally no specific cures due to the variation in symptoms between individuals.  A healthcare provider may ask you to write down the changes in emotional and physical symptoms that you get during your menstrual cycle.
Diet changes, stress reduction and regular exercise generally help to alleviate physical and emotional symptoms. 

Natural therapies

Many women feel they benefit from natural therapies.  Vitamin B6 (Pyridoxine), Evening Primrose Oil and St John’s Wort are some that are commonly prescribed by naturopaths.

Hormonal therapies

The combined oral contraceptive pill prevents ovulation and for some women this will provide relief from symptoms.  Other hormone preparations such as progestins, progesterone and oestrogen preparations have been tried, but only oestrogen patches and implants have been shown to be beneficial in controlled studies.

Selective Serotonin Reuptake Inhibitors (SSRI)
The SSRI have been studied extensively in placebo-controlled trials and have shown significant benefit in reducing symptoms, particularly the emotional symptoms. These medications increase serotonin in the brain and improve mood, in particular, and are the recommended treatment. If you don’t respond to either hormonal therapies or SSRI, it’s likely you have a disorder of mood rather than PMS and should seek specialist help.

References:

Better Health

Fact sheet – Premenstrual Syndrome
Jean Hailles Foundation for Women’s Health