Premenstrual syndrome (PMS) refers to a wide range of physical or emotional symptoms that typically start 11 to 5 days before the beginning of a woman’s menstrual cycle and can be severe enough to interfere with her life in some way. The symptoms usually stop when menstruation begins, or shortly thereafter. PMS is estimated to affect up to 75% of women during their childbearing years. The symptoms typically get worse in a woman’s late 30s and 40s, approaching the transition to menopause.
PMS can be divided into four subgroups. While subgroups exist they are not always mutually exclusive and a woman can experience symptoms from several groups. Identifying a dominant subgroup can be useful in guiding treatment.
Which PMS type are you?
PMS Type A: this is the most common subgroup consisting of premenstrual anxiety, irritability and nervous tension, sometimes expressed in behavior patterns detrimental to self, family and society. Elevated blood estrogen and low progesterone have been observed in this subgroup.
PMS Type H: associated with symptoms of water and salt retention, abdominal bloating, breast tenderness and weight gain. The severe form of PMS Type H is associated with elevated serum aldosterone.
PMS Type C: characterized by premenstrual craving for sweets, increased appetite and indulgence in eating refined sugar followed by palpitation, fatigue, fainting spells, headache and sometimes the shakes. PMS Type C patients have increased carbohydrate tolerance and low red-cell magnesium.
PMS Type D: the least common subgroup but the most dangerous because suicide is most frequent in this group. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. PMS Type D has been associated with low estrogen and high progesterone levels, and high lead levels in hair tissue and chronic lead intoxication.
Diagnosis and Testing
There are no specific diagnostic tests for PMS. Your health care provider will be able to evaluate and diagnose your PMS based on thorough history taking and report of symptoms. A symptom calendar can help women identify the most troublesome symptoms and confirm the diagnosis of PMS. In some cases, a Female Hormone panel (usually saliva) may be recommended, but is often not required.
Treatment
A healthy lifestyle is the first step to managing PMS. For many women with mild symptoms, lifestyle approaches are enough to control symptoms. A few basic nutritional supplements such as B6 and Magnesium may also be used. In more severe cases your Naturopathic Doctor may recommend a Detoxification protocol, Vitamin-Mineral injections, Heavy metal testing and/ or food allergy testing.