PMS is common – 80% of women report symptoms that occur during their cycle that “forecast” the start of their period and 40% of women seek medical assistance for their symptoms. These symptoms include: depression, angry outbursts, irritability, anxiety, social withdrawal, breast tenderness, bloating, headaches, and swelling.  Sound familiar?

When these symptoms happen most months but go away within the first few days of bleeding, you probably fit the diagnosis of mild to moderate premenstrual syndrome. However a small percentage of women do experience symptoms that impact their daily lives.  These women experience fatigue or sometimes, insomnia, extreme changes in appetite, severe anxiety, difficulty concentrating, and/or a marked decreased interest in normal home and work activities. This may be a more serious condition called Pre-menstrual Dysphoric Disorder or PMDD.

What causes this?
As with many complicated disorders, researchers don’t really know what causes premenstrual syndromes.  The current consensus among researchers is that PMS and PMDD are probably caused by normal hormone functions in a woman and are not hormonal imbalances. There may be some link between the sex hormones (estrogen and progesterone) and neurotransmitters like serotonin, but the research continues.

How do I know if I have PMS or PMDD?
There is no specific blood test to diagnose PMS or PMDD. Your provider will do a routine exam to check for any abnormalities that may be causing your symptoms, such as a thyroid disorder or depression.

The best thing that you can do to help your provider is to keep a diary of your symptoms. There are several tools available (i.e. Calendar of Premenstrual Experiences ) to help you keep a daily record and to help you and your provider develop a treatment plan.

Is there anything that will help my symptoms?
There are several changes that you can make on your own to try and improve your PMS symptoms, including dietary changes and vitamin supplements. Dietary changes include: decreasing or avoiding caffeine intake, eating a balanced diet, adequate water intake, and decreased high-salt foods. There are some vitamin and mineral supplements that have been researched and are thought to help as well.

Alternative therapies that help many women include relaxation techniques, guided imagery, yoga, aerobic exercise, and massage/reflexology. These activities all help in stress reduction which may improve PMS symptoms. Your provider may also recommend a psychiatric professional in certain cases, which has proven very helpful in teaching coping skills to deal with the cyclic changes that are happening.

There are also several prescription drug options that you and your provider may consider.

You are not ALONE!
It is okay to ask for help with your PMS symptoms. There is no magic pill to fix PMS, but you and your provider can work together to stop PMS from interfering with your life.

By:  Allison Nissen, CNM

Request an appointment with a MUSC provider.

When should I bring my daughter to the gynecologist?
The American College of Obstetrics and Gynecology recommends having an “initial reproductive health visit” with a gynecologist between the ages of 13 and 15. 

What happens at this visit?
This initial visit is designed to be a preventative care visit.  It serves as an opportunity for young women to establish a relationship with a gynecologist.  It allows the doctor to screen young women for high-risk behaviors and to educate them about age and experience appropriate topics.  This visit is a good time to discuss and initiate HPV vaccination if you haven’t done so already.

Will there be a pelvic exam?
No.  The gynecologist is explicitly discouraged from doing a routine screening pelvic exam at this visit.  A pelvic exam would only be indicated if the medical history revealed certain physical complaints or a high-risk sexual history.

When should a woman have a pelvic exam?
A woman should have her first pap smear (cervical cancer screening) at the age of 21 or 3 years after the onset of sexual activity, whichever comes first.  We recommend yearly STD screening for all sexually active women under the age of 25.

by:  Ashlyn Savage, M.D.

Request an appointment with a MUSC provider.