That Time Again
8 Nov 2006
Mood swings, sore breasts and stomach cramps are a monthly trial for millions of women. Why do their bodies react in this way to menstruation, and what can they do to ease the symptoms? Sara Loane reports for Norwich Union Healthcare's Thrive magazine.
Over nine million women in Britain regularly experience PMS symptoms, according to the National Association of Premenstrual Syndrome (NAPS). The symptoms include chronic fatigue, poor concentration, irritability, tearfulness, anxiety, bloating, breast tenderness, headaches, cravings and binge eating. In a few women, these symptoms are severe enough to interfere with normal activities, and can even lead to a breakdown in personal relationships.
PMS is associated with falling levels of the hormones progesterone, oestrogen, and serotonin, and nutritional deficiencies and blood sugar imbalance. The symptoms begin at or after ovulation and are present for most of the latter part, or luteal phase, of the menstrual cycle. Symptoms then improve or stop with the onset of menstruation, or a day or so after.
“Correct diagnosis is crucial to the management of PMS,” says Nick Panay, NAPS chairman and a leading expert on PMS in the UK. “This cannot be accurately established by retrospective recall. It needs to be made by the prospective logging of symptoms by the patient, ideally over two cycles. A symptom questionnaire [which can be downloaded from the NAPS website] is the best way of documenting the symptoms and may actually reveal a complete absence of cyclicity to the symptoms. Psychological illness such as depression, anxiety and chronic fatigue syndrome may mistakenly be ascribed to PMS by the sufferer or by doctors. If these conditions are at all suspected, then a psychiatric opinion should be sought."
There are a number of self-help treatments for PMS. As a first step NAPS recommends eating less sugar, fat and salt, and drinking less alcohol, while increasing intake of fruit, vegetables and water, combined with a regular three-hourly carbohydrate snack – such as rye crisp breads, teacakes or a rich tea biscuit – which assist the body’s production of serotonin, a naturally occurring substance that lifts the mood and relieves pain. Exercise and lifestyle changes, together with stress-busting techniques, can also make an enormous difference.
“There is little doubt that severe PMS can be aggravated by social and environmental factors, which can tip people over the edge,” says Panay. “Stress at work or relationship difficulties appear to lower the tolerance threshold above which severe symptoms occur so merely investing time in oneself will have a significant effect.”
One of the most established dietary supplements for PMS is an extract of an exotic fruit known as agnus castus, which is thought to reduce prolactin levels and increase the production of progesterone. These effects help to correct the hormonal imbalances common in PMS, thereby helping to ease its symptoms. The normal recommended dose of agnus castus is 40mg of dried herb or 40 drops of concentrated liquid extract once a day, or 20mg of dried herb, twice a day. Agnus castus preparations are readily available in health food stores. Evening primrose oil is also helpful in easing low moods, sugar cravings and breast pain linked to PMS. It helps to even out hormonal imbalances, but needs to be taken at doses of up to 3g a day for at least three months before an effect may be noticed. Vitamins B6 and E, gamma-linolenic acid (GLA), calcium and magnesium have also been thought to alleviate symptoms of PMS. Many women find them helpful, but studies have mixed results. Your GP can advise you if these simple measures don’t work for you. He or she may recommend hormone treatments such as the contraceptive pill, which suppresses ovulation and improves PMS symptoms, or progestogen, a synthetic or man-made hormone that mimics the effect of naturally occurring progesterone. Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant drug often used in the treatment of depression and anxiety, may also be prescribed.
It’s his hormones!
Grumpiness, aches and pains and even poor concentration are often excused as a part of a woman’s monthly cycle. Now it seems men may have a similar get-out clause. They too are buffeted by cyclical changes in their bodies’ natural rhythms. Irritable Male Syndrome (IMS), with its various symptoms of irrational anger, depression and loss of control, is triggered by a sudden drop in levels of the sex hormone, testosterone. The newly recognised condition plays havoc with male animals, temporarily turning confident, chest-beating Tarzans into withdrawn, grumpy wimps. The symptoms may also resemble those of the so-called male menopause, but Gerald Lincoln, of the Medical Research Council’s Human Reproductive Sciences Unit in Edinburgh, believes the condition can affect men of any age when stress causes testosterone levels to plummet.
Self-help tips from PMS sufferers
Julia, 29: “I’m a big fan of natural progesterone which not many people know about. I’ve been taking this for a year and it has practically solved all my mood swings and painful period problems. I avoid sugar, as fluctuating blood sugar levels make me more moody, and I definitely try to do a few gentle yoga or Pilates classes in the runup as these seem to ease the cramps.”
Kiran, 32: “I used to suffer from PMS quite badly – horrible bloated feelings, headaches, cramps, irritability, weepiness, the lot! I find ibuprofen is effective but I prefer taking a combination of evening primrose oil, which helps with my mood swings, and agnus castus, which I read about in a magazine once and which actually eases the pain considerably.”
Sarah, 40: “All of a sudden, everybody is really irritable and unreasonable .If I, and my nearest and dearest, are lucky, I’ll realise it’s merely hormones and put the knife back in the drawer. However, even though it’s been going on for 27 years (oh God!),it usually takes me by surprise. Muttering to myself while pottering in the garden seems to afford some relief. To me, and everybody else.”
Nadine, 38: “In the past I’ve used starflower oil with some success .But now I’ve started taking 100mg of vitamin B6 each day, which seems to help with the fatigue and emotional symptoms of PMS such as depression and irritability.”
Nicky, 36: “One big tip: get pregnant! Stops PMS in an instant...”
This article is brought to you by Norwich Union Healthcare. To request your copy of the full Thrive magazine please email
info@atompublishing.co.uk
.
For more information about Norwich Union Healthcare policies please call 0800 42 42 42* quoting reference NAPS ZR4.
To trial Norwich Union’s Personal Health Manager which gives you access to medical experts, symptom assessment, waiting list guide, health planner and much more go to https://www.personalhealthmanager.co.uk/ and follow the links to get your free 30 day trial.
*calls may be monitored and/or recorded
