PMS (Premenstrual Syndrome)
by Dr. Gary Farr on 23 November 2001

What is it? / Characteristics / Cause

What is it?

"Premenstrual Syndrome" (PMS) is the name given to the cyclic occurrence of distressing symptoms experienced by many women in their reproductive years. The symptoms usually appear 1 to 2 weeks prior to menses but diminish significantly or disappear completely within 5 to 7 days after the start of menstruation.

Up to 150 different symptoms have been reported. The most common symptoms associated with PMS are approximately as follows: 80% experience irritability, anxiety, abdominal cramps; 60% report cravings for sweets and binge eating; 40% report bloating, weight gain and fluid retention; 5-20% describe depression. Mood swings, breast tenderness, fatigue, headaches, insomnia, dizziness or fainting, crying, alternating constipation and diarrhea, allergic complaints and skin irritations are also cited.

Characteristics

Premenstrual Syndrome is one of the most common problems afflicting younger women. According to Dr. Susan Lark, a women's health expert, up to half of all American women between 20 and 50 years of age (10 to 14 million) suffer from some of the symptoms of PMS. In a six year study with premenopausal women, it was found to be present in almost every type of gynecologic problem.

According to Dr. G.E. Abraham, a noted PMS expert, PMS also has a great impact on the family and society at large. Child abuse and marital strife have been reported in some PMS patients. Over 30 years ago, absenteeism from work due to PMS resulted in an estimated loss of 5 billion dollars to the American industry. Today, with the high prevalence of PMS and more than 40% of adult American women in the work force, the loss to industry now is probably several times that amount.

Cause

Some experts believe that PMS results when there is an imbalance between specific feminine hormones. That imbalance and its possible effects are illustrated below:

Excess

Deficient

Estrogen

Progesterone

Prolactin

Prostaglandins

The Action of Feminine Hormones in PMS

Estrogen Progesterone
  • May cause bloating, weight gain and water retention by causing sodium retention.
  • May reduce bloating, weight gain and water retention by supporting sodium excretion.
  • May act as a central nervous system stimulant to produce irritability and anxiety.
  • May act as a central nervous system depressant to calm irritability and anxiety.
  • May increase histamine release which may promote skin and allergic problems.
  • May help to block histamine release which may help prevent or reduce skin and allergic problems.
  • May cause an increase in pro-inflammatory prostaglandins, producing a tendency toward pain, redness and swelling.
  • May cause an increase in anti-inflammatory prostaglandins, inhibiting pain, redness and swelling.
  • May stimulate increased contraction and cramping of the smooth muscles of the uterus.
  • May reduce contraction and cramping of the smooth muscles of the uterus.

Unbalanced nutrition may play a role in PMS development. Women with PMS in one study were shown to consume:

275% more refined sugars
45 times less vitamin B2
79% more dairy foods
6 times less niacin
78% more sodium
11 times less vitamin B5
100% less fiber
37 times less vitamin B6

12 of 14 normal women ingested nutritional supplements regularly. By contrast, only 6 of the 39 PMS patients ingested nutritional supplements on a regular basis.

23% less magnesium
15% less chromium
15% less chromium
45 times less vitamin B1
77% less manganese
52% less zinc
53% less iron

A recent survey of 502 American physicians revealed that 90% provide dietary guidance and nutritional supplements in the management of PMS.

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Symptoms, Medical Diagnosis, Medical Treatment

Symptoms

There is probably not a woman in the country who does not know what the initials PMS stand for; and few are the women who have been completely spared the physical and behavioral changes that characterize Premenstrual Syndrome (PMS). Estimates of the number of women affected by PMS vary widely. The American College of Obstetricians and Gynecologists suggests that 20 percent to 40 percent of women experience some premenstrual difficulties, with 5 percent affected significantly. Some medical experts maintain that up to 90 percent of American women experience one or more symptoms. Whatever the actual figures, women and their doctors agree that PMS is real.

PMS symptoms can begin anytime after ovulation, which occurs approximately 2 weeks before the start of your period. During the last three to 14 days of your cycle, you may notice a variety of changes in your body or disposition that can cause some degree of distress. These include:

Overall, more than 150 physical and behavioral symptoms have been associated with PMS. This complicates diagnosis and makes it difficult to classify the condition as a specific disease. And the mild premenstrual changes that many women experience have added to the confusion over PMS. Multiple severe symptoms that persist over a period of days, month after month, are more likely to be recognized as PMS than a single symptom or infrequent complaints. In addition, because the variety of symptoms and their causes are not well understood, doctors have no reliable method to determine who is susceptible to PMS, and why.

Unrelated medical problems can also mimic PMS and mislead you and your doctor. These include:

In recent years, PMS has generated a great deal of controversy in the media. While some physicians and researchers have portrayed nearly all women as suffering from PMS, generally the medical community acknowledges a significant difference between the more serious "syndrome" and the PMS "symptoms" experienced by many women.

Unfortunately, the politics of the debate have deflected attention from the very real difficulties caused by PMS. While some of the outbursts attributed to PMS have been casually dismissed as "raging hormones," family, social, and work relationships may, indeed, suffer when a woman experiences the physical discomfort and emotional peaks and valleys of PMS. Truly violent tendencies, however, are usually caused by psychological or medical problems completely unrelated to PMS.

