Cramps arent the only problem women suffer in their monthly cycles. For
many, premenstrual syndrome (PMS) can be just as bothersome.
PMS occurs in the last 7 to 10 days of the menstrual cyclecalled the
luteal phase. The time at which these symptoms occur is very important
because its what allows doctors to track their cyclic nature and make a
diagnosis.
While premenstrual syndrome remains a mysterious malady, there is growing
recognition that it is a true physical syndrome, and there are a number of
new treatments to help lessen its symptoms.
The American College of Obstetrics and Gynecology (ACOG) says from 20 to 40
percent of all women suffer some symptoms of PMS, which it defines as "a
recurring cycle of symptoms that are so severe as to affect lifestyle or
work." ACOG estimates that 5 percent of women have severely disabling PMS.
The variety of symptoms and combinations of symptoms are usually divided
into four major groups, according to Lisa Rarick, M.D., medical officer in
FDAs division of metabolism and endocrine drug products. Breast tenderness,
swelling, weight gain, and bloating comprise one group of symptoms. A second
group includes emotional changes such as depression, forgetfulness, crying,
insomnia, and confusion. A third group involves headaches, food cravings
(especially sweets), increased appetite, fatigue, and dizziness. The fourth
group includes anxiety, nervous tension, mood swings, and irritability.
For the most part, PMS is alleviated by treating its symptoms. For example,
for those who suffer from symptoms of water retention, diuretics may help.
They are a component of many OTC medications for PMS. In 1988, FDA
tentatively proposed that three OTC diuretics could be used in menstrual
drug products (including those that treat PMS): caffeine, ammonium chloride,
and pamabrom.
It is believed that caffeine may help relieve bloating and water retention
because it acts as a mild diuretic, and that it also may help relieve the
fatigue many women complain of in the premenstrual period. On the other
hand, excessive amounts of caffeine may aggravate anxiety and tension, and
some doctors think it may be associated with increased breast tenderness.
Some over-the-counter medications for PMS combine several ingredients. One
product, for example, contains pyrilamine maleate (an antihistamine approved
for OTC use but not specifically for PMS), pamabrom and acetaminophen. Women
should read the labels of OTC products and check with their doctors for
advice on the best treatments for the specific PMS symptoms they have.
Some doctors believe women may be able to help themselves through the
discomfort of PMS without pills by exercising, eliminating or cutting down
on smoking, and changing their diets.
"I recommend eating small frequent meals because a lot of food causes blood
sugar to swing up and down, and that may effect premenstrual problems," says
M. Yusoff Dawood, M.D., director of the Division of Reproductive
Endocrinology at the University of Texas Medical School in Houston.
To stem water retention, many doctors recommend reducing salt intake, and to
reduce headaches, avoiding liquor. No scientific studies have proven that
exercise can reduce PMS, but there is much anecdotal and indirect evidence
that it does, doctors say.
"The idea is that exercise raises levels of beta endorphins, [which] have a
positive effect on mood and behavior," says Michelle Warren, M.D.,
co-director of the Division of Reproductive Endocrinology at St.
Lukes-Roosevelt Hospital in New York City. Moreover, she believes exercise
may reduce water retention.
Vitamin B6, known as pyridoxine, is recommended by some doctors to relieve
PMS, but studies on its effectiveness have been inconclusive, according to
Dawood. Use of extreme doses of it have been associated with neurological
problems.
For those whose PMS is unrelieved by most common treatments, more help is
available. While not approved for these uses by FDA, some doctors prescribe
birth control pills and use of progesterone suppositories (during the
premenstrual phase) for PMS. Oral contraceptives prevent ovulation and
therefore prevent the luteal phase from occurring. Although progesterone
suppositories have proven no more successful than a placebo in controlled
studies, because they seem to help some women, Warren believes they are
worthwhile. Prescription painkillers, diuretics, tranquilizers, and
antidepressants are also prescribed by physicians in severe cases.n
Hilton Johani is a leading expert on period pains,Tinnitus, hyperacusis and Menieres disease and has been assisting John Currie in running his tinnitus related website since 1999.
His advice and tinnitus treatment plans have helped thousands of people around the world.
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