What is a menstrual period?
When puberty begins, your brain signals your body to produce hormones. Some of these hormones prepare your body each month for a possible pregnancy. This is called the menstrual cycle. Hormones cause the lining of the uterus to become thicker with extra blood and tissue. One of your ovaries then releases an egg. This is called ovulation. The egg moves down one of the two fallopian tubes toward the uterus.
If the egg is not fertilized with a man’s sperm, pregnancy does not occur. The lining of the uterus breaks down and flows out of the body through your vagina. The release of blood and tissue from the lining of your uterus is your menstrual period (also called “your period”).
Menstrual Irregularities to be concerned about:
- If you are bleeding so much that you need to change your pad or tampon every 1–2 hours or if your period lasts for more than 7 days, you should see your doctor. See your doctor right away if you are light-headed, dizzy, or have a racing pulse.
- You should tell your doctor if your periods are usually regular but then become irregular for several months. You also should see your doctor if your period comes more often than every 21 days or less often than every 45 days.
What is premenstrual syndrome (PMS)?
Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as PMS.
What are some common symptoms of PMS?
Emotional symptoms include the following:
- Angry outbursts
- Crying spells
- Social withdrawal
- Poor concentration
- Increased nap taking
- Changes in sexual desire
Physical symptoms include the following:
- Thirst and appetite changes (food cravings)
- Breast tenderness
- Bloating and weight gain
- Swelling of the hands or feet
- Aches and pains
- Skin problems
- Gastrointestinal symptoms
- Abdominal pain
How is PMS diagnosed?
To diagnose PMS, a health care provider must confirm a pattern of symptoms. A woman’s symptoms must
- be present in the 5 days before her period for at least three menstrual cycles in a row
- end within 4 days after her period starts
- interfere with some of her normal activity
Can PMS be treated?
If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, your health care provider may recommend medication.
Can exercise help lessen PMS symptoms?
For many women, regular aerobic exercise lessens PMS symptoms. It may reduce fatigue and depression. Aerobic exercise, which includes brisk walking, running, cycling, and swimming, increases your heart rate and lung function. Exercise regularly, not just during the days that you have symptoms. A good goal is at least 30 minutes of exercise most days of the week.
What relaxation methods can help relieve PMS symptoms?
Finding ways to relax and reduce stress can help women who have PMS. Your health care provider might suggest relaxation therapy to help lessen PMS symptoms. Relaxation therapy may include breathing exercises, meditation, and yoga. Massage therapy is another form of relaxation therapy that you may want to try. Some women find therapies like biofeedback and self-hypnosis to be helpful.
Getting enough sleep is important. Regular sleeping habits—in which you wake up and go to sleep at the same times every day, including weekends—may help lessen moodiness and fatigue.
What dietary changes can be made to help relieve PMS symptoms?
Simple changes in your diet may help relieve the symptoms of PMS:
- Eat a diet rich in complex carbohydrates. A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. Complex carbohydrates are found in foods made with whole grains, like whole wheat bread, pasta, and cereals. Other examples are barley, brown rice, beans, and lentils.
- Add calcium-rich foods, like yogurt and leafy green vegetables, to your diet.
- Reduce your intake of fat, salt, and sugar.
- Avoid caffeine and alcohol.
- Change your eating schedule. Eat six small meals a day rather than three large ones, or eat slightly less at your three meals and add three light snacks. Keeping your blood sugar level stable will help with symptoms.
Can dietary supplements help with PMS symptom relief?
Taking 1,200 mg of calcium a day can help reduce the physical and mood symptoms that are part of PMS. Taking magnesium supplements may help reduce water retention ("bloating"), breast tenderness, and mood symptoms. One study has shown that vitamin E may help reduce symptoms of PMS.
There are many products that are advertised to help with PMS. Most of these products have either not been tested or have not been proved to be effective. It is important to talk with your health care provider before taking any PMS product or supplement. Taking excess amounts of them or taking them with some medications may be harmful.
What medications reduce PMS symptoms?
Drugs that prevent ovulation, such as hormonal contraceptives, may lessen physical symptoms. However, not all may relieve the mood symptoms of PMS. It may be necessary to try more than one of these medications before finding one that works.
Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms. They can be used 2 weeks before the onset of symptoms or throughout the menstrual cycle. There are many kinds of antidepressants. If one does not work for you, your health care provider may prescribe another.
If anxiety is a major PMS symptom for you, an anti-anxiety drug can be tried if other treatments do not seem to help. These drugs are taken as needed when you have symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain. Talk with your health care provider before taking NSAIDs. Long-term use of NSAIDs may cause stomach bleeding or ulcers.
Diuretics ("water pills") are drugs that help reduce fluid buildup. Your health care provider can prescribe a diuretic if water retention is a major symptom for you. Tell your health care provider what other drugs you are taking, especially NSAIDs. Using NSAIDs and diuretics at the same time may cause kidney problems.