What is PMS?

You can't stop PMS from paying you a visit every month. But you can ease the pain by eating the right foods — and avoiding the ones that make symptoms worse.

PMS is estimated to affect about 40 percent of American women of childbearing age. Between 3 and 9 percent of women have a more extreme form of PMS called premenstrual dysphoric disorder (PMDD). PMS and PMDD cause physical and emotional symptoms — including irritability, sadness, mood swings, low self–esteem, difficulty concentrating, bloating, water retention, lack of energy, and breast tenderness — for some portion of each month, triggered by normal hormonal changes associated with the menstrual cycle.

PMDD is casually defined as PMS that is so severe that it significantly decreases a woman's quality of life. PMS feels uncomfortable and unpleasant, but PMDD can turn social lives, work lives, families, and marriages upside–down.

Regardless of whether you experience a little extra moodiness near your period, or full–on emotional breakdowns, good nutrition can help alleviate some of your premenstrual symptoms.

WHAT AFFECTS PMS?

No one knows exactly why some women experience symptoms while others do not. One leading theory is that some women have a greater sensitivity to the effects the female hormones estrogen and progesterone have on their serotonin levels. Serotonin is a brain chemical that plays a key role in mood regulation and sensitivity to pain, and research and clinical results seem to confirm that it significantly influences the onset of PMS. When women with the most severe premenstrual symptoms are treated with a serotonin–enhancing antidepressant (similar to Prozac), about 70 percent get substantial relief.

What we do know is that for many women, PMS is an uncomfortable fact of life. The exact severity and cluster of symptoms will differ from woman to woman. Some will have fatigue, bloating, and depression; others will have breast tenderness and irritability, or any combination of any of the symptoms. Most typically, symptoms begin the week before a woman is due to get her period, peak the day before the start of her period, and then disappear within a day after her period starts. The vast majority of women with PMS have symptoms for five to seven days each month. But some women can have symptoms that last two, or even three, weeks each month.

If you are a woman of childbearing age experiencing mood issues, I recommend keeping a PMS diary. On a regular calendar, write down your primary moods, emotions, and unusual physical symptoms each day. On the same calendar, keep track of your menstrual cycle. If your troubling moods or other symptoms occur primarily within the two weeks prior to the start of your period, you may have PMS (in addition to all the regular aggravations of life). However, if the days you experience irritability or depression are evenly spaced throughout the month, PMS probably isn’t the culprit, and you may be experiencing another mood issue or disorder.

It is important to note all your physical symptoms in your PMS diary. For reasons that aren’t exactly clear, many the symptoms of many diseases or disorders get worse premenstrually, a phenomenon known as premenstrual exacerbation. Depression and anxiety are prone to this exacerbation, as are migraines, epilepsy, asthma, allergies, diabetes, irritable bowel syndrome, and many autoimmune disorders. Just because your symptoms aren’t generally included in a list of the symptoms of PMS doesn’t mean that they aren’t related to your menstrual cycle. If your worst symptoms seem to occur the week before your period, talk with your doctor about whether there are things you can do to better control your particular disorder.