Pre-Menstrual Syndrome (affectionately called “Pissed at Men Syndrome”) or Pre-Menstrual Dysphoric Disorder are the labels given to the condition of  exaggerated mood swings, emotionality and physical symptoms that may accompany a normal hormonal fluctuation of a menstrual cycle.   Most women find that they notice some mild changes but are not seriously affected. Unfortunately, some women and teens can become nearly non-functional for the week or so before their periods.  Testing hormones is not helpful at all.
Some women experience significant breast swelling and tenderness, bloating, cravings, water retention, bowel function changes, headaches, moodiness, anger, rage, sadness, crying spells among other symptoms.   As with all conditions, we start with the basics:  *Diet and Exercise.  Low carb, low sugar, high water, whole foods, good protein, lots of fruits and veggies, no processed or junk foods, and good vitamins, especially D3, especially in the winter are all key to better mood and less PMS symptoms over all.
    
* Exercise is a word most people cringe to hear (including me), but “get active” is something we can all do for a simple 10 minute walk daily.  Also, create at least 10 minutes of *time for yourself EVERY day to walk, relax, unwind, breathe, clear your mind, be present, and listen to your heart.  Some call this prayer, or meditation, either way, empty your mind and stay alert for solutions that arise in this stress reduction downtime.  This is critical to do often.
Next most important is good solid *sleep, for 6 – 8 hours per night.  People literally go insane when the brain is deprived of its critical assimilation time.  And put down all those *electronic devices as much as possible!  Our current society’s overly intense bombardment of info through computer, internet, phone, messaging, emails, TV, i-pads, etc. can muddle thinking and worsen mood by constant overstimulation.
     
* Less caffeine improves breast tenderness, and NO smoking also decreases inflammation and helps mood.  Smoking also interferes with hormonal function by lowering estrogen effects and creating hammock-woman2.jpg inflammation, worsening all PMS symptoms.  For this and many heart and lung health reasons, it is important to *STOP tobacco use.  There are a number of *Herbs to try such as Black Cohosh, Vitex, Dong Quai, Red Clover, and Evening Primrose Oil (EPO).  The 2 I see work best are Vitex (Chaste Tree Berry) and E.P.O.  1,000 mgs of EPO 3 – 5 times a day helps well with breast pain.  Please come in for a discussion so we can tailor these potential options to your needs.  NSAID’s such as Motrin, Aleve, Ibuprofen, or 500mgs of magnesium can help with menstrual pain.  See next newsletter for more info on Pain.  There are many convincing studies that show *Medical Cannabis helps well for period pain, but cramps are NOT a current indication for certification of legal use in NH, ME, or MA.
The *Birth Control Pill helps lots of women minimize the normal fluctuations in estrogen and progesterone, and reduce the symptoms of PMS.  There are lots of pros and cons to using the pill and this must be tailored to each patient.  Sometimes it takes a few tries to find the best prescription to help these issues.  Some pills actually worsen some symptoms in some women, so be cautious.
If there is a mood concern for more than 10 days before a period starts, then there may be an underlying anxiety or depression issue which gets worse when estrogen levels drop.  If this is the case, all of the above can certainly help along with seeing a *therapist, and working on *stress management.
If that is not enough, *Prozac, in low doses for short periods of time can improve not only the mood premenstrually, it also helps lower water retention, breast tenderness and other physical symptoms as well.  We must discuss the pros and cons of any medication before trying it out.  So if you are having problems, please try the simple ideas above, or come in to review your treatments options for feeling better.  And don’t forget, *laughter is the “Best Medicine”, so don’t take yourself too seriously.