Think of it as biological warfare, its battles played out on the fields of a woman's body and mind. Once a month, about 1 to 2 weeks before she begins to menstruate, the opposing armies—estrogen and progesterone—begin to amass. These female hormones, which regulate the menstrual cycle and affect a woman's central nervous system, normally work in tandem. It's only when one tries to outdo the other that trouble looms.
Some women escape the conflict altogether, their hormones striking a peaceful balance before a single sword is drawn. Others are less fortunate. For one woman, estrogen levels may soar, leaving her feeling anxious and irritable. In another, progesterone predominates, dragging her into depression and fatigue.
The battles can rage for days. You may feel bloated and gain weight, have a headache, backache, acne, or terrible breast tenderness. You may crave ice cream and potato chips. Your mood may shift without reason, swinging from euphoria to depression. Then, suddenly, the troops clear out and peace of mind returns—just as your period begins.
Premenstrual syndrome, or PMS, is believed to affect to varying degrees between one-third and one-half of all American women between the ages of 20 and 50, says Susan Lark, M.D.
Certain factors, such as bearing several children or being married, seem to increase the risk of PMS, says Guy Abraham, M.D., who has conducted extensive investigation into the disorder.
The problem may have a genetic basis, says Edward Portman, M.D.
Not all women with PMS have the same symptoms and the same intensity of discomfort, says Dr. Abraham. Nor do all respond to the same treatments. Finding the best way to handle your PMS may require some trial and error. Here are some recommendations.
The symptoms of premenstrual syndrome rarely call for medical intervention, but drastic circumstances demand drastic measures. If you've tried almost everything here and nothing seems to help, see your doctor about a prescription medication. In addition, if the symptoms of PMS are seriously affecting your health and other daily activities, see your doctor as soon as possible. Oral contraceptives and antidepressants may be appropriate treatment methods if nothing else can reduce your PMS symptoms.
Guy Abraham, M.D., is a former professor of obstetrics and gynecologic endocrinology at the UCLA School of Medicine in Los Angeles and has conducted extensive research on PMS.
Penny Wise Budoff, M.D., founded the Women's Medical Center in Bethpage, New York, and is author of No More Hot Flashes and Even More Good News and other related books.
Susan Lark, M.D., is the author of Dr. Susan Lark's Premenstrual Syndrome Self-Help Book.
Edward Portman, M.D., was formerly the director of the Portman Clinic in Madison, Wisconsin.
Peter Vash, M.D., is executive director of the Lindora Medical Clinic in Costa Mesa, California. He is also an endocrinologist and internist on the clinical faculty of the UCLA Medical Center in Los Angeles and a specialist in eating disorders.