Recently, I have been consulted by a few women regarding symptoms around their period. All of them experience similar bloating, headaches and mood swings as part of their symptoms and they occur every month.
One of them has severe, disruptive symptoms that means she needs to stay off work for a few days.
Such conditions are not uncommon for every healthy woman and can be called "premenstrual syndrome" or PMS. It is estimated that 85% of women experience some degree of PMS, however, only a few have severe symptoms that disrupt work or personal relationships, known as premenstrual dysphoric disorder (PMDD).
Any woman who has a period can get PMS, but some women are more likely to have symptoms, including those in their late 20s to mid-40s, and those with a history of depression or other mood disorders. Older teens tend to have more severe PMS than younger teens, and the symptoms may be more severe in their 40s.
PMS can be a concern if the symptoms occur during the five to seven days before your period, and once your period starts, symptoms end within four days and return for at least three menstrual cycles.
Common symptoms include bloating, stomach upset, headache, breast tenderness, abdominal and back pain, acne, and constipation. Some women get specific cravings when PMS strikes, often for sweet or salty foods.
Mood swings may be the worst part of PMS. Irritability, anger, crying spells, depression and anxiety may come and go during the days before the period and these symptoms are totally unpredictable
What causes PMS? The exact cause of PMS is not clear, but many believe that the changes in female hormones during the week before menstruation triggers the symptoms.
In addition, changes in brain chemicals, as well as certain lifestyle changes may play a role.
Hormone treatments, especially birth control pills, are among the most common and effective treatments. They can prevent ovulation by regulating hormones and usually reduce PMS symptoms. Other types of hormonal treatment as well as other medication (such as anti-anxiety treatments and antidepressants) are also available.
Certain lifestyle changes can also minimise PMS symptoms. Regular exercise can help boost your mood and fight fatigue. Aim for 30 minutes of moderate physical activity on most days of the week, not just when PMS symptoms appear, for it to be more effective. It is also important to find healthy ways to cope with stress such as yoga, meditation or massage.
Avoiding certain foods including salt, fat, sugar, caffeine and alcohol may help ease PMS symptoms. A diet rich in complex carbohydrates (wholegrains) may reduce mood symptoms and food cravings. Calcium-rich food, such as yoghurt and green vegetables, may also help.
If you experience mild symptoms, you may want to try lifestyle changes as well as common pain relievers first. But if the signs and symptoms of PMS are seriously affecting your health and daily activities, see your doctor for more specific treatment.
Assoc Prof Dittakarn Boriboonhirunsarn is a member of the Faculty of Medicine, Siriraj Hospital.