About PMS (cont)
How can PMS be diagnosed?
Diagnosis depends entirely on the timing of symptoms in the menstrual cycle. There are no blood tests that can be taken to confirm PMS and keeping a menstrual chart is the only reliable method of diagnosis. The NAPS menstrual chart , with instructions for using it can be downloaded.
A chart will accurately reflect symptoms and will show the days on which they occur, the days when they are absent, the days of menstruation and the duration of the menstrual cycle.
A chart needs to be kept for at least two cycles,before discussing it with a doctor. It provides both the PMS sufferer and the GP with an evidence base from which to both diagnose and treat PMS.
Can PMS be cured?
There is no known ‘cure’ for PMS except a hysterectomy as that is the ultimate form of ovulation suppression but with appropriate treatment it can be successfully managed.
PMS can occur in any woman during child bearing years. It is estimated that as many as 30% of women can experience moderate to severe PMS, with 5-8% suffering severe PMS/PMDD, this being around 800,000 in the UK.
PMS appears to begin and increase in severity at times of marked hormonal change:- in puberty ( even before the first period), starting/stopping the oral contraceptive pill, after pregnancy, with pre-eclampsia, postnatal depression, sterilisation or termination.
Who suffers from PMS?
PMS is no respecter of persons and has no regard for race or economic status.
It can affect the whole family, not only sufferers but also husbands, partners and children and it can impact adversely too on friends and work colleagues.There will be families where PMS is experienced by successive generations but equally there are PMS sufferers with no family members similarly afflicted. Research on whether PMS is inherited has so far been inconclusive but there may be a genetic cause.
What are the treatments for PMS?
Lifestyle changes: reducing stress, diet, exercise, limiting alcohol and smoking can improve PMS symptoms but they will be insufficient in managing moderate to severe PMS. There is evidence that certain complementary therapies may be of benefit in such cases – Agnus Castus and Magnesium in particular. Medical treatments for moderate to severe PMS fall into two categories – ovulation suppression and SSRis- Selective Serotonin Reuptake inhibitors.
The recommended therapies suppressing ovulation are :- some combined oral contraceptive pills, oestrogen patches or implants with cyclical progestogen or Mirena. Where these prove not to be successful GnRH analogue therapy can be employed. If severe PMS persists then a Hysterectomy is the ultimate medical treatment.
SSRis in the form of Prozac, Cipramil and Cipralex can be used to treat PMS on the basis that serotonin may be important in causing the condition.
Detailed information on all therapies are available to members of NAPS.