A few years ago I first noticed that for one full day just before I get my period, I’m always incredibly irritable. Minor disagreements, tiny inconveniences, bad smells—all things mildly annoying—make my blood boil. You might think that after so many instances of this, I would come to expect it and sort of schedule it in: “Okay, I’m going to be crabby that day. Better not leave the house.” But in reality, it always takes me at least half a day to recognize the underlying reason for my irritability. That means, for at least the first half of one day every month, I just think everyone is a jerk (though, to be honest, many people are just jerks…but it’s worse when hormonally unbalanced).
And I have it easy: my single PMS symptom lasts for one day and is relatively mild. In fact, what I experience isn’t really premenstrual syndrome in the clinical sense; it’s just a symptom related to the fluctuation of hormones in my body prior to my menstrual period. Women who suffer from actual PMS often must grapple simultaneously with several emotional, physical, and behavioral symptoms—sometimes for as long as a week or two. According to some experts, there are as many as 200 PMS symptoms, which affect all PMS sufferers in unique combinations and intensities. Of course, no one gets all 200 symptoms; the most common ones are irritability, weepiness, mood swings, breast soreness, bloating, weight gain, acne, food cravings, fatigue, headaches, abdominal cramps, and lower back pain. For some women, PMS strikes with such severity that it interferes with their daily activities, causing them to miss work or school, avoid social situations, or lash out physically or verbally. Whether you fall into this category or, like me, are merely annoyed by premenstrual symptoms, you should be able to find relief through the suggestions below.
Best PMS Remedies
Eating a healthy, balanced diet may make you feel better no matter which PMS symptoms you experience. Following the guidelines of the USDA food pyramid is a good place to start, but be especially vigilant about avoiding excessive sugar and salt (even if these are the very things you crave most), since they can contribute to bloating, breast tenderness, and dizziness. It’s also not a bad idea to nix caffeine—which can increase anxiety and depression, and has a habit of making sore breasts even sorer—and alcohol, which increases fatigue and could mess with your already messed-up moods. On the other hand, complex carbohydrates like fruits, vegetables, and whole grains provide energy and may actually stimulate your brain to produce a feel-good chemical called serotonin. Also keep in mind that eating small frequent meals will keep your blood sugar (and in turn, your mood) stable, with the added bonus of preventing the full, bloated feeling you can get after a big meal.
Vitamins and Minerals
You can also use nutrition to combat symptoms of PMS by upping your intake of certain vitamins and minerals.The most useful of these is also one of the easiest to come by: a daily dose of 1200 mg of calcium has been shown to reduce most PMS symptoms, especially emotional imbalances, food cravings, fluid retention, and all the various types of premenstrual pain. Some women also find 400 daily mg of magnesium effective against an array of symptoms, including bloating and breast pain. Vitamin E, in a dose of about 400 IU a day, can lessen cramps and breast tenderness by disabling prostaglandins that participate in the process of inflammation and pain. In addition, zinc may help to clear up your pre-period acne, and vitamin B6 might elevate your mood—but you don’t need much of it: the Recommended Daily Value is only 2 mg, and more than 100 mg can have toxic effects. Obviously, all of these vitamins and minerals are present in food, so if you’re eating a balanced and varied diet you may already be getting all you need. If not, individual supplements or a good women’s multivitamin will fill the gaps. You can find Multivitamins from Nature Made at Amazon.
Exercise is always important to feeling good, whether you have PMS or not. But when you do have PMS, exercise acts directly against some of the most debilitating symptoms. Not only does regular aerobic exercise give you energy during the day and help you sleep better at night; it can also prod your brain into producing dopamine, serotonin, and endorphins, which are all chemicals involