fitness articles

Disease Management

PRE-MENSTRUAL SYNDROME (PMS)

� INTRODUCTION

� SYMPTOMS

� DIAGNOSIS

� TREATMENT

� MEDICATION

 

 

Every woman's menstrual cycle differs, both in length and symptoms experienced. The usual oestrogen and progesterone hormone cycle rotates around a 28-day pattern, with five to seven days of menstrual bleeding, a state we refer to as a 'period'. The healthier and better nourished you are, the earlier you start your periods, the more regular they will be and the longer you will have them. PMS is defined by a series of physical and emotional symptoms that occur in the luteal phase of the menstrual cycle, which is the two week timeframe between ovulation and menstruation.

 

 

Although some women seem to sail through their monthly cycles without any problems, others suffer with painful periods or find the physical and emotional symptoms and stress a great encumbrance. The symptoms include weight gain, fluid retention, food cravings, bloating, constipation, diarrhoea, breast and abdominal tenderness, headache, fatigue, energy crashes, irritability and depression. Of course these symptoms can be felt at anytime of the month, but they are most common during the week before the period and can last into the first few days. Women who suffer in this way are said to suffer from pre-menstrual tension (PMT) or pre-menstrual syndrome (PMS). 

 

 

Symptoms

 

Physical symptoms of PMS include:

• Weight gain due to fluid retention

• Painful breasts

• Headaches, migraines

• Backache, and 

• Skin disorders.

Psychological symptoms include:

• Tension,

• Irritability, 

• Depression, 

• Lethargy, 

• Food cravings, and 

• Poor concentration.

 

Many of the pre-menstrual symptoms can be alleviated by following a healthy eating plan, along with a positive state of mind and low level of stress throughout the month, but especially during the week before the period starts.

 

Diagnosis

PMS is difficult to diagnose because there is not a clear cause and the symptoms are varied and are found in other disorders. The cyclical pattern is crucial for a diagnosis: symptoms appear prior to menstruation and resolve when bleeding begins. The medical history and physical examination involve an evaluation of the symptoms and when they occur in relation to menstruation. Many health care providers advise women to keep a diary of menstrual cycles and the physical and psychological changes they experience over the course of several months. The menstrual diary provides clues to the physician and helps women understand and cope with the changes.

Treatment

Treatment focuses on relieving symptoms and involves exercise, dietary changes, and medication.

 

EXERCISE
 Exercise causes your body to produce endorphins, chemicals that make you feel exhilarated and happy. It also helps the body maintain good fluid circulation and tissue drainage and tissue drainage, which can alleviate fluid retention. Women, especially those who experience PMS, are encouraged to exercise regularly, 20-45 minutes, 3 times a week. In case, if you take vigorous exercise, you might lower your blood sugar, so take extra starchy food at the meal/snack before the exercise or soon afterwards.

 

DIETARY MODIFICATIONS
 Weight gain is the most common PMS symptom. It can lead to a number of physical problems, such as pain due to pressure exerted on organs surrounding the womb, bowel problems, breast tenderness and pain in the joints. You may put on as much as 3 to 3.5 kg (6to 8 pounds) during the week leading up to your period, with symptoms such as puffy eyes and distended tummy. Before you make any changes to your diet you need to establish whether the excess weight is fluid, fat or gas.

• CUT DOWN ON SALT

Put less sodium into your body to reduce the sodium level. A decrease in the level of salt you eat will reduce the amount of fluid you gain. Cutting down on the amount salt you put on your food and avoiding salty foods such as crisps, chips, olives, anchovies, pickled vegetables, smoked and salt-cured fish and meats, such as ham and bacon, helps your body to correct this balance. Look to other ways of enhancing flavours.

• Instead of salt experiment with herbs and spices.

• Wine is a wonderful flavour enhancer. When it is boiled the alcohol evaporates, leaving behind the aromatic 'essence' of the wine.

• Mustard really brings out the flavours of cheese. You will gradually adjust to a less salty diet and learn to appreciate the more subtle flavours that were hidden by the overriding tang of salt.

Warning: If you live in an excessively hot climate where you sweat a lot, or you're going to a hot country during the time leading up to your period, make sure that you don't cut back on your salt intake too much, as this could interfere with your fluid balance. Seek the advice of your doctor.

• INCREASE YOUR WATER INTAKE

Increasing the volume of water you drink helps your body dilute the salt level in your tissues and enables it to excrete more salt and fluid. You should aim to drink at least two to three litres (four to five pints) of water a day, especially in the week before your period. Some women find that still water lies in the stomach more easily than sparkling, as it doesn't contain gas.

• REDUCE YOUR TEA AND COFFEE INTAKE

A mistake women often make is to think that coffee and tea count as part of a healthy pre-menstrual fluid intake. Most women know that caffeine is found in coffee, but many don't realize that it is also found in traditional Indian and China tea, chocolate, cola-based drinks and even some medications such as over-the counter painkillers. Although caffeine is a diuretic, the water it makes you lose from some parts of your body actually impedes the excretion of excess salt and fluid from your tissues.

 

 

  Caffeine also aggravates the majority of hormone-based problems such as breast tenderness, headaches and the general feeling of muzziness.

 

    Herb teas are a good alternative when you want a caffeine-free hot drink. There is a huge variety available, some specially blended to give you early morning zest, others, such as camomile, for evening soothing.

• BOOST YOUR POTASSIUM INTAKE

Potassium and sodium are two minerals found in cells throughout the body. The levels of the two minerals are constantly fluctuating as they find the balance that is right for the work your body needs them to do. Boosting your intake of potassium-rich foods is an effective way of bringing down the body's sodium level. Remember, however, that you need to consider potassium, sodium and water together, and reduce your salt intake and increase your fluid intake at the same time as eating plenty of foods high in potassium, such as bananas, tomatoes, green leafy vegetables, wholegrains, and fresh fruit juices.

 

Warning: Do not think about taking a potassium supplement for fluid retention unless your doctor has prescribed it.

• USE HIGH-FIBRE FOODS WITH SOME SUGAR AS SNACKS

When you have a sugar craving, you should eat a food that has a little sugar (preferably natural fruit sugar) to satisfy your craving, but also contains fibre. The fibre releases the sugar slowly into your system and therefore helps avoid any sugar peaks and crashes. Good snacks for when you have a sugar craving include a piece of fresh fruit, a bowl of fruit compote or poached fruit, a flapjack, wholemeal or fruit scone, or a slice of cake made with wholewheat flour and/or dried fruit such as figs, dates or raisins.

 

• TRY TO RESIST THE FIRST BITE OF VERY SUGARY FOOD OR CHOCOLATE

Once you take in a small amount of these rapidly absorbed sugars your blood sugar rises. This gives you a temporary 'fix', but unfortunately the body then secretes a lot of insulin, the hormone that breaks the sugar down. The surge in insulin then causes your sugar level to crash, giving you a sugar low. This vicious circle cannot be conquered, unless you avoid starting it.

 

Try to eat 3 main meals per day with 3 smaller snacks in between, all of which should contain starchy foods. This is particularly important in the premenstrual phase of the cycle. Irregular and hurried eating habits can also increase bloating. If you leave your gut empty for a long time the secretion of digestive enzymes slows down slightly. If you then eat a lot it can over-load the gut which can cause more gas. Also, you tend to gulp more air when you eat quickly. So eat small, regular meals, slowly.

Meditation

Drugs prescribed for PMS include diuretics for fluid retention, antidepressants for psychological problems, hormones such as progesterone to relieve all symptoms, and bromocriptine for breast pain. Tranquillizers are still occasionally prescribed for some patients. Always consult your doctor before taking any medication to relieve the symptoms.