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PMS, also known as premenstrual tension, is a syndrome caused by natural hormonal changes in the menstrual cycle and that can generate emotional symptoms such as anxiety, crying spells, anger, irritability and depression in some women, and that appear around 1 to 2 weeks before menstruation.
In addition, some physical signs and symptoms can also appear during PMS, such as swelling, headache, excessive tiredness, acne and weight gain, which tend to decrease shortly after the onset of menstruation.
The practice of physical activity, balanced diet and some teas can help prevent and improve signs and symptoms of PMS. However, some women may experience stronger symptoms and may also need medication, which should only be used under the guidance of a doctor. See other tips to prevent and relieve PMS symptoms.
Main signs and symptoms
The physical and emotional signs and symptoms of PMS appear 1 to 2 weeks before menstruation and the intensity of each varies from woman to woman.
1. Physical signs and symptoms
Key physical signs and symptoms of PMS may include:
- Muscle and joint pain;
- Sore breasts;
- Weight gain;
- Excessive fatigue.
In addition, nausea and vomiting are also some of the physical signs and symptoms that can arise during PMS. Know other symptoms that can appear in PMS.
2. Emotional symptoms
Some of the most common emotional symptoms that can arise during PMS are:
- Anxiety or stress;
- Change in appetite;
- Frequent anger or irritability;
- Difficulty concentrating;
- Crying crises;
- Insomnia or excessive sleep;
- Decreased libido.
Some signs and symptoms can be more serious in some women, characterizing premenstrual dysphoric disorder, a condition that causes symptoms similar to PMS, but that can generate anxiety attacks, greater aggression and absences from work, for example, making simple everyday tasks difficult. Understand what it is and how to treat premenstrual dysphoric disorder.
How to confirm the diagnosis
Because there are no laboratory tests to diagnose PMS, the general practitioner or gynecologist usually makes an assessment of the reported signs and symptoms. For this, the doctor can also ask for a note, for at least 2 months, about the beginning and end of the signs and symptoms, and the duration of menstruation.
According to the American College of Gynecologists and Obstetricians, the presence of 5 or more physical and emotional signs and symptoms 5 days before menstruation indicate the presence of PMS.
As the signs and symptoms of PMS can be confused with other situations, such as thyroid problems, depression or anxiety, the doctor may also order some more specific tests, such as blood and imaging tests for better evaluation.
Although the causes of PMS are not yet fully understood, it is believed that this condition is caused by the variation of the hormones estrogen and progesterone in the central nervous system, which decrease the levels of serotonin, a neurotransmitter that helps regulate the mood, sleep, anxiety and appetite.
Furthermore, some theories indicate that genetic predisposition and deficiencies in serotonin, vitamin B6 and magnesium can also cause PMS.
How the treatment is done
Treatment to alleviate the signs and symptoms of PMS must be done according to the severity of the symptoms and individually, and can be done with the use of medicines or natural options.
1. Treatment with drugs
The remedies to treat the most intense symptoms of PMS and which should only be used under the prescription and monitoring of a general practitioner, or gynecologist, are:
- Oral contraceptives,such as ethinylestradiol and drospirenone, which inhibit hormonal changes in the menstrual cycle, decreasing swelling;
- Progesterone injection, such as medroxyprogesterone, which is a contraceptive that stops menstruation for 3 months, inhibiting the signs and symptoms of PMS;
- Anti-inflammatories,such as ibuprofen and ponstan, which relieve headaches, cramps, breast or leg pain;
- Antiemetics,such as dimenhydrinate or bromopride, may be helpful in controlling motion sickness at this stage;
- Antidepressants,such as sertraline and fluoxetine, which help increase the amount of serotonin, relieving some PMS symptoms such as irritability, anxiety, depression and binge eating;
- Anxiolytics,such as alprazolam and lorazepam, which have calming properties, relieving symptoms of stress, anxiety and irritability.
Treatment for women with premenstrual dysphoric disorder is done in the same way as PMS. However, larger doses of medication and follow-up with a psychiatrist, to adjust medications and a psychologist, may be necessary to help manage anxiety, irritability or stress.
2. Natural treatments
Natural treatments can be enough to relieve milder PMS symptoms, but they can also be used to complement drug therapy in cases of stronger symptoms. Some natural treatments for PMS include:
- Physical exercises such as yoga, walking or cycling help increase serotonin and endorphin levels in the body, reducing stress and anxiety, as well as improving bowel and blood circulation, fighting swelling;
- Supplements,such as magnesium, evening primrose oil, calcium, vitamin E and vitamin B6, can improve serotonin levels in the body, relieving PMS symptoms;
- Phytotherapics,in the form of teas, tablets or extracts, such as valerian, passionflower, agnocast and St John's wort, can be used to relieve various PMS symptoms, such as anxiety, tiredness, irritability, insomnia and breast pain;
- Acupuncture,that promotes relaxation, decreasing headache, stress and anxiety, and improving sleep quality. See how acupuncture can help treat PMS.
During PMS it is recommended to maintain a balanced diet, prioritizing foods rich in omega 3, such as fish, avocado, almonds and olive oil, which have anti-inflammatory properties, helping to reduce symptoms such as irritability, headache, anxiety and insomnia.
In addition, it is also important to prioritize the intake of fresh vegetables and fruits, which have good amounts of fiber, potassium, magnesium and vitamin B6, helping to fight bloating, constipation and improving general well-being.. Know all the foods that should be prioritized during PMS.