Premenstrual syndrome (PMS)

This article was written by a nurse from one of the US clinics that wished to stay anonymous.

She shares her knowledge about emotional symptoms during PMS and how to fight them. If you found the information useful, please leave your comments.

During PMS many women experience various emotional problems like mood swings, stresses, sudden willing to cry or argue with everyone around. The most frequent emotional symptom of PMS is anxiety that causes big discomfort in everyday life.

During a long time scientists didn’t connect emotional discomfort to premenstrual syndrome, but later they realized that psychological state is directly connected to cyclic hormonal changes in the female organism, and anxiety and stress are common PMS symptoms.

Such emotional changes have various origins, not only PMS. It can be related to various problems at home or at work, conflicts in relationships, mental health disorders, etc. The environment can affect your emotional stability, causing stresses that can be regarded as PMS symptoms. Combined with hormonal changes, problems around can worsen the situation, turning woman into a deep depression.

It was found that the main reason of anxiety and other emotional changes during PMS is estrogen level changes. Perhaps severe stress is an alarm of PMDD that has a lot in common with PMS but its symptoms are much stronger and sometimes unbearable. PMDD is the most difficult case of PMS that requires medical assistance.

Every tenth woman of childbearing age suffers from PMDD in the USA. Most of them experience the same emotional problems that are typical for manic depression. As a rule patients with PMDD experience rapid mood swings from happiness in the first minute to deep sadness in the second. Such swings lead to deep emotional instability and exhaustion. Also they admit extraordinary sensitivity to things that has no matter to them before.

It is natural for women to be sensitive to different things, but the natural sensitivity has nothing in common with unbearable symptoms of PMS or PMDD especially. Stresses and feel of anxiety are only a part of possible reactions to hormones during premenstrual period, and women struggle from them each month before periods begin. The only way to fight instability is to learn how to control emotions and stresses, helping yourself to manage with PMS and return your life into the normal state.

Many specialists will advise you to take vitamins of B-group, go in for sports like aerobics, use relaxation practices like meditation and balance your diet to avoid potential impact on hormones.

Also natural progesterone creams showed effective results in treating anxiety and mood swings during premenstrual period. The alternative supplement for stabilizing emotions before periods is Kava Kava.

There are a lot of medications available today, that is why it is better to consult a doctor who can select the best treatment for your individual set of symptoms.

Don’t wonder if he will prescribe something that was not listed in this article, it is fully possible.

Do your best to tune your lifestyle on the right way and follow doctor’s advices to feel good at any period of cycle!

The PMDD symptoms are successfully obviated by several medical therapies described below.

Antidepressants (SSRIs)

Several medicines from the group of selective serotonin reuptake inhibitors (SSRIs) are successfully used to relief the symptoms of PMDD by removing their reason. These medications influence on human organism by influencing on the level of serotonin in the brain.

SSRIs whose effectiveness has been proved include the following drugs:

- sertraline (Zoloft)

- fluoxetine (Prozac, Sarafem)

- paroxetine (Paxil)

- citalopram (Celexa)

SSRI medicines are reported to be very effective therapy, as about 75% of women who used SSRIs felt significant alleviation of symptoms. Side effects, such as nausea, headaches and uneasiness are experienced by 15% of women who take SSRIs. As a rule SSRI drugs are prescribed for continuous intake or taking only during 14-days of the luteal phase. Other groups of antidepressants, as well as lithium medicines (like Lithobid) haven’t shown their effectiveness in PMDD prevention therapy.

Oral contraceptives and GnRH agonists

Other ways of PMDD treatment are avoidance of ovulation and ovarian hormones control. For this purpose oral contraceptives are used. OCPs, birth control pills change the menstrual cycle by inhibiting the ovulation process.
Gonadotropin-releasing hormone analogs (GnRH analogs or GnRH agonists) influence on hormones production and are widely used in anti-PMDD therapy. Suppressing estrogen production by influencing on pituitary gland as inhibitor of regularly hormones secretion causes the stoppage of menstrual periods. GnRH agonists are used in one of two available forms – injection or nasal.

