The last week of a woman’s menstrual cycle is often a bad time for her both physically and emotionally. Premenstrual syndrome or PMS as it is commonly known is a medical condition that requires treatment when the symptoms cause distress. Women are often hesitant to voice their experiences with regard to PMS for fear of being thought 'fussy'. However, there are over 150 reported symptoms of PMS, some of which may continue even after the period starts. This section discusses a number of frequently asked questions about PMS:

• What is PMS and how many women suffer from it?
• What causes PMS?
• What are the symptoms of PMS?
• Do you need to see a doctor for PMS?
• How is PMS treated?
• Things you can do to help reduce the severity of PMS

What is PMS and how many women suffer from it?

Premenstrual syndrome (PMS) is the term to describe the physical and emotional symptoms that some women experience during the last one or two weeks of the menstrual cycle (usually the week just before the next period). Sometimes, PMS symptoms persist even after the period begins. It is estimated that about 40 per cent of all women suffer from some of these symptoms. PMS symptoms vary from one woman to another in both type and severity. PMS often gets worse as a woman grows older, being at its worst in the 20s and 30s and disappearing after menopause.

What causes PMS?

The cause of PMS is not known, but it is related to hormonal changes during the menstrual cycle. Research has indicated that women who do not have enough zinc, magnesium, Vitamins E and B6, or certain fatty acids in their diets are more likely to have PMS. It is often difficult to diagnose PMS as some PMS symptoms are also symptoms of depression, endometriosis, and thyroid disease (these are also likely to get worse during the pre-menstrual phase).

What are the symptoms of PMS?

• Physical symptoms: Swollen feet and hands; bloated abdomen; enlarged and tender breasts; weight gain; pain in the joints; cramps and lower abdominal pain; skin rash and blemishes; headache; nausea, vomiting, diarrhoea or constipation; backache; altered eating habits, with cravings; and asthma.
• Emotional symptoms: Irritability, moodiness, anger, depression, anxiety, tension, tiredness, difficulty in concentrating, and nervousness.

Do you need to see a doctor for PMS?

If the symptoms of PMS cause a lot of discomfort and disrupt your ordinary lifestyle, it is a good idea to seek a doctor’s help. A woman who suffers from PMS may be asked to keep a calendar or journal in which she notes down symptoms and their date of occurrence.

How is PMS treated?

The kind of treatment adopted for PMS depends on the kind of symptoms experienced. There are a number of things you can do to reduce the severity of PMS. If they do not alleviate the symptoms, a doctor may prescribe multivitamin or mineral supplements such as Vitamin B complex, magnesium and calcium. Other medication prescribed includes hormone treatments, anti-depressant drugs, mild tranquillisers, birth control pills, and diuretics to reduce bloating. Some doctors prescribe nutritional supplements containing evening primrose oil, a good source of gamma linolenic acid (GLA), an essential fatty acid. A lack of GLA could be related to PMS symptoms in some women.

Things you can do to help reduce the severity of PMS

Changes in your lifestyle could markedly improve PMS. These are some of the things you can do to reduce the symptoms of PMS:

• Increase the level of serotonin in your body: Low levels of a neurotransmitter called serotonin could result in feelings of depression. Serotonin levels can be boosted pre-menstrually by eating starchy food like rice, chapathis and potatoes. Imbibing carbohydrates through snacks can help, but research indicates that the carbohydrate should not be combined with fat and protein. Unsalted popcorn without butter or oil is an example of such a snack.
   
• Don’t drink too much coffee: Caffeine (a substance that coffee contains) is a stimulant. Too much caffeine in the premenstrual phase only serves to increase irritability and anxiety. If you are addicted to coffee, reduce your intake gradually, over a number of days, and not abruptly.
   
• Get into a regular exercise programme: Regular exercise can really help reduce the symptoms of PMS. Exercise helps to elevate your mood and fight tiredness. It also helps to increase blood circulation and this reduces fluid retention in your body. Many women find a daily walk very beneficial in fighting PMS. Yoga is also recommended both to relieve stress as well as to stretch and exercise the pelvic muscles.