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.

The birth control pill was invented in 1960 and many improvements have been made over the years. Women who are thinking about starting birth control pills have many questions about possible effects. Below are some answers to the most frequently asked questions about the birth control pill.

Will the pill make me gain weight?
The pill does not make you fat. Most women who use the pill do not experience a change in weight. Getting older, exercising less, and changes in your diet are more likely to cause weight gain than your birth control pills.

Will using the pill now hurt my chances of becoming pregnant in the future?
No. The pill works by suppressing ovulation, or the formation of an egg each month. As soon as you stop taking the pill, you will be able to form an egg each month and potentially become pregnant. If you do experience difficulty getting pregnant after stopping the pill, see your doctor because there are other reasons that you might be having difficulty.

What are the side effects of the pill?
Most women do not have side effects while taking the pill. Some women will have nausea and mild headaches during the first few weeks. These side effects almost always go away after the first month and may be better if you take the pill just before going to bed.

If I have bleeding between periods, does that mean the pill is not working?
Some women have small amounts of bleeding between periods called breakthrough bleeding. This is not harmful and usually disappears after the first few months. It doesn’t mean your pill is not working. However, forgetting or skipping pills can lead to breakthrough bleeding and increase your chance of getting pregnant. It is very important to take the pill every day.

Does the pill cause blood clots?
Pills may cause a small increase in the risk of blood clots, but the risk is much less than during pregnancy. Blood clots among healthy women are rare whether or not they take the pill.

Does the pill cause cancer?
Using the pill does not increase your risk of breast cancer and actually protects against cancer of the ovary and uterus. Pap smears and yearly exams are still important when you use the pill.

If you are not happy with the pill for whatever reason, see your doctor to discuss all the other options available for birth control including the ring, patch, injection, implant, and intrauterine device.

by:  Angela Dempsey, M.D.