From fatigue to depression, headaches, cramping and bloating, nearly every woman experiences discomfort of some kind before, during and after her menstrual cycle. Premenstrual Syndrome (PMS) and Premenstrual Dysphonic Disorder (PMDD) are intense and unfortunate exaggerated responses of menses, but there are numerous approaches to treating the symptoms. By identifying what your body is going through, talking to your doctor and exploring different forms of treatment, it is possible to prevent PMS and PMDD from sidelining you once a month.
What are the symptoms of PMS/PMDD?
PMS/PMDD can take on many forms, and women can experience different variations of these symptoms. To be formally diagnosed with PMS or PMDD, a woman must experience at least five symptoms for at least three consecutive menstrual cycles, so I stress to my patients the importance of taking note of symptoms that are serious enough to interfere with their normal activities. These include: insomnia, mood swings, dizziness and migraines, to name a few.
What can I do about PMS/PMDD?
The first step is to identify what you are feeling and make a plan for fighting it. I focus on helping my patients identify the symptoms bothering them the most, with special emphasis on depressive symptoms, including anxiety and irritability, bloating, mastalgia (breast pain) and cramping. We then work together to devise a treatment regimen that can include herbal supplements, changes in diet and exercise, and in some extreme cases, medication. Herbs, acupuncture, and other mind-body techniques tend to take a little longer to see their effect, so I will often schedule a three to six month check-in to re-evaluate and see if there is anything we need to change or modify.
Can I do it by myself?
While you can pursue many treatment options on your own, I always tell my patients to keep their doctors informed before beginning a new routine. Managing PMS/PMDD can sometimes be as easy as adding 30 minutes of moderate-intensity exercise and reducing caffeine intake during menses. A variety of mind-body exercises, including meditation, yoga and cognitive behavioral therapy can also make a difference in the intensity of PMS/PMDD symptoms. Additionally, I recommend my patients consider supplements such as calcium, magnesium, vitamins B6 and D3, or a multivitamin; and herbs, including chastetree berry/Vitex, black cohosh, St. John’s Wort, dong quai, ginkgo and evening primrose oil.
How can my doctor help?
One of the benefits of working with your doctor to manage your PMS/PMDD symptoms is that your doctor can support you in developing a tailored plan based on your health needs. Personally, I really treat the individual and customize my recommendations to include both conventional and alternative methods to facilitate the body’s innate healing response. By adding nontraditional methods, I am often able to decrease the dose of prescription medications. Working with your doctor also allows for the prescription of oral contraceptives and antidepressants, if necessary.
Can nontraditional methods really help?
Integrative therapies help the body heal itself, and often the patient will find balance in many different aspects of her life—in addition to relief from the symptoms of PMS/PMDD. As an integrative practitioner, I consider all the factors that influence health, wellness and disease including the mind, body, spirit and community. I do remind my patients to remember that this type of approach can often take longer to see results. Herbs tend not to be quite as strong as traditional medications, so it can take at least three months to see the effects. Treatments like acupuncture may also take up to six sessions to feel results.
The most important part of treating the symptoms of PMS/PMDD is being an active participant in the fight! Adding dietary supplements and a new exercise routine before and during menstruation can take some time to adjust to, but the results are worthwhile. Bottom line: be open and honest with your doctor about what you are experiencing around your period, and how you would like to approach treatment.