GnRH agonists used in PMDD treatment include:

- leuprolide (Lupron)

- goserelin (Zoladex) and

- nafarelin (Synarel)

There are a whole variety of side effects caused by GnRH agonist medicines: vaginal dryness, occasional bleedings, mood swings, tiredness, hot flashes and osteoporosis (the loss of bone strength). These side effects are caused by the shortage of female hormones and can be minimized by additional intake of estrogen and progesterone.

Danazol (Danocrine)

This synthetic medicine influences on hormone balance, increasing the content of androgen (male hormone) and decreasing estrogen content in the organism. Such hormonal environment suppresses ovulation and inhibits ovarian estrogen production. Danazol is effectively used to prevent PMDD symptoms, but in 75% of cases the treatment is accompanied with various side effects including:

- Weight growth,

- oedema,

- breast size decreasing,

- male-like hair growth

- voice mutation (deeping),

- acne and oily skin,

- headaches,

- libido changes,

- mood swings.

These side effects except voice mutations are convertible. But returning to the normal state can take months or even years. That is why Danazol (Danocrine) is used only when other medications are helpless. The intake of these drugs is forbidden for women with certain liver, kidneys and heart disorders.

Other treatments

Alternative therapy of PMDD include chasteberry extract (agnus castus fruit), special diets with additional intake of calcium, B6 and E vitamins. These therapies have shown their effectiveness in relieving the PMS/PMDD symptoms.

About three fourth of women at childbearing age feel discomfort during premenstrual period caused by various symptoms of premenstrual syndrome. In 10 percent of cases premenstrual syndrome (PMS) reveals in much more serious form called premenstrual dysphoric disorder (PMDD).

The difference between PMS and PMDD is in the strength of symptoms. Being more severe, PMDD has bigger influence on women’s daily activities and psychological state. As a rule, the symptoms of PMDD reveal themselves in the last week of menstrual cycle and disappear in a few days after menstruation starts. The typical symptoms include:

1 – Depression, continual nervousness or sadness

2 – Shifts of mood with often wing-dings

3 – Heightened irritation and furiousness

4 – Apathy and loss of interest to usual day-to-day activities

5 – Pain in joints, muscular ache, headache and other flu-like symptoms

6 – Breasts hypersensitivity

7 – Tiredness and sleepiness

8 – Slumber disorders – insomnia or sleeping too much, problems with falling asleep

9 – Surfeit, constant feel of hunger or loss of appetite

The reasons of PMDD are not found yet. Most of scientists note big resemblance between PMDD and major depression. But PMDD also affects women without major depression history.

Premenstrual dysphoric disorder (PMDD) is healed by decreasing or preventing the impact of its sympthoms. The main drugs used for this are:

1 – Nonsteroidal anti-inflammatory drugs (NSAIDs) are able to relieve breast sensitivity and cramping. Advil, Mortin and other medicines of this group are usually taken before or at the beginning of menstrual period.

2 – Antidepressants including serotonin reuptake inhibitors (SSRIs) are able to ease emotional discomfort and problems with slumber.

3 – Oral contraceptives can be used to neutralize the main cause of PMDD. They stop ovulation that lead to hormonal stability.

4 – Nutritional supplements like calcium, magnesium and vitamin B-6 reduce various problems caused by PMDD. Taking them regularly helps to normalize physical and emotional state.

5 – Herbal remedies can be used to reduce emotional symptoms of PMDD and headaches, as well as improve sleep. L-tryptophan and chastberry are clinically studied remedies.

6 – Diet and regular physical exercises. They both effectively reduce premenstrual symptoms, as well as recondition the whole organism. Reducing caffeine intake may decrease anxiety and emotional instability. Carbohydrates are able to improve mood.

It is important to consult a doctor when feeling the aforementioned symptoms. Only a qualified medic can determine the origin of symptoms, if it is PMDD or other disorder. If the reason is PMDD, a doctor will prescribe specific treatment for your symptoms that will help to minimize the impact of PMDD.