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From time to time, a woman becomes very irritable and cannot sometimes explain what is responsible for such a reaction, or would later accept that a certain situation was not enough to produce a harsh reaction from her. Some women may find themselves laughing one minute and crying the next minute for no apparent reason. For others, there is a feeling of not being in control of their emotions and reactions to circumstances around them. For many who have bothered to observe it, this undesirable, seemingly uncontrollable short-lived period is commonly noticed days or weeks before the monthly menstrual period and goes away within a few days after the onset of the menstrual period. Many have often used the phrase, “It’s that time of the month” as a way of describing a female’s sudden, unexplained, unusual mood swings, physical or behavioural changes.
Premenstrual syndrome (PMS) can be described as a series of physical, psychological or behavioural changes that occur in women weeks to days before their menstrual period. Premenstrual syndrome affects only females as the name implies. It is commoner in females between the ages of 20- 40years. In some cases, PMS can lead to behavioural changes that affect the individual’s interpersonal relationships and lifestyle. There is an extreme form of PMS which is known as Premenstrual Dysphoric Disorder (PMDD) and is considered to be a mental disorder in which affected persons may become severely depressed, anxious or markedly irritable and may require medical treatment for symptoms to resolve. People with PMDD will experience the symptoms of PMS in an exaggerated way.
The exact cause of PMS is not known. However, research has shown that certain associated factors like reduction in the body’s serotonin levels, certain micronutrient deficiencies, hormonal changes (like fluctuating levels of progesterone), amongst others, have been found to be causative of the condition. Majority of females in their reproductive age are affected by PMS, though the severity and manifestation may vary amongst individuals. Some risk factors also found to be associated with increased chances of developing PMS are obesity, smoking, high sodium intake, alcohol, caffeine, excess sugar intake and positive family history of depression.
The symptoms of PMS include a history of periodic mood swings or behavioural changes that occur before the onset of the menstrual period, and gradually resolve within the first few days of the menstrual period. Many other symptoms which are usually cyclical include poor sleep, headaches, abdominal bloating, breast tenderness, anxiety, tiredness, irritability, food cravings, depression, being angry for no reason, being easily upset, having low self-esteem, weight gain, acne, confusion, delusion, hallucination, body aches/pain and in severe cases, there may be panic attacks, crying often, lack of interest in daily activities and relationships, difficulty with focusing, feeling out of control, feeling of sadness or despair amongst other symptoms. Due to the fact that the symptoms of PMS are not specific to it alone, it is important that other conditions with similar symptoms are excluded.
The diagnosis of PMS is mainly clinical after the doctor gets a health history from the affected person and thoroughly examines the person to rule out any other medical condition. Women may assist in diagnosis by keeping a record of their symptoms over a period of time so that the doctor can assess the pattern of the condition. Depression is of huge concern, but it is mostly overlooked by the affected individual and can lead to more serious consequences if not treated early.
The treatment of PMS targets the relief of symptoms. There are different modalities of management of PMS which include medical treatment, behavioural therapy, stress management techniques and psychological counselling. Medical treatment with drugs should be done by medical practitioners and not over-the-counter therapy to avoid abuse of drugs and be sure the right drugs are being used. Drugs may be required in moderate-to-severe cases of PMS. Medication like antidepressants, hormonal treatment, multivitamin, food supplements to mention a few, may be used on doctor’s prescription or recommendations. Modalities of management will depend on severity of symptoms, how it affects the quality of life of the woman and should be discussed with medical practitioners. Some other measures that may be adopted to relieve PMS (though the list cannot be exhausted) include:-
Eating a healthy diet
Lifestyle modification
Adequate relaxation and using effective stress management techniques
Behavioural counselling
Spending time on activities the person enjoys
Cutting down on excess sugar and salt intake
Identifying the condition will help the individuals respond appropriately and be aware of their emotions at all times to manage it better. Family and community support is highly essential for people with PMS as it can reduce the number of cases that progress to become severe.
Health quote of the week:
There is nothing shameful about Premenstrual Syndrome. A lot more awareness is needed to help women know about it and how to manage it better.
