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Those difficult days

Understanding the symptoms and maintaining a positive attitude help handle premenstrual syndrome

MANONMANI DREADS getting her periods. She knows that for a few days before her periods, she will be irritable, cry at the least provocation and just will not have the energy to carry on her normal routine. On those days, her home could easily qualify as a war zone. What is worse, she cannot lose her temper at any time, without her family wondering if it was "that time of the month again"!

Manonmani has premenstrual syndrome or PMS. PMS is the combination of physical and emotional symptoms that some women have before their menstrual period begins. At least 75 per cent of all menstruating women have some symptoms of PMS.

Symptoms vary from woman to woman and may be mild to moderate. PMS usually starts worsening in the thirties and can continue till menopause. Rarely, women have severe symptoms such as anger that is out of control. This can seriously disrupt family routine and might require psychological counselling.

Why does PMS happen?

PMS is related to hormonal changes during the menstrual cycle. A single cause has not been found. The emotional symptoms may be related to an imbalance of the hormone serotonin in the brain, which can lead to depression and irritability. PMS symptoms usually occur during the second half of the menstrual cycle. Often the symptoms start a few days before the menstrual period, but they may start as much as two weeks before the period.

Physical symptoms may include a bloated stomach, swollen feet or hands, tender, enlarged breasts, cramps in the lower abdomen, weight gain, headache, nausea, vomiting, diarrhoea, constipation, appetite changes, joint or muscle pain and acne.

Some women experience sleeplessness and many others have palpitations. Emotional symptoms may include irritability, anger, depression, anxiety, tension, fatigue, lack of energy, lack of concentration, crying spells, feeling overwhelmed or out of control, lack of or decrease in the sex drive. Girls and younger women may also find that their mathematical abilities seem to deteriorate premenstrually!

Many women who have PMS also experience difficulties in their relationships with families and friends.

If you suffer from moderate to severe PMS, don't despair. You are not alone. There are many women who have the same problem. You have to remember that it is not your fault, but caused by the dynamics of changing hormone levels. You need to focus on feeling good. Most importantly, this is the worst time to get confrontational with your husband, children or in-laws! Walk away from an argument. Tell them you are not feeling quite rational at that particular moment.

Regular exercise has definitely been shown to reduce the symptoms of PMS. Stress reduction techniques like meditation, pranayama, and listening to music are potent remedies. Cutting down on coffee and tea, sugar and salt can contribute to better handling of PMS.

Alleviating the pain

The physical symptoms of PMS, like pain and cramps can be alleviated with the use of anti-inflammatory drugs like naproxen or ibuprofen. There are newer drugs that reduce the pain and cramps and your gynaecologist can advise you on that. In severe cases, your gynaecologist might have to prescribe anti-anxiety drugs. Usually these are reserved for women whose quality of life is severely affected by PMS.

There is no reliable way to prevent PMS because the cause of this disorder has not been identified. Hormonal treatment, including birth control pills, does not help with PMS. You may be able to lessen the symptoms if you eat a healthy diet, maintain a normal weight, exercise regularly, and take anti-inflammatory drugs when necessary. Understanding your symptoms and maintaining a positive attitude will help you handle PMS better.


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