Over the past few years, cases in premenstrual syndrome (PMS) have increased because of awareness of this disorder in women. The disruption that severe PMS can cause to the lives of a woman and her family should not be underestimated – it can literally be disabling.
Premenstrual syndrome may be defined as: “distressing physical, psychological and behavioural symptoms not caused by organic disease, which regularly recur during the same phase of the menstrual (ovarian) cycle and which significantly regress during the remainder of the cycle.”
Severe PMS probably affects between 5 and 10% of menstruating women, and is a common disorder.
PMS is influenced by cyclical ovarian function. This is evident from the close association of PMS symptoms to ovarian cycle, the absence of PMS before puberty, during pregnancy and after menopause, and the marked reduction in symptom levels achieved by ovarian suppression or removal.
The diagnosis of PMS is entirely clinical, and based on the definition given above. The range of possible symptoms is wide, but those most frequently experienced are listed below:
* Feeling swollen, bloated – feeling of fullness in breasts, abdomen, face and feet
* Loss of efficiency
* Irritability
* Gain in weight – in some cases weight gain of 0.5 Kg to 4 Kg can be measured
* Difficulty concentrating
* Tiredness
* Mood swings
* Tension – some cases suffer from a type of migraine
* Restlessness
* Depression
* Gastrointestinal upset – colon spasm and constipation
The classical pattern is for symptoms to start 7-10 days before the onset of menstruation, peak the day preceding it, and decline within a few days of menstruation.
Almost all women (90-95%) are aware of some changes or symptoms in the 4th week of the cycle, which forewarn them of the imminent start of their period, but for the majority, these symptoms are mild and do not interfere with living. Such women do not suffer from PMS. What distinguishes PMS is that symptoms are abnormally severe. This means that they interfere with the individual’s ability to function, whether at work, in relationship or socially.
When the diagnosis is uncertain, prospective recording of symptoms can help. In the cases of PMS, the relationship of the symptoms to the late luteal phase of the cycle should be evident to the physician, as no laboratory test can confirm the diagnosis of PMS.
Management of PMS:
* Reassurance – when a diagnosis of PMS is made, it is important that the doctor conveys to the woman that PMS has a physical basis related to her hormones and that the effective treatment is available
* Limited water intake and a salt free diet for the ten days preceding menstruation
* For the congestion of the breasts adequate support is essential
* Homoeopathic medicines:
Aurum met. – Mental depression and suicidal thoughts before menses
Calc. carb. – Nervousness and swelling in breasts before menses
Calc. phos. – Headache 3 to 7 days before menses, great sexual desire
Caust. – Sadness and anxious dreams before menses
Cham. – Irritable, snappish and frontal headache before menses
Conium – Great anxiety, weeping mood, great fear when being alone, but dreads company and strangers, swelling of breasts with feeling of hardness and pain before menses
Ignatia – Sighing and sobbing with weak and empty sensation in stomach before menses
Kali carb. – General bad feeling about a week before menses
Lac can. – Great engorgement of breasts those are sore to touch before menses
Lyc. – Sadness and melancholy with distension of abdomen before menses
Nat. Mur. – Sadness and anxiety, faintishness and palpitations with throbbing headache before menses
Puls. – Weeping, sadness and migraine before menses
Sel. – Before menses irresistible desire for liquors, wants to get completely drunk and afterwards feels distressed and wants to be taken to the insane asylum
Sep. – Sadness and weeping before menses
Stann. – Great anguish and melancholy the week previous and ceasing with the appearance of menses
Sulph. – Restlessness and anxiety with weak, faint spells before menses
Zinc. Met. – Before menses, irascible and weeping, incessant fidgety feeling in lower limbs and feet, cannot keep them still.