Premenstrual Syndrome (PMS)

What is Premenstrual syndrome? or, PMS?

A very common condition affecting the women mostly in their 30s and 40s. They notice premenstrual worsening of their physical wellbeing and mood. The symptom may vary month to month; being minimal in one month severe in other and moderate discomfort in some months. Some women also notice that the symptoms are less when they are on combined contraceptive pills. 3% of the affected women get these symptoms regularly and they may be so severe, that it cause major disruption to their lives. This syndrome is also known as Premenstrual tension or. PMT

What are the symptoms of PMS or PMT?

Tension, irritability, depression, bloating sensation, heaviness and tenderness in the breasts, headache, craving for carbohydrates, lack of sexual drive or, libido are the common symptoms. Many other bizarre symptoms may appear. To know whether one has PMS or, not it is essential to keep a diary of events. This diary will help the treating doctor to differentiate PMS with other disorders and will be helpful to find any psychological disturbance, she may be having. If she is having her symptoms worst premenstrual, she will have at least one week symptom free period after her menstruation.

How to treat Premenstrual syndrome (PMS)?

Reassurance is very important and she must understand this is not going to produce any serious disease or, cancer in future. Cooperation from the spouse and children is required to cope up with life. Find self help group support in the area. Improvement of diet, proper exercising, Yoga and rest, avoiding tobacco and alcohol will help. Herbal remedies though not tested properly some find them helpful. Try sage and fennel for irritability. Pyridoxine (Vitamin B6) 10 mg orally daily, either continuously or during the discomfort may help to elevate the mood and relive headache.

For severe cyclical pain in the breasts, cyclical mastalgia:

Avoid eating saturated fats as they increases the affinity of the oestrogen receptors for oestrogen.

Gamolenic Acid 160 mg orally 12 hourly

Bromcryptine 2.5 mg orally twice daily from 10^th to 26^th day of the cycle ( prescribed even when the prolactin level is within normal limit)

Danazol 100 – 200 mg 12 hourly orally for 7 days prior to menstruation.

Suppression of ovulation help in relieving symptoms in PMS

Yasmin a new entrant in combination pill is specially helpful to alleviate symptoms of PMS by suppressing ovulation.

Oestrogen Implants with cyclical progesterone is also used.

Danazol can also be given to suppress ovulation, but has other side effects like pimple, hair fall, weight gain etc.

Diuretics Spironolactone 25mg orally 6 hourly is also prescribed from 16^th to 26^th day of the cycle ( 1^st day being the first day of menstruation) when there is excessive fluid retention.

Other than these alprazolam, mefenamic acid and other analgesics are used to treat PMS.

In intractable patients removal of uterus and ovaries may be done and results are 96% satisfactory. These women should receive oestrogen replacement (HRT) following their operation.

This article is also republished at India Study Channel