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Living with my enemy: Premenstrual syndrome revealed

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Δυσπαρευνία: ο πόνος στη σεξουαλική επαφή

Living with my enemy: Premenstrual syndrome revealed

Have you ever felt sad, angry, and irritated without a real cause? Have you ever seen your body bloated and aching, your trousers not fitting without any change in your routine and diet?  Have you ever found yourself absent-minded and far away, unable to perform any mental activity?  Do these symptoms appear several days prior to your menstruation?

The story starts with  the wandering uterus

It was Hippocrates (460-340 BC), a Greek physician of the ancient times and the father of western medicine, who first wrote that menstrually-related mind and body disorders were a fact and they were attributed to hysteria, a disease where the uterus, travelling around the body, could cause trouble by blocking vital passages. Although, hysterias’, explanatory theory changed over time, from Hippocrates’ physiology to moral failings associated with devil possession, in the medieval ages, to the hazards of modern society, threatening the patriarchal family, in the classical ages, the connection between woman’s mental health and her reproductive system always persisted.

PMS gets the media and the doctors’ attention

But it was an English doctor Katharina Dalton who introduced the term PMS when she co-authored an article in the British Medical Journal in 1953. Interestingly enough in 1981, in a trial in London of a woman murdering her lover, Dalton, as chief defence medical expert, she successfully argued that the defendant was not responsible for murdering her lover because she suffered from severe PMS. Since then PMS gained a lot of attention and doctors accepted it as a real disease.

So, now it all makes sense…

Three of every four women experience some kind of PMS annoyances, 1-2 weeks prior to their period, which may be mental-emotional (depressed mood, anger flares, irritability, crying outbursts, anxiety, confusion, social withdrawal, poor concentration, memory loss, insomnia or drowsiness as well as changes in the libido) or physical (thirst and appetite changes, characterized by the desire for certain types of food, breast tenderness,  bloating and weight gain, swelling of hands and feet, headache, musculoskeletal pain, fatigue, skin problems, gastrointestinal problems and abdominal pain). Symptoms subside in the early days of the period. Furthermore, to the same woman for a certain period of time symptoms may be particularly severe and for another, they may manifest more mildly. Although in some women PMS causes very little discomfort, for others is a factor for antisocial behaviour and daily life impairment. That explains why so many women during this phase of their menstrual cycle may be prone to fights, may be absent from their work or could get alienated and show low self-esteem. Anyway, if you are one of them, you should not let it dominate your life. You better start a recording of symptoms, their intensity (mild, moderate, severe) and duration in a diary for 2-3 months, which might help your doctor, find their cause and give you the proper guidance.

Syndrome without a cause

The cause of premenstrual syndrome has not been determined yet, but there are several factors that contribute to its manifestation, as:
1. Exaggerated response to normal changes in hormone levels during the cycle.
2. Changes in the levels of the neurotransmitter serotonin in the brain, causing depression, fatigue, appetite disorders and desire sleep.
3. Any intense stress, which may exacerbate the syndrome.
4. An unbalanced diet, which leads to lack of vitamins and minerals, such as magnesium and calcium, salty foods, that contribute to fluid retention and swelling and coffee and alcohol, causing mood disorders and fatigue.

Pms’s rivals

There are cases that mimic premenstrual syndrome and it is important to make the right diagnosis because they require different treatment. These include depression, anxiety neurosis, perimenopause, chronic fatigue syndrome, irritable bowel syndrome and thyroid diseases. Often the above conditions are aggravated before the period and this can create a diagnostic problem, but usually, they occur throughout the month. Furthermore, some health problems such as asthma, epilepsy, migraines, allergies may show deterioration in the days prior to the period, but this is not considered premenstrual syndrome.

The wise PMS

Don’t let PMS control your life. Plan your wise PMS (Personal Modification Strategy)! Try some lifestyle modifications which may help make mild to moderate symptoms subside. For example, it would be very helpful to manage your stress with frequent aerobic exercise (at least 30 minutes, almost every day), relaxation (yoga, stretching, massage, etc.) and a good eight hours sleep. Eat small and frequent meals. The diet should contain enough complex carbohydrates, such as wholemeal bread and pasta, cereals, brown rice and legumes. Carbohydrates exert their sedative effect on premenstrual mood by increasing serotonin in the brain.  Reduce fat, sugar and salt and avoid alcohol and caffeine. Foods high in calcium, such as milk, cheese, yoghurt and green leafy vegetables seem to be beneficial.  You should take 1200 milligrams of calcium a day from food sources and supplements.

Vitamin B6 at doses of 50-100 mg / daily, seems to help. Other supplements such as magnesium, vitamin E are possibly beneficial. Capsules of the plant agnus castus (chaste berry) reduce swelling and pain of the breasts. Of course, since no solution works equally well for everyone, you could utilize more than one of proven natural approaches.

If the above does not help to eliminate the symptoms of PMS or reduce their intensity, then your doctor may suggest a  medication such as birth control pills, GnRH analogues, antidepressants, analgesics or diuretics. Complementary and alternative strategies have been explored, with very promising results, for patients with PMS. These include herbal medicines, acupuncture and light therapy daily for 30 minutes.

And a pinch of willpower…

So, why don t you turn PMS to your advantage with a bit of willpower? PMS might be warning you of what is not right in your life, whether it is the excessive stress, the lack of exercise or poor nutrition. Maybe it’s your body calling for more attention and a need to slow down. Or it could be the time for you to show assertiveness by withdrawing from the everyday overload, take care of yourself, let go multitasking and rethink the way you work, relate, and live your life.