In fact, the most convincing evidence of PMS is its cyclical nature. All symptoms -- both physical and behavioral -- should disappear rapidly once menstruation begins. If physical changes continue for more than a few weeks or fail to subside once your period begins, it's important to contact your doctor to rule out other possible medical causes. Likewise, if you feel depressed premenstrually and your mood doesn't lift when your period starts, you should bring this to your doctor's attention.

Medical Diagnosis

There are no specific blood or laboratory tests which can be performed to diagnose PMS. Standard blood tests may be needed in order to rule out other physical conditions which may have similar symptoms to PMS such as irritable bowel syndrome, depression and chronic fatigue syndrome.

Your GP may ask you to keep a 'menstrual diary' which is possibly the most useful diagnostic tool for PMS. This is kept by the patient and records their emotional and physical symptoms over at least three months. If symptoms begin around or after the middle of the menstrual cycle, and ease once the period begins then PMS is the likely diagnosis. The key here is the lack of symptoms after a period.

Medical Treatment

There is no specific medical treatment for PMS. Drugs are given for symptoms. Non-steroidal, anti-inflammatory drugs are sometimes used to relieve premenstrual pain.

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CRA Diagnosis & Nutrtional Treatment

CRA Diagnosis

The following reflexes will often be active:

Nutritional Treatment

The following supplements can help restore the various female endocrine system back to a normal state. Your doctor can best determine your specific needs.

Exercise: Many women also find that exercise produces positive benefits in moderating PMS symptoms, while improving their general health. Consider a monthly workout plan that rotates activities designed to strengthen your muscles, reduce fat, and relieve tension. Vigorous exercise—running, biking, swimming, aerobics, racquet sports and the like—has been shown to elevate your mood and improve alertness, while calisthenics and body-building tone muscles and improve strength. Contrary to popular belief, exercise helps to control—not increase—your appetite.

With your doctor's approval, try a program that mixes more vigorous cardiovascular exercises during the early days of your menstrual cycle with stretching, flexibility exercises, and less vigorous cardiovascular work such as walking on the days when you're most prone to PMS symptoms. This regimen can increase your heart-lung capacity and improve your overall physical condition while reducing the strain on your breasts, thighs, and abdomen during the latter phase of your cycle.

PMS is also associated with disruptions in a woman's normal sleep patterns. Women with moderate to severe PMS symptoms are more likely to complain of insomnia and are known to spend less time in deep sleep than those who are symptom-free. Reducing caffeine intake can help. You may also benefit from short naps on certain days. In any event, try to get at least eight hours of uninterrupted sleep each night, especially during the latter half of your cycle.

Additional Information: Read

CRA Reflex Treatment

Treatment for PMS involves the patient staying in good communication with her doctor/practitioner on a regular basis. It is important to realize that it can take several months for the symptoms to dissipate as the hormonal cycle itself is much like balancing the strings of a piano. If there are multiple organ systems involved it can take several months for all of the "musicians" of the body to play in tune.

Diet

Avoid Caffeine: Caffeine is a major culprit of PMS symptoms. Found in a variety of substances—coffee, tea, soft drinks, chocolate and some over-the-counter medications—caffeine is a stimulant that is often consumed precisely for the “lift” it provides. Nevertheless, caffeine can exaggerate PMS-related problems such as anxiety, insomnia, nervousness, and irritability, and it can interfere with carbohydrate metabolism by depleting your body of vitamin B. Reducing your caffeine intake is a smart move to counteract PMS symptoms and can provide almost instant relief. In fact, some doctors routinely advise eliminating caffeine from the diet before every menstrual period as a first step in coping with PMS. To get the entire scoop on caffeine go {caffeine} here.

Many women with PMS gain several pounds during the two weeks preceding their period, much of this in fluid weight. Avoiding salty foods can dramatically reduce bloating and water buildup, resulting in less breast and abdominal tenderness and less swelling in the hands and feet. Since brain cells also have a tendency to retain fluid, you may find that a salt-free diet eliminates or curbs headaches and allows you to concentrate better.

Avoid Sugar: Sugar can also play havoc on your body, especially in the days preceding your period. Eating sugary foods often initiates a vicious cycle of additional sugar cravings, as an increase in your body's need for B-complex vitamins prompts even more craving for sugar-laden simple carbohydrates. Although a link between PMS and difficulties in metabolizing sugar has not been proven, consuming sweets can put your body on a roller coaster between feeling weak and feeling high strung and jittery—your body's response to low sugar levels at one extreme, and elevated sugar levels at the other.

Avoid Nicotine: Nicotine, a brain stimulant, can magnify PMS symptoms much like caffeine, so reducing or eliminating smoking should be part of any treatment program. Alcohol can also intensify symptoms because it depletes the body of vitamin B, disrupts the metabolism of carbohydrates, and affects the liver's ability to process hormones.

Avoid Refined Carbohydrates: Some foods may genuinely relieve PMS symptoms. Complex {carbs} carbohydrates such as whole grains, beans, fresh fruits, and vegetables help to maintain your body's essential vitamins and minerals. Eating a low-fat diet based on grains and vegetables while reducing your intake of red meat—especially during the two weeks prior to the beginning of your period—may help to control your PMS symptoms.

Chiropractic Treatment

Chiropractic has a very impressive record in treating menstrual disorders. Go {chiro_subl} here for information regarding chiropractic treatment.

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