By Karen McElroy

Premenstrual symptoms affect about 80-90% of women of reproductive age and symptoms can vary in severity from mild to severe. Symptoms may include weight gain and fluid retention, mood swings, tension and irritability, weepiness, depression, fatigue, cramps, breast tenderness or swelling, headaches and food cravings. By definition, symptoms must occur after ovulation and can last from as little as a day or two up to 2 weeks before the period. Whilst many women seek help, often their disorders are undiagnosed or misdiagnosed. Other women do not seek support, believing there is nothing that can be done or that it is just a ‘woman’s lot’.

However, studies have shown that around 40% of women have symptoms severe enough to be classified as premenstrual syndrome (PMS). In these cases women must report both physical and mental symptoms that affect their work or social capability. For most women, their premenstrual symptoms do not substantially impair their functioning at work or home. However, a small group of women (around 5%) suffer from a more severe type of PMS known as premenstrual dysphoric disorder or PMDD with more severe symptoms that impact heavily on their relationships or their ability to perform at work.

While the exact cause of premenstrual symptoms is unknown it is thought that PMS is caused by different mechanisms involving the hormonal and nervous systems. Behavioural and social factors such as exercise, smoking, alcohol, caffeine intake, nutritional factors and stress have also been linked to PMS. Low levels of neurotransmitter serotonin have been implicated in the depressive symptoms, irritability, anger, and food cravings experienced by women with PMS/PMDD.

Specific types of the oral contraceptive pill or antidepressants are often used in the conventional treatment of PMS and PMDD. However some women experience worse symptoms on the pill and I find it is far better to focus on the cause, than simply take hormones or pharmaceuticals. These approaches include aerobic exercise, dietary changes, herbal medicine and stress management. Herbal medicine provides some wonderful herbs for managing premenstrual syndrome. Herbalists normally combine a range of herbs for the nervous system, adrenals and the reproductive system to tailor an individual tonic for women suffering from PMS.

Regular exercise causes release of endorphins and can in turn improve both mood and other physical symptoms. Women should get a minimum of 20-30 minutes of aerobic exercise at least 3 days a week, preferably throughout the month, not just in the premenstrual phase. Some women find exercise a great strategy for coping with mood change, fatigue and fluid retention during the premenstrual period.

Avoiding coffee, alcohol and sugar can help with PMS. The minerals calcium and magnesium have been shown to be effective in mediating PMS, whilst vitamin B6 was shown to be more effective than placebo in treating premenstrual fluid retention and mood disorders. Correcting underlying nutritional problems can help to decrease sugar cravings, irritability and anxiety. Counselling, relaxation and meditation are also useful tools to combat premenstrual syndrome. Overall, women will experience the best results when they are treated holistically – adopting a range of modalities or therapies best suited to them.  

A referral from your GP to see a doctor specializing in PMS is also advised if the above methods are not effective.