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PMS, Your Treatment Options

Before we talk about your options for getting relief from Premenstrual Syndrome (PMS), let’s review what PMS is.

PMS refers to a group of physical and emotional symptoms that some women experience in the week or two before their menstrual period. Symptoms subside when the menstrual period starts and within a couple days of menstrual flow. Symptoms can range from mild to “get away from me you crazy wench” severe. Some symptoms are physical and some emotional. You may have some or all of these symptoms in varying degrees. Breast swelling and pain, headaches, cramps, nausea/vomiting, food cravings (get me some chocolate, now!), bloating, water retention leading to weight gain and swelling, fatigue, and the dreaded emotional symptoms: crying spells, depressed mood, irritability, anger, anxiety. Some of these symptoms may make you a difficult person to be around. Premenstrual Dysphoric Disorder (PMDD) is a more severe form of PMS whose treatments are similar.

So when we talk about treating these symptoms, we usually will suggest some natural treatments first, before using medications. These natural treatments include:

  • Eat regularly. Don’t skip meals. Don’t skip breakfast. Keep lunch light. Small, frequent & nutritious is the key to keep blood sugar stable. Complex carbohydrates are mood lifters e.g. baked potatoes, whole grains. Increase fruits and vegetables. East fish 2 x per week.
  • Avoid or reduce caffeine (coffee, tea, colas, chocolate)
  • Limit refined sugars
  • Reduce salt intake
  • Avoid or reduce alcohol
  • Exercise regularly 3-4 x per week
  • Use stress management/relaxation techniques such as yoga, meditation, biofeedback
  • Vitamin B6 50-100mg per day
  • Vitamin E 400 IU per day
  • Vitamin D 400 IU per day
  • Magnesium 250mg per day
  • Calcium citrate or carbonate 500mg 2 x per day
  • Get sunshine (use sunscreen though)
  • Keep symptom log daily when still sorting symptoms out
  • Try the PMS Self Help Book: A Woman’s Guide, by Susan Lark, MD

If these natural remedies don’t work, there are basically two prescription treatments used for PMS. One is the birth control pill. This works by stabilizing hormone levels throughout the month so that hormones are more balanced during this second part of the cycle when you don’t feel like yourself. While the pill may work great for many women, you may be one of those women whose symptoms worsen with the pill. A small percentage of women will have headaches and mood swings with the pill, which is another motivation for trying the natural things first.

The other prescription remedy for PMS is fluoxetine, the generic for Prozac. Yes, I see some of you cringing at the thought of taking an antidepressant for PMS, but it doesn’t just help the emotional symptoms, it helps the physical symptoms, too. The company that makes Prozac knew some women would be hesitant to take it for PMS, so they tried marketing fluoxetine as Serafem for the treatment of PMS. But since it is now available in generic, the name is not important. What is important is that this medication is right for a number of women with PMS. Again, try natural remedies first.

Better yet, make an appointment to come talk to one of us so we can find the right treatment for you.