Premenstrual conditions

It is common for women to experience physical changes as well as changes in their mood a week or so before their period starts each month. These changes are called premenstrual syndrome (PMS) or premenstrual tension (PMT).

PMS can include:

• irritability, moodiness, impulsiveness, anxiety and/or feeling a ‘loss of control’
• a depressed or lower mood
• difficulty concentrating
• bloating, swollen and tender breasts, and body aches.

These changes can be mild, moderate or severe. They can last for a day or two, or right up until when your period arrives. Some women only have physical symptoms, others only mental ones and some women a mix of both.

PMS can be so strong that it can affect your ability to do the things you normally do.

A very severe kind of premenstrual disorder called premenstrual dysphoric disorder (PMDD) can significantly affect your quality of life.  Around eight per cent of women are affected by PMDD and experience both severe physical and mental changes.

What causes premenstrual conditions?

Unfortunately, we don’t know. Researchers agree that there are physical or biological factors at play, not just psychological ones. Recent research also suggests that abnormal hormone levels are not to blame, and that women who suffer from strong PMS or PMDD may in fact be particularly sensitive to the normal hormone changes of a menstrual cycle.

Some hormone medications can cause PMS or PMDD in some women, but this is usually when they are used to treat menopause symptoms. This is also easily fixed by switching to a different type of hormone medication.

Treating premenstrual conditions

If you find your symptoms are difficult to manage it will help you to see a health professional to get further advice and assistance. You may find that very simple strategies help or you may need more complex care.

If you are someone who normally has anxiety, depression, epilepsy or migraines, you may find that your symptoms worsen just before you get your period. These can look and feel very similar to premenstrual conditions, but need to be treated differently. It is important to tell your doctor about any existing medical problems you have so they are not mistaken for PMS/PMDD.

Visit your GP

• Tell them about any physical or emotional changes you have had.
• Let them know if you have any other medical conditions or health problems.

They may:

• ask you questions about the history of your health
• examine you
• refer you to a mental health specialist
• ask you to keep a record of your symptoms for two months. This usually means making a note each day of how you felt, what changes you noticed and when your period started and stopped.

Treatment for PMS/PMDD

Antidepressant medication is the most common treatment. Certain antidepressants increase the level of serotonin in your brain which can change the way your hormones affect your mood. These come as a tablet that you take either every day or just in the week before your period.

Cognitive behavioural therapy involves activities and work with a psychologist who guides you to challenge your thinking style and alerts you to the way your thoughts affect your emotions and behaviour.

Hormonal therapies control the hormones that may contribute to PMS and PMDD. Taking the contraceptive pill daily is the most common hormonal therapy. Occasionally, this can involve taking medication that stops you from releasing an egg (ovulating) each month. This is usually only an option if other treatments haven’t worked.

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