Treating PMS (premenstrual syndrome)

Dear Readers,

P.G. is a 26-year-old woman from Kingston 10. She writes that for several years she "suffers" every month before and during her monthly period. She experiences period cramps, but that is not the worst part.

Her tummy is bloated and her breasts become very tender and swollen. She often has headaches and just doesn't feel like herself.

P.G. says that she lacks energy and feels depressed at this time. She visited a doctor about her problem and was given pain killers and 'water pills' but she still doesn't feel any better.

P.G. seems to be suffering from the condition, premenstrual syndrome. Many women have some minor symptoms associated with their monthly menses. Dysmenorrhea (pain-ful periods) and menorrhagia (heavy periods) are common and women often complain of abdominal distension at this time.

When these symptoms are exaggerated and severe enough to disrupt a woman's life at this time, then she is suffering from premenstrual syndrome (PMS).

Premenstrual symptoms occur naturally due to normal physiological changes in the body related to the female hormonal, ovarian cycle.

The majority of women cope with these symptoms but some women have such severe symptoms that their lives are totally disrupted.

Some women even feel 'mentally ill' at this time. The fact that the distressing symptoms and feelings are resolved at the end of the period is diagnostic of this disorder. The symptoms of the premenstrual syndrome are actually the same as those experienced in women normally at the time of the menses - only much more severe. The behavioural changes that occur at this time are often perceived to be even more distressing than the physical symptoms.

Behavioural and Physical Symptoms are:

Loss of control of emotions

Irritability

Anxiety

Tension

Aggression

Poor concentration

Clumsiness

Physical Symptoms

Abdominal bloating

Breast swelling

Breast tenderness

Headaches

Acne

Pelvic pain

In PMS, the normal ovarian cycle results in increased responsiveness of the body's tissues to the hormonal changes, and in particular, increased responsiveness to the hormone, progesterone.

Although women with PMS often feel bloated, research has proven that there is no increase in weight or water retention at this time. Because of this diuretics (water pills) should not be used as treatment. The bloated feeling may well be due to a gaseous distention of the bowel caused by the progesterone hormone. Progesterone causes relaxation of the muscles in the intestinal walls.

Treatment is difficult and multi-faceted. Learning how to relax and cope with stress is important. Antidepressants such as Prozac and Paxil are helpful and a few women will require hormone therapy. Danazol is used by some women to suppress the cycle altogether and prevent the syndrome.

In older women who have completed their families and suffer badly with PMS, a hysterectomy with removal of the ovaries is curative.

Dysmenorrhea (painful periods) can be treated with a non- steroidal anti-inflammatory drug (Nsaid) such as Ponstan, feldene or cataflam.

Dr. A.J. MORGAN, Contributor.

Do you have a health question? Write to Lifeline, c/o THE STAR, 7 North Street, Kingston.

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