Premenstrual Syndrome (PMS) Care

Prior to the monthly periods, most women can see and feel certain changes in their bodies and their feelings. The changes occur due to the normal fluctuations in hormones throughout the menstrual cycle. These changes, when they become problematic and interfere with daily living are referred to as Premenstrual Syndrome (PMS).

PMS typically starts 5 to 10 days before the onset of menstruation and gets better as the menses begin. PMS can be different for each woman. Some experience only mild symptoms, others struggle to get along at work, in school or with family.

Physicians think PMS is related to hormone and brain chemical fluctuations, such as serotonin. A healthy lifestyle and early treatment can help to minimize signs and symptoms and overall wellbeing.

What is premenstrual syndrome?

Premenstrual Syndrome (PMS) is a collection of physical, emotional and behavioural changes that happen prior to menstruation and subside soon after.

PMS is very common, seen in women of reproductive age. The symptoms recur monthly.

What causes Premenstrual Syndrome?

The reasons for this remain unclear, however, there are a number of possible explanations:

• Stress, fatigue, low energy, nutrition, or exposure to alcohol or drugs.
• Changes in the level of serotonin in the brain.
• Stress
• Lack of sleep.
• Poor diet.
• Family history.
• Low physical activity.

What are common symptoms of PMS?

Physical symptoms

• Bloating
• Breast tenderness.
• Headache
• Back pain.
• Fatigue
• Water retention, or weight gain.
• Acne
• Aching knees and joints.
• Food cravings.

Emotional symptoms

• Mood swings.
• Irritability
• Anxiety
• Sadness
• Feeling overwhelmed.

Behavioural symptoms

• Difficulty in concentrating.
• Poor sleep.
• Changes in appetite.
• Low motivation.
• Social withdrawal.

Symptoms tend to get worse after the first menstruation.

Which of the following individuals is at the greatest risk for developing PMS?

PMS is a problem of any menstruating woman, but occurs more often in women who

• Have a 20- to 40-year age range
• Be predisposed to PMS by family history
• Experience high stress
• Have a history of depression or anxiety.
• Do not exercise regularly
• Consume junk food on the regular basis

How is PMS diagnosed?

No single lab test needed.

Doctors usually:

• Ask about symptoms
• Review menstrual history
• Conduct a physical exam
• For at least two menstrual cycles, ask women to maintain a symptom diary.
• Monitoring symptoms can be used to verify the symptoms present before and improve after a period.

For PMS, what lifestyle changes can be made to help manage it?

Adopting healthy habits can minimize many PMS symptoms.

Healthy diet

• Fruits
• Vegetables
• Whole grains
• Lean protein
• Nuts and seeds

Reduce:

• Salt
• Sugar
• Fried foods
• Caffeine
• Alcohol

Regular exercise

Do 30 minutes of exercise daily, except as noted above.

• Walking
• Cycling
• Swimming
• Yoga

Exercise helps to alleviate stress and enhance mood.

Good sleep

• Get 7-9 hours of sleep each night.

Stress management

• Deep breathing
• Meditation
• Yoga
• Relaxation techniques

Which drugs are prescribed for PMS?

Treatment is based on the severity of the symptoms.

Doctors may recommend:

• Headache Pills or Neck pain relievers for Cramps.
• Hormonal contraceptive pills.
• Diuretics for bloating.
• Supplements of calcium and Vitamin D as required.

Always take medicines under medical supervision and avoid use of antidepressants (SSRIs) for severe mood symptoms.

Are vitamins and supplements beneficial?

For some women, symptoms may be alleviated by some supplements.

These include:

• Calcium
• Vitamin D
• Magnesium
• Vitamin B6

Please seek advice from a health care professional prior to using supplements.

When do people need to go to see a doctor?

Don’t hesitate to call for medical advice if:

• Symptoms disrupt work or school activities.
• Daily routines are difficult to carry out.
• Severe depression occurs.
• Feeling of self-harm begins to form.
• heavy bleeding.
• Symptoms lasting throughout the month.
• Episodes of loss of consciousness.
• Severe abdominal pain.

Treatment at an early stage can help to improve quality of life.

Can PMS be prevented?

It is not always possible to completely avoid PMS, but it is often possible to minimize symptoms.

Helpful habits include:

• Good Diet: Eating a diet rich in fruits, vegetables, whole grain, and lean protein can help keep hormones in balance which can minimize the symptoms of PMS, including mood swings, fatigue and bloating.
• Reduce Alcohol Use: Excessive alcohol use can disrupt sleep and cause mood swings. Alcohol abuse can exacerbate the symptoms of PMS, so reducing the amount of alcohol consumed can diminish symptoms.
• Drinking Water: Drinking lots of water can help ease bloating, digestive problems and normal bodily functions and help symptoms of PMS to be less painful.
• Regular Exercise: Exercise regularly and this has been found to improve circulation, lower stress levels, increase mood and also help with PMS symptoms such as irritability and fatigue.
• Proper Sleep: Sleep is crucial for emotional and physical health, and should be adequate and regular. Mood swings, tiredness and a lack of concentration will be reduced during the premenstrual period if sleep is of a good quality.
• Avoid Smoking: Smoking can aggravate PMS symptoms, due to it affecting the hormone levels and overall health. If you don’t smoke tobacco, you can help manage your symptoms and live a better life.

Which Modern Innovations are includes in PMS Care?

Medical technology is helping women with managing PMS.  Mobile apps for tracking menstrual cycles are becoming increasingly popular.

Women can use apps to:

• Track symptoms.
• Predict periods.
• Record mood changes.
• Monitor pain levels.

These records assist medical providers to make better therapy choices.

Wearable health devices

Smart watches can monitor:

• Sleep
• Heart rate.
• Physical activity.
• Stress levels.

This information enables women to detect patterns of symptoms.

Telemedicine

Women can access medical information without having to go to the hospital in online consultations.

These enhances specialist access, particularly in rural areas.

Digital Cognitive Behavioural Therapy (CBT) is a form of psychotherapy which helps individuals to find and modify their negative patterns, behaviour and thoughts.

Online CBT courses offer women instruction on how to handle:

• Anxiety
• Mood swings
• Stress

Emotional symptoms have been positively affected by these programs.

Artificial Intelligence (AI)

Academic researchers are working on AI technologies that can decode the patterns of symptoms and predict bad PMS days.

In the future, AI systems can suggest individual treatment plans.

Personalized Hormone Testing

Hormone patterns are being researched to try to identify women who might benefit from individualised treatment.

Personalized care is still in its infancy, but has the potential to enhance outcomes for the future.

Nutritional Precision Medicine

Researchers are looking to see if genetic and gut microbiota-based personalized nutrition can enhance PMS symptoms.

Further study is required before it can be used regularly.

Premenstrual Syndrome is one of the common health issues that includes physical and emotional health prior to the start of the menstrual cycle.

The exact cause of the disorder is not known, but lifestyle changes, exercise, diet and stress management along with proper medical treatment are effective in reducing the disorder’s symptoms. Raising awareness, early diagnosis and personalized care are crucial to women’s health.

New technologies are coming to the market, like tracking apps for menstruation, telemedicine, wearable technology, digital CBT and artificial intelligence, that will help to manage PMS better.

Research into the future will help to discover safer and more effective and targeted treatments.