Q & A Library
Prone to PMS?
What do you recommend for PMS? I'm miserable every month, and nothing I do seems to help.
Answer (Published 3/7/2006)
Three out of four menstruating women experience some degree of premenstrual syndrome (PMS) in the week leading up to their periods. Symptoms can range from mood swings, fatigue, irritability and depression to tender breasts, abdominal bloating, anxiety, insomnia, headache, fluid retention, and increased appetite with cravings for sweet or salty foods. Of course, not all women have all the symptoms – and not all affected women have symptoms of the same intensity month after month. Still PMS can be so severe that some of those affected can’t go about their normal activities.
We don’t know what causes PMS, or why some women have it and others don’t. Clearly, hormonal fluctuations play a role, as PMS symptoms tend to disappear when hormone levels are stable, such as during pregnancy and after menopause.
Conventional medicine treats PMS with non-steroidal anti-inflammatory drugs (NSAIDS), which can ease cramps and relieve breast discomfort. (Taking these drugs before your period can help prevent cramps by lowering blood levels of prostaglandins, hormones that promote inflammation.) Oral contraceptives can help as well, because they prevent ovulation and its associated hormonal changes. In some cases, conventional physicians prescribe antidepressant drugs. These boost the levels of serotonin in the brain and have been shown to reduce fatigue, food cravings and sleeping problems. (Some doctors recommend taking them only during the two weeks prior to menstruation.) Another more drastic alternative is an injection of Depo-Provera, a hormone that stops ovulation temporarily but can also cause increased appetite, weight gain, headache and depressed mood.
I recommend trying the following lifestyle changes and supplements, which can go a long way toward relieving PMS symptoms:
Andrew Weil, M.D.
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