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Most estimates hold that 70-90% of women experience premenstrual symptoms at some point during their childbearing years. Of this group, an estimated 30-40% have PMS, with symptoms debilitating enough to interfere at least somewhat with daily living activities. Only 3-7% of women have PMDD (premenstrual dysphoric disorder). So what exactly is the difference between PMS and PMDD? "A current generally accepted definition of PMS by the gynecological community is psychological and physical symptoms that occur for up to two weeks prior to menses - with relief by the end of the menstrual period - which are moderate to severe in nature and which interfere with daily functioning. "PMDD is sort of the severe end of the PMS continuum," adds Roca. "Women with PMDD actually have impairment in either social or occupational functioning. For these women, it's fairly consistent. Most months they are impaired." To arrive at a diagnosis for either PMS or PMDD, both gynecologists and psychiatrists ask their patients to keep a "prospective diary." In these notebooks, women list and rate their physical and emotional distresses for a minimum of three months, which helps the physician correlate these symptoms with the menstrual cycle. Since there are so many varied symptoms, this diary will also help the doctor with a proposed treatment plan. For a woman to be diagnosed with PMDD, the monthly disturbances must significantly interfere with work, school, or personal relationships. If the symptoms don't abate with the end of menstruation, however, it's not PMS or PMDD. Cause : "It's still a mystery. In 1998, two intriguing studies were published. One, conducted by Drs. David Rubinow and Peter Schmidt at NIMH, investigated the long-held theory that fluctuating estrogen and progesterone hormones played a role. Interestingly, the doctors found that while the female sex hormones need to be present to trigger PMS symptoms, "the hormones themselves are not the cause of the disorder. The other study, headed up by endocrinologist Dr. Susan Thys-Jacobs at St. Luke's Roosevelt Hospital in New York, took the hypothesis that calcium deficiencies are at the heart of the PMS issue. Thys-Jacobs and colleagues researched the effect of calcium in a bone-density trial and looked at women with symptoms and women without symptoms in a clinical trial. For those women who exhibit a moderate-to-severe degree of anxiety, irritability or depression, psychiatric medications or therapy may be suggested. Still, many women find relief with a variety of therapies (such as calcium, magnesium, St. John's wort, and Prozac). Some vitamins and minerals that appear to be helpful are B-6 (50 mg, one to two times per day); calcium(1,000-1,500 mg per day); magnesium (325-750 mg per day); zinc (15-25 mg daily); and vitamin E (400-800 IU daily). As for herbs, evening primrose, flaxseed or borage oil capsules provide essential fatty acids that can help with both physical and emotional symptoms. Evening primrose oil is widely used to alleviate premenstrual breast tenderness. Herbs such as chamomile or valerian root can ease tension, but take valerian only at bedtime as it can be pretty sedating. Dandelion leaf is a good diuretic and can be used for severe fluid retention. St. John's wort (Hypericum) is widely used in Europe for the treatment of PMS, and it has been shown to be effective. I recommend 300 mg of a standardized preparation daily, increasing to 300 mg three times per day from about cycle day 10 until the start of your period. (The first day of a period counts as Day 1 of a new cycle.) This seems to be the most effective regimen, although some women need to use the higher amounts every day, and others only need to use the higher dosage from just before ovulation (which occurs about Day 14) until menses. Exercise and diet are also essential in treating PMS. Regular aerobic exercise improves moods and relieves depression; it also helps with bloating and cramps. Frequent, small high-carbohydrate meals also improve mood by elevating serotonin levels in the brain. It is important to eat complex carbohydrates such as vegetables and whole grains rather than simple carbohydrates such as cookies and candy.  TopBack Your comment |
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