Premenstrual Syndrome

WHAT YOU SHOULD KNOW:

• Premenstrual (pree-MEN-stroo-al) syndrome is also known as PMS. It covers a group of symptoms that may begin one or two weeks before menstruation (your monthly period). These symptoms usually go away soon after the start of your period. PMS may be worse some months and better others. It can affect the way you act or feel. About half of all women have PMS at some time. It can happen to any woman having her period, but is most common in women ages 25 to 40.
  
  
• Changes in hormone levels (chemical messengers in the body) may cause PMS. Changes in brain chemicals may also cause PMS. Things that may make PMS worse are a poor diet, lack of exercise, or eating and drinking too much caffeine. Symptoms of PMS may be worse if you have stress or mental problems. Caregivers do not know why some women have PMS worse than others. PMS symptoms may be helped by diet, lifestyle changes, and medicines.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• Your medicines may include:
  
  
  • Over-the-counter pain medicine: You may use over-the-counter (OTC) pain medicines, such as ibuprofen or acetaminophen, for pain or swelling. These medicines may be bought without a caregiver's order. These medicines are safe for most people to use. However, they can cause serious problems when they are not used correctly. People with certain medical conditions, or using certain other medicines are at a higher risk for problems. Using too much, or using these medicines for longer than the label says can also cause problems. Follow directions on the label carefully. If you have questions, talk to your caregiver.
    
    
  • Diuretics: Diuretics are often called "water pills." This medicine helps your body get rid of extra fluid. Some OTC pain medicines and herbal supplements may also act like diuretics. Ask your caregiver before taking any of these products.
    
    
  • Antidepressants: This medicine may be given to help improve your mood or behavior. Sometimes it is given only during the last two weeks of your menstrual cycle. Some vitamins, herbal supplements, or food supplements may interact with this medicine. Ask your caregiver before taking these products.
    
    
  • Hormonal contraceptives: Caregivers may give you hormones if your PMS is very bad. This medicine helps to even out the changes in hormones that may be causing your symptoms.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Home care:

• Record your symptoms: Use a diary or calendar to keep a record of your symptoms during each month. This record should include when your periods start and stop. Also include your symptoms, such as changing moods, behavior, and physical changes. Write down if your symptoms were mild, moderate, or severe. Record your symptoms for at least two cycles (months) so that your caregiver can check for any patterns. This record can help your caregiver focus on which of the problems are most bothersome and should be treated first.
  
  
• Activity and rest:
  
  
  • When having PMS symptoms, try to stay away from people or activities that cause you to feel upset or stressed. Stress often makes PMS symptoms worse. Yoga, relaxation exercises, or biofeedback may also help you decrease stress. Ask your caregiver for more information about any of these.
    
    
  • Exercising at least three times a week may decrease stress and PMS symptoms, and help you feel better. Try to exercise for at least 20 to 45 minutes at a time. Talk to your caregiver before you start exercising. Together, you can plan an exercise program that is right for you.
    
    
  • To help you sleep better:
    
    
    • Avoid drinks that contain alcohol or caffeine in the late afternoon or evening. Also avoid nicotine (tobacco products).
      
      
    • Do not exercise within three hours of going to bed.
      
      
    • Make your bed a place for sleep and relaxation. Try not to eat, read, work, or watch television in bed.
      
      
    • Go to bed at the same time each night and get up at the same time every day.
      
      
    • Get a good amount of sleep every night. Most people need six to eight hours. Ask your caregiver how many hours of sleep you should have.
  
  
• Diet and nutrition: Eat a variety of healthy foods every day. These should include fruits, vegetables, breads, dairy products, and protein (meat, beans, and fish). Eating healthy foods may help you feel better and have more energy. Other ways to improve your diet and decrease PMS symptoms include the following.
  
  
  • Do not eat foods that have a lot of salt. Eating less salt may help decrease body swelling. Read labels on food or drink packages to find out how much salt (sodium) is in the food or drink. Do not eat or drink more than 3000 mg (milligrams) of sodium a day.
    
    
  • Avoid foods and drinks have caffeine in them, such as chocolate, coffee, some teas, and soda. Too much caffeine can make you feel more nervous or moody.
    
    
  • Eat more fiber. Fiber is found in fruits, vegetables, and whole-grain breads.
    
    
  • Decrease the amount of fat in your diet. Avoid snack foods, processed foods, and fast foods. Try to eat lean meats, which are meats that have little or no fat in them.
    
    
  • Eat less sugary food. Read package labels to find out how much carbohydrates (sugars) are in the foods you eat. Sugar may be called "sucrose," "fructose," "corn syrup," or "high fructose corn syrup." If you feel the need to eat sweets, try foods high in healthier complex carbohydrates instead. Examples of foods rich in complex carbohydrates include pasta, whole wheat breads, cereal, and potatoes.
    
    
  • Increase your intake of calcium-containing foods. Some foods that contain calcium are dairy (milk) products, broccoli, salmon, and some types of nuts (almonds and brazil nuts).
    
    
  • Avoid drinks that contain alcohol for one week before your period.
    
    
  • Your caregiver may want you to take calcium, magnesium, or certain vitamins. Taking these supplements may help your PMS. Ask your caregiver for advice before taking herbal supplements for PMS. Some supplements may interact with your other medicines. They may also worsen your PMS if they are taken the wrong way.

Coping:

Accepting that you have PMS may be hard. Talk about how you are feeling with your caregiver. A counselor may help you learn to decrease stress and handle problems in your life. Learn as much as you can about PMS. Your caregiver can suggest books about PMS. There are also support groups for women with PMS. Call or write the following organizations for more information about PMS:

• The National Women's Health Information Center
  8270 Willow Oaks Corporate Drive
  Fairfax , VA 22031
  Phone: 1- 800 - 994-9662
  Web Address: http://www.womenshealth.gov
  

• The American College of Obstetricians and Gynecologists
  409 12th Street, SW
  Washington , DC 20090
  Phone: 1- 202 - 638-5577
  Web Address: http://www.acog.org
  

CONTACT A CAREGIVER IF:

• You feel pain in your abdomen (belly) and have shaking, chills, or a fever.
  
  
• You have symptoms that last longer than two weeks each month.
  
  
• You feel very sad most or all of the time.
  
  
• Your PMS symptoms cause problems in your life or relationships.

SEEK CARE IMMEDIATELY IF:

• You feel out of control or feel that you may hurt yourself or someone else.
  
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Premenstrual Syndrome (Discharge Care)