Premenstrual Syndrome: No One Loves This Three Letter Word

Before the iPhone, Twitter, and #FF, PMS was one of the best-known abbreviations amongst both men and women.

Many women have suffered from fatigue, bloating and irritability before their period, but is this really Premenstrual Syndrome (PMS)? If you think you are suffering from PMS or PMDD (Premenstrual Dysphoric Disorder) but aren’t sure, we’ll help you learn about what symptoms to look out for.

The Nitty-Gritty: Your menstrual cycle is broken down into two phases: the follicular and the luteal phase. When your period starts, this is considered day 1. From day 1 until day 14 (approximately the time you ovulate) is considered the follicular phase.This phase also includes your menstruation days. From day 15 to 28 is the luteal phase. The symptoms of PMS occur in the luteal phase.

PMS: A true diagnosis of PMS requires you to have symptoms during the luteal phase of your cycle. This means the days leading up to your period are when you feel the worst. Many women feel bloating, irritability and fatigue. Generally, those who suffer from PMS are symptom free after they begin to menstruate.

PMS usually involves both physical and behavioral symptoms, so if you’ve been unusually upset for being interrupted during the Real Housewives reunion show, you may have a reason.

Common Physical symptoms include: 1) Breast tenderness 2) Bloating or weight gain 3) Diarrhea or constipation 4) Skin changes (including acne) 5) Fatigue or decreased energy 6) Insomnia 7) Headaches, back pain, or muscle cramping

Common Behavioral symptoms include: 1) Irritability 2) Sadness 3) Lack of Concentration 4) Anxiety or Depression 5) Feelings of Frustration or Anger

Bloating, fatigue, breast tenderness and headaches are the most common symptoms with greater than 50% of women experiencing at least one of these. Don’t be ashamed if you have designated “period pants”. Up to 90% of women experience bloating before their period, so many of your girlfriends are likely to have a pair too.

There are several theories on the mechanism of PMS, but the exact cause remains unclear. Some research suggests that although normal menstruation causes a shift in hormone levels (progesterone and estrogen), some women are more sensitive to these varying levels. Additionally, the variability in estrogen and progesterone is also thought to influence brain chemicals like serotonin and epinephrine, which are responsible for mood regulation and energy levels.

Your physician should make sure you do not have any other medical problem that could be causing your symptoms (thyroid disorder, underlying depression, anxiety, etc.), before diagnosing you with PMS.

If these symptoms sound familiar, you may have PMS. If, on the other hand, you feel like you’ve gotten a super-sized order, you may be suffering from PMDD.

PMDD: Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS. PMDD is similar to PMS in that it occurs during the days before your period begins, however women with PMDD generally have extremely severe symptoms that can affect multiple aspects of their life. In most cases, relationships with spouses, children, and friends are affected. Although women suffering from PMDD have physical symptoms, they are predominantly affected by mood symptoms. In order for a physician to diagnose someone with PMDD she must have at least five of the following symptoms: 1) depressed mood or feeling hopeless 2) anxiety 3) labile mood 4) anger or irritability 5) decreased interest in usual activities 6) difficulty concentrating 7) fatigue and lethargy 8) change in appetite or overeating 9) insomnia or sleep disturbance 10) feeling overwhelmed 11) bloating, breast tenderness, headaches or back pain.

One of the symptoms also must be a mood symptom from 1-4 (above). There are a few other criteria for PMDD that may be confusing. Speak with your physician to help get an accurate diagnosis. He or she may offer you several different treatment options to help you feel better.

So you’ve confirmed you feel miserable, and you may even know why. What can you do about it?

Exercise: Several studies have shown that daily exercise during the luteal phase improves both physical and mood symptoms of PMS and PMDD. Try to exercise for at least twenty to thirty minutes in the weeks before your period starts.

Healthy Diet: Maintaining a healthy diet can also help you feel more energetic. Avoiding foods high in salt and preservatives will reduce bloating. Swapping coffee and soda for water (try adding lemon) and decaffeinated tea may help improve some of the physical symptoms.

Treatment: In some cases your physician may recommend treatment with medication to help improve your symptoms. He or She will review the symptoms that are most debilitating for you and tailor the medication options based on this.

Now that you’ve learned the signs and symptoms of PMDD and PMS you can speak to your personal physician about the best treatment options for you. And hopefully PMS won’t be the week before your period when you say “Pass My Sweatpants” anymore!