PMS or premenstrual syndrome - it's real!

Dr Sachin Nichite, leading gynaecologist, tells us more about PMS and the changes that need to be made in order to overcome the symptoms.

Rutuja, is a 28-years-oldhard working, ambitious woman, who is great at her job But there are those days in the month when she is just not at the top of her game. Irritable, fatigued and extremely emotional, Rutuja shies away from making presentations or any sales pitches during those few days. Not only do her co-workers see the change in the overachiever, her husband too has to bear the brunt of the ever-changing moods. Extremely clumsy and disinterested, Rutuja prefers not to get intimate during those few days before her periods. What the couple don't know is that Rutuja is suffering from an extremely common condition called PMS or premenstrual syndrome. She and her husband Rohit visited Dr Sachin Nichite, a gynaecologist who explained the condition to them:

Rutuja:I have PMS? What is that?

Dr Sachin: There is nothing to worry Rujuta, just relax. PMS or premenstrual syndrome is a collection of physical and emotional symptoms, that occur around one to two weeks before you get your periods. The symptoms of PMS usually reduce once you start your menses, and almost disappear after they are over. But, when these problems occur every month, on a regular basis, and affect one's day-to-day activities, it definitely requires some attention. (Read: Premenstrual syndrome (PMS) tips to deal with it)

Rutuja: Okay, but why does it happen?

Dr Sachin: Like many things that happen in the human body, the exact reason for PMS is still unknown. Scientists believe that it is due to the severe hormonal fluctuations that occur just before, during and after every women's menstrual cycle. Unfortunately in women who are obese, live extremely stressful lives, eat a lot of junk food or food with high salt content, drink lots of coffee or alcohol suffer from these symptoms more often. In short they are more prone to suffering from PMS.

Rutuja: So, what are the symptoms of PMS? And how does a doctor diagnose it?

Dr Sachin: Well, the symptoms vary, but braodly a woman will experience irritability, hot flashes, bloating, mood swings, depression, craving for sweet or salty foods and sensitvity to certain foods and smells. In some cases a woman may experience spotting and cramping in the abdomen. When a woman visits a doctor, these symptoms are usually enough to diagnose the condition, but there are three criteria that are essential to making the right diagnosis, they are:

• Experiencing symptoms at least five days before the onset of the woman's periods and for three months in a row.
• If the symptoms subside within four days after one's periods start.
• Symptoms that are so severe that they interfere with the woman's everyday activities.

Since all these signs are usually subjective it is best that a woman maintain a diary, where she can write down what she is experiencing. This helps the doctor make a more accurate diagnosis.

Rutuja: With these symptoms, are there any other conditions that I should be worried about?

Dr Sachin: Yes, there are other conditions that mimic the symptoms of PMS. Conditions like depression, anxiety, peri-menopause (the time just before a woman steps into menopause), irritable bowel syndrome (a condition that affects the intestines), thyroid disease (hypo or hyper thyroidism), do show symptoms like PMS. That being said, these symptoms must be present throughout the month and not intermittently.

In order to diagnose any of these conditions, a woman's doctor will ask you some questions to eliminate the more common causes.

Rutuja: And how can PMS be treated?

Dr Sachin: Initially, I will try to implement certain diet and lifestyle changes to see if they affect the symptoms in anyway. But apart from implementing the changes I mention, it is important that you maintain your symptoms diary. This will help us understand if the changes are helping relieve your symptoms.

Rutuja: What diet changes should I make?

Dr Sachin: They are fairly simple ones, like:

• Swap the carbohydrates in your diet for complex carbohydrates, like whole wheat, brown rice, beans, and lentils. The complex carbohydrates help reduce the intensity of mood swings and food cravings.
• Reduce the amount of salt, sugar and fatty foods in your diet.
• Reduce or avoid the amount of caffeine you drink.
• Eat six small meals in a day rather than three large meals. A stable blood sugar level throughout the day helps reduce the symptoms.
• Include foods like green leafy vegetables and yoghurt in your diet.

Rutuja: What about the lifestyle changes?

Dr Sachin: The lifestyle changes are complimentary to the diet alterations. Both go hand-in-hand and need to be implemented together. Simple changes like exercising more often, regularizing your sleeping patterns, implementing relaxation methods like meditation, yoga, or getting a massage can be of great help. Some patients do prefer opting for alternative methods to relieve pent up stress like self-hypnosis and biofeedback therapy.

Apart from all the things that you implement, it is essential that your significant other help during this time. Doing simple things, like allowing you to express yourself openly, and being supportive goes a long way in relieving the symptoms.

Rutuja:What if I don't find any relief with changes?

Dr Sachin: In such cases you might need to have some medicines or surgery to help you feel better. The medicines that are most often prescribed are oral contraceptives. These pills stop the production of the ovum or egg by the ovaries, thereby controlling the hormones released. If you suffer from severe depression, or other very strong emotional symptoms, then you will have to take anti-depressant or anti-anxiety medication, to find some relief.

If all else fails, there are some surgeries that can be performed to help you. Although, they are used in extremely rare cases where the patient has very severe symptoms, and finds no relief with the medicines prescribed. The surgeries include removal of the uterus (hysterectomy), removal of the ovaries (oophorectomy) or removal of both the uterus and ovaries (pan hysterectomy). (Read: Tried and tested tips to reduce pain during menstrual periods)

Rutuja: So do only women suffer from this condition? Do males have an equivalent too?

Dr Sachin: Yes, we do. There is a condition called 'irritable male syndrome', which is also caused due to hormonal fluctuations.

All in all, PMS is a manageable condition, and women must remember that they are not alone. Finding a way to vent your emotions is the key to glide through this tough time.