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November 19, 2010 | Comments: 0

PMS: 9 Do’s and Don’ts

There’s no agreement about what causes premenstrual syndrome. Proposed culprits range from nutritional deficiencies and hormonal irregularities to underlying emotional disorders. But here are some possible ways to get relief. 

Most menstruating women experience at least one premenstrual symptom, such as breast tenderness, bloating, headaches, fatigue, or mood swings. Usually, the symptoms are mild and manageable. In 5% to 10% of women, however, the symptoms are severe enough to be classified as premenstrual syndrome, or PMS. Symptoms may also include insomnia, aggressive feelings, and an inability to concentrate on work or even take part in family life.

PMS was named in 1953 by Dr. Katharina Dalton, a British physician who claimed that progesterone treatments would cure it (they don’t). She was instrumental in defining it as a disease, blaming PMS for female suicides and some violent crimes. Not everybody thinks this was a positive step.

If you have PMS:

• Many women find that aerobic exercise, such as brisk walking or cycling, helps PMS.

• Many women attest to the value of reducing emotional stress. This is easier said than done—but you may want to try yoga, tai chi, deep breathing techniques, meditation, or other forms of relaxation. 

• There’s preliminary evidence that calcium reduces PMS symptoms. Some doctors advise getting 1,000 to 1,200 milligrams of calcium daily from supplements (that’s the amount all women should aim for, anyway). A few years ago a study found that diets rich in calcium and vitamin D help reduce PMS symptoms. Vitamin B6, widely touted, has not been shown to be of any value for PMS.

• Some women say that limiting caffeine or sodium helps. But no research has found that caffeine is to blame for PMS, or that salt has any effect on PMS.

• Progesterone treatments don’t help PMS, according to most evidence. This is true whether the progesterone is natural or synthetic, administered orally or as suppositories.

• Be wary of herbal supplements. Many herbs (evening primrose oil, chasteberry, ginkgo biloba, black cohosh, St. John’s wort, and others) are promoted for PMS relief. There’s no convincing evidence they help.

Other therapies

• Aspirin and over-the-counter pain relievers such as ibuprofen (Motrin, for example) and naproxen (Aleve) may help PMS. You usually start one of these pain relievers seven days before your period and continue for four days after it starts. You can also try acetaminophen (such as Tylenol). We don’t recommend Midol and other tablets marketed for PMS. They usually contain a pain reliever, diuretic, and antihistamine—the last two are useless for PMS symptoms. Some PMS pills are simply overpriced pain relievers.

• Prescription antidepressants such as fluoxetine (Prozac or Sarafem) and sertraline (Zoloft) may reduce PMS symptoms. Talk with your doctor about these drugs. They may help relieve the depression and anxiety that are often part of severe PMS.

• Oral contraceptives, which depress ovulation, seem to help some women, though the evidence is not clear. One brand, Yasmin, has been found in some studies to reduce PMS symptoms. Women with migraines, diabetes, blood clotting, or a history of heart disease are advised not to take oral contraceptives.

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