Premenstrual Syndrome – Diagnosis and Treatment
Diagnosis
Doctors cannot confirm premenstrual syndrome (PMS) with a single test or physical exam. Instead, they look for a clear pattern of symptoms that happen before each period.
Patients should track their symptoms and menstrual cycles for at least two months. Keeping a record helps both the patient and doctor notice when PMS or premenstrual dysphoric disorder (PMDD) symptoms begin and end.
Common steps in evaluating PMS and PMDD include:
- Keeping a daily record of physical and emotional symptoms
- Tracking the start and end dates of menstrual periods
- Noting when symptoms disappear
Some health problems, like thyroid disorders, mood disorders, or chronic fatigue syndrome, can look similar to PMS. Doctors may order thyroid tests or mood screenings to rule out these conditions.
This process helps make sure the diagnosis is accurate and not caused by another issue.
Treatment
There are several ways to manage premenstrual syndrome (PMS). The treatment depends on how severe the symptoms are.
Medication Options
Doctors may recommend medications to control PMS symptoms.
- SSRIs (Selective Serotonin Reuptake Inhibitors): These medicines can improve mood symptoms. Patients may take them daily or only during the two weeks before a period starts.
- NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Ibuprofen and naproxen sodium can relieve pain, cramping, and breast discomfort when taken before or as symptoms begin.
- Diuretics: Doctors sometimes use spironolactone to help reduce bloating and water retention.
- Hormonal Contraceptives: Some oral contraceptive pills can prevent ovulation and may reduce PMS symptoms.
- Other Treatments: If regular treatments do not help, doctors may use gonadotropin-releasing hormone agonists or danazol.
Some dietary supplements, such as vitamin B6, vitamin E, and calcium, might offer mild relief for some symptoms. People should talk to a doctor before starting any supplement.
Taking Care of Yourself
Make Changes to What You Eat
Eating habits can affect premenstrual symptoms. Smaller, more frequent meals may help decrease bloating.
Limiting salt and salty snacks can reduce water retention. Eating more fruits, vegetables, and whole grains adds complex carbohydrates that support well-being.
Calcium-rich foods or a calcium supplement can also help, especially if dairy isn’t part of the diet. Cutting back on caffeine and alcohol is best since these can worsen symptoms.
Add Physical Activity to Your Daily Life
Regular aerobic activity, such as brisk walking, cycling, or swimming, can help. Aim for at least 30 minutes on most days.
Exercise can improve energy levels and mood. Physical activity supports a healthy body and can ease fatigue and emotional ups and downs.
| Activity | Suggestions |
|---|---|
| Walking | 30+ minutes per day |
| Cycling | Try to go regularly |
| Swimming | Join a local pool |
Find Ways to Lower Stress
High stress can make symptoms more intense. Sleep is very important for feeling well.
Practicing muscle relaxation or deep breathing may help with headaches or sleep problems. Yoga and massage can also help reduce anxiety during this time.
Keep Track of Your Symptoms Over Time
Writing down symptoms every month can help spot patterns. This record shows if certain things make symptoms better or worse.
Keeping a journal lets people try different self-care strategies and notice what helps.
Alternative Medicine
Some people use other methods to manage symptoms tied to hormonal changes, like mood swings, anxiety, and depression before their period. Several vitamins and minerals are often considered, such as calcium, magnesium, vitamin B6, and vitamin E.
These nutrients may help with symptoms, but strong evidence is still limited.
Herbal products are also used by some people. Items like chasteberry, ginkgo, ginger, evening primrose oil, and St. John’s wort are chosen for their possible effects on mood and discomfort.
These remedies are not checked or approved by official agencies, so their safety and real effects are not always clear.
The table below shows some commonly used alternative remedies for PMS-related symptoms:
| Remedy | Possible Benefits | Notes |
|---|---|---|
| Calcium, Magnesium | May help mood swings | Limited scientific support |
| St. John’s Wort | Mood improvement | May affect other medicines like birth control |
| Acupuncture | Symptom relief | Some find it helpful |
Always talk to a health professional before starting these options, especially if you are taking medicines for mood disorders or antidepressants.
Getting Ready for Your Visit
Steps to Take Before Your Appointment
Plan ahead so your appointment goes smoothly. Check if you need to do anything before your visit, like fasting or bringing medical records.
Call the office if youโre not sure. Keep a record of your symptoms.
Write down details such as when they happen, how strong they are, and if they are linked to a certain part of your menstrual cycle, like the luteal phase. Note if your symptoms began after menarche or if they have changed with age.
List all current medications, supplements, and vitamins. Bring this list with you.
Include treatments for any other health problems. This helps your doctor understand your health better. Prepare some questions in advance.
For example, you may want to ask:
- What lifestyle changes might help lower my symptoms?
- Do symptoms usually get easier with time or age?
- How do I know if my symptoms are part of PMS or something more serious?
- Are there good treatment options, and are generic versions available?
- Where can I learn moreโare there trusted sites like Healthnile or printed materials?
Bring a notepad and pen. Use these to write down answers or advice during your visit.
Hereโs a quick checklist:
| What to Bring | Purpose |
|---|---|
| List of symptoms | Helps track patterns and severity |
| Medications list | Ensures accurate treatment |
| Written questions | Makes sure all concerns are addressed |
| Notepad & pen | Take notes during appointment |
Questions Your Doctor May Ask
The doctor will likely ask questions to better understand your situation. These may include:
How do your symptoms affect your everyday life?
Are some days of your cycle, such as the days before menstruation, worse than others?
Do you notice symptom-free days during the month?
Can you predict when symptoms will begin based on your cycle?
What helps your symptoms, and what makes them worse?
Have you noticed changes in your mood, like feeling sad or hopeless?
Has anyone in your family had mental health issues?
What have you tried so far for relief? Did anything help?
Bring clear information about your menstrual cycle. Share any lifestyle changes you have tried. This will help your doctor understand your situation and suggest the best next steps.
