Health Services
Self Care

Premenstrual Syndrome

Description
Premenstrual syndrome (PMS) is an umbrella term for symptoms many women experience from one to fourteen days prior to their menstrual period. Symptoms usually resolve with menopause. Estimates on the incidence of PMS in the United States range from 30 to 50% of women of childbearing age, although the true number may be higher if mild symptoms are included.

The cause of PMS is not yet known. Several theories involving imbalances in hormones have been suggested. However, none of these imbalances have been shown to be present in all women who have PMS. Current research suggests that the interaction of the hormones that regulate the menstrual cycle may be involved in the syndromes. Other research on endorphins (natural brain hormones which have a morphine-like effect on the body) and their possible effect on PMS may shed further light on the cause of PMS. Stress, nutritional imbalance and lack of regular exercise are thought by some researchers to be important contributing factors to PMS symptoms. Other factors which may be involved include postponing pregnancy until later child-bearing years, recent birth of a child and use of, or recent discontinuance of, birth control pills.

The diagnosis of PMS is complicated by the fact that there are no simple blood tests or physical findings that will confirm the presence of PMS. The diagnosis is based on careful observation and recording of symptoms throughout the menstrual cycle, preferable for at least two cycles.

Symptoms
The most commonly reported symptoms of PMS include: irritability, anxiety, depression, breast tenderness, water retention, food cravings (especially for "junk food" or chocolate) and mood swings. The symptoms range from mild to severe or disabling. Menstrual cramping is NOT a symptom of Premenstrual Syndrome, but may also be present (see information card regarding Menstrual Cramps).

Treatment
Since no single cause of PMS has been identified, no cure is yet available. For many years, treatment of PMS has been largely symptomatic. Many medications have been recently tested for PMS, but none have been consistently effective. The most widely tested medication for PMS is progesterone. Although progesterone has been helpful for some women, it is expensive and is not a cure-all.

Many women and researchers have been seeking non-medical treatments to control the symptoms of PMS. Certain life-style changes seem to help many women reduce their symptoms to a manageable level. These changes include:

Aerobic exercise: Regular aerobic exercise helps to reduce stress, improve circulation, tone the body (often resulting in improved, self-esteem), give one a sense of control of one's life if performed regularly. Any aerobic exercise you enjoy and can do for 15-20 minutes/day 3-5 days a week is recommended. Before beginning an exercise program, it is important to familiarize yourself with proper exercise techniques, warm-up, etc.

Nutrition: Some researchers feel that the "typical" American diet (high in animal fats and simple sugars) contributes directly to PMS symptoms. The basic suggestions for dietary changes are: Limit protein to 9 oz./day (for 120 lb. person) maximum, reduce animal fat in the diet by reducing red meat intake and high-fat dairy products; replace red meat protein with poultry, fish or vegetable proteins; decrease simple sugar intake; increase whole grain products, fresh vegetables and fruits. Caffeine, salt, alcohol and nicotine may aggravate symptoms of PMS.

Stress management: Chronic stress seems to aggravate PMS. Learning to control reactions to stressful situations may ease the effects that stress can have on the body. Stress management assistance is available through the Engle Center for Health and Counseling Services at Messiah College. Call 691-6035.

More Information/Questions
For more information, Messiah students may call the Health Center at 691-6035.