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The Truth About PMS

September 01, 2011

Ware-Dyanne Tappin, MD, obstetrician/gynecologist at Baystate Medical Practices-Mary Lane OB/Gyn providing a full range of gynecological and obstetric care to women of all ages shares expert advise on PMS and PMDD.  


Do you find yourself reaching for potato chips and chocolate every month as your period approaches? You’re not alone. Research suggests that many women experience food cravings as part of their PMS symptoms, a result of their body trying to make up for the chemical changes about to happen.


In fact, most woman experience PMS (Premenstrual Syndrome) to some degree.  It is a medical condition that can include both emotional and physical symptoms that affect each woman differently.  According to the American Congress of Obstetricians and Gynecologists approximately 85 percent of women have at least one PMS symptom as part of their monthly cycle.  There are many things that can be done to ease the symptoms of PMS.


PMS is a syndrome in women where they can experience both physical and behavioral symptoms that occur consistently in the 1-2 weeks before the menstrual period only. These symptoms may vary from month to month.  The physical symptoms can include painful menstrual cramping or dysmenorrhea, breast swelling or tenderness, appetite changes, bloating, upset stomach, joint or muscle pains, irritability, fatigue, headaches, and migraines.  Other less common symptoms include hot flashes, palpitations, and dizziness.  Emotional and behavioral changes may include anxiety, depression, irritability, panic attacks, tension, lack of coordination, trouble sleeping, decreased work or social performance, and altered libido. More severe PMS cases are now being categorized as premenstrual dysphoric disorder (PMDD).  PMDD affects between 3-5% of women.


The causes of PMS and PMDD are not clear, but several factors may be involved. Changes in hormones during the men­strual cycle seem to be an important cause. These changing hormone levels may affect some women more than others. Chemical changes in the brain may also be involved. Stress and emo­tional problems, such as depression, do not seem to cause PMS, but they may make it worse.


For many women the treatment for PMS can be simple; lifestyle changes often help dramatically.  In some cases of PMS and PMDD, pre­scription medicines like birth control pills, anti-depressants, and other medications, are used for treatment.  It is first important to find out whether you have other conditions that are easily confused with or overlap with PMS, including thyroid disorders, depression, anxiety, or peri-menopause. 


To help with the diagnosis of PMS and PMDD, it is important to record your symptoms 1-2 weeks before your menstrual cycle for at least for two menstrual cycles, paying special attention to any symptoms that worsen or linger to get a clear understanding of what is occurring in your cycle.  


Many of us don’t realize how dramatically exercise, diet, and other lifestyle changes can affect our hormonal balance. Processed food, sugar, and caffeine are diet shortfalls that can lead to worsening symptoms of PMS.


Controlling your blood sugar is a crucial step in easing symptoms and possibly eliminating PMS. It is important to have regular meals and to be sure that you have enough protein and complex carbohydrates, such as whole wheat bread, to maintain steady blood glucose level and avoid energy highs and lows.  Choose fruit as a healthy dessert choice instead of sweets. 


Caffeine affects PMS in several ways.  Symptoms of PMS often cause women to increase their caffeine intake. Naturally if you feel tired or fatigued, you think a cup of coffee will give you the energy boost you need to get through your day. Caffeine can increase the amount of nervous tension that accompanies PMS.  Studies also show that many women get over a quarter of their daily recommended calories (base on a 2000 calorie a day diet) simply from drinking iced coffees, mocha’s and iced teas.  With a little whipped cream on the top, these drinks can have upward of 500 calories-- a diet disaster!


Throughout your menstrual cycle, the levels of certain nutrients are thought to fluctuate. These nutrient fluctuations may cause some women to become deficient in certain vitamins and minerals at various points in their menstrual cycle.  Taking a daily vitamin supplement can help.  Choose one that has calcium, B6 (100 mcg) and B complex.  Some supplements can have harmful health effects and even interact with other medications that you take. Your health care provider can make sure that you take supplements safely.


Exercise is also helpful for PMS because it reduces stress and tension, acts as a mood elevator, provides a sense of well-being and improves blood circulation by increasing natural production of beta-endorphins. Many women are surprised when their PMS symptoms seem to disappear after they’ve begun a regular exercise program. Not only can regular exercise reduce your PMS symptoms but your overall health will improve as well. Regular exercise significantly reduces your risks for heart disease and many types of cancer. Regular exercise also helps improve the symptoms of depression, anxiety and stress. 


Your body may have different sleep needs at different times during your menstrual cycle, so it is important to get enough rest.  If your body is telling you to slow down, listen!At BMP-Mary Lane OB/Gyn, our approach to PMS and PMDD is one that is individualized to each of our patients, taking into account all that applies to a woman’s unique health picture. Talk to your Ob-Gyn provider more if you have concerns and questions about possible PMS and/or PMDD.


Dr. Dyanne Tappin joins Dr. Mohammed Ahmed and Lisa Beaudry, CMN, Certified Nurse Midwife; together they share the common goal of providing a full range of gynecological and obstetric care to women of all ages through every stage of their life. Flexible prompt appointments are available at both their hospital locations at Baystate Mary Lane Hospital in Ware and at the 95 Sargent Street location in Belchertown. 


For more information, or to schedule an appointment, call the Baystate Medical Practice Mary Lane Ob/Gyn at 413-967- 2655.