Premenstrual syndrome (PMS) refers to a group of physical and behavioral symptoms that occur during the second half of the menstrual cycle.

The most common symptoms are bloating and feeling tired, angry, or worried.

Other symptoms can include; feeling sad or hopeless, or crying a lot, mood swings, trouble concentrating, eating more than usual or craving certain foods, sleeping too much or having trouble sleeping, breast soreness or swelling, headaches, joint or muscle pain and weight gain

Premenstrual dysphoric disorder (PMDD) is a term used to describe the severe form of premenstrual syndrome. Common symptoms include anger, irritability, and internal tension that are severe enough to cause those affected to have trouble at work, school, or getting along with family and friends.

Mild premenstrual syndrome is most common, affecting up to 75 percent of women with regular menstrual cycles with only 3 to 8 percent of women experiencing severe forms. This condition can affect women of any socioeconomic, cultural, or ethnic background.

Though not common, severe premenstrual syndrome is usually a chronic condition and can have a serious impact on a woman’s quality of life. Fortunately, a variety of treatments and self-care measures can effectively control the symptoms in most women.

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition. Cyclic changes in hormones during a woman’s menstrual cycle, chemical changes in the brain, or an underlying undiagnosed depression have been associated with premenstrual syndrome.

There is no single test that can diagnose premenstrual disorder. The clinician will diagnose the disease basing on the pattern of one’s symptoms. These symptoms which occur only during the second half of the menstrual cycle, most often during the 7-14 days before the menstrual period, and associated with physical as well as behavioral symptoms will be indicative of the condition. Although a woman’s symptoms may suggest premenstrual disorder, a clinician may request that she carefully records her symptoms on a daily basis for two or more full menstrual cycles

Blood tests are not usually necessary to diagnose premenstrual disorder, although may be recommended to screen for other medical conditions that can cause symptoms similar to this condition, such as anemia or diseases of the thyroid gland.

Lifestyle and home remedies measures for dealing with premenstrual syndrome may be recommended first, including regular exercise, relaxation techniques, and vitamin and mineral supplementation. These therapies relieve symptoms in some women and have few or no side effects. If these therapies do not bring sufficient relief, prescription medication can be considered as a second option.

Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness, limit salt and salty foods to reduce bloating and fluid retention, choose foods high in complex carbohydrates such as fruits, vegetables and whole grains.

Choose foods rich in calcium and if you can’t tolerate dairy products or aren’t getting adequate calcium in your diet, a daily calcium supplement may help. Avoid caffeine and alcohol as this might worsen the condition. Vitamin and mineral supplements, such as vitamin B6 might have a small benefit for women with mild premenstrual disorder, although should be taken in less dozes (No more than 100 mg of vitamin B6 should be taken per day) unless prescribed by one’s doctor.

Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise and plenty of sleep can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.

Practicing progressive muscle relaxation or deep-breathing exercises can help to reduce headaches, anxiety or trouble sleeping (insomnia), as well as yoga or massage to relax and relieve stress.

If one’s symptoms don’t respond to life style and home remedies, the doctor might prescribe one or more medications for premenstrual syndrome. The success of medications in relieving symptoms varies from woman to woman. Commonly prescribed medications for premenstrual syndrome include; drugs to treat depression can be successful in reducing mood symptoms. Medicines to reduce pain and swelling (NSAIDs) such as ibuprofen, diclofenac can ease cramping and breast discomfort.

Some women find that their premenstrual disorder improves after they start taking birth control pills. There are different types of birth control pills and one’s doctor can decide to choose among those accordingly.

Dr. Ian Shyaka is a Resident in Surgery, at Rwanda Military Hospitaliangashugi@gmail.com