subject: Management of Pre-menstrual Syndrome [print this page] Management of Pre-menstrual Syndrome Management of Pre-menstrual Syndrome
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Pre-menstrual syndrome (PMS) is defined as a disorder of non-specific somatic, psychological or behavioral symptoms recurring in pre-menstrual phase of menstrual cycle.
The symptoms should be of sufficient severity, so as to produce social, familial or occupational disturbances. Symptoms must have occurred in at least four of previous six cycles.
Five to fifteen percent of women often result in work or social impairment and another 30-50% experience some type of pre-menstrual discomfort. Approximately 30% of women seeking treatment for PMS have a chronic psychiatric disorder.
Symptoms: The exact etiology of PMS is not well understood. Some of suspected causes are: excess estrogen level in blood, fluid retention, Vitamin B6 deficiency, progesterone hormone deficiency, hypoglycemia, excessive serum pro-lactin level, serotonin deficiency and thyroid abnormality.
Since the inception of this entity, more than 150 symptoms have been described. Out of these the more common one are: depression, fatigue, social withdrawal, confusion, angry outbursts, breast tenderness, vague aches and pains, abdominal bloating, oedema, weight gain and mastalgia (pain in breasts).
Treatment of PMS: An individualized approach should be taken, though many pharmacological agents have been tried, no drug has shown universal benefit. Recently many experimental evidences have supported the "self-help therapy" as a first line management of PMS, and this has benefited about 50-70% of patients. This includes education about dietary modification, lifestyle recommendations and vitamin and mineral supplementation.
Dietary Modification includes: losing weight if obese, eating regularly, reducing the intake of salt; caffeine; sugar and junk food, limiting the intake of animal fats, reducing the use of tobacco and alcohol, by eating plenty of nutritious; wholesome foods and by taking frequent meals.
Use of evening bright lights (Phototherapy) improves sleep patterns in women with PMS. Amongst the vitamins- vitamin A, E and B6 have been used in various trials; many studies have shown that a daily dose of 100 mg of vitamin B6 helps in ameliorating PMS syndrome. Lifestyle Modification includes regular exercise, relaxation, communicating with partner and family members and good sleep in night.
Drug therapy is used for specific complaints. For example, for breast tenderness, a support bra can be employed and oral contraceptive or bromocriptine is recommended. Beside this spironolactone or any other diuretic can be given for excessive weight gain. The total duration of PMS therapy may vary from 2 years till menopause. More research is required to define its etiology and finding a definite cure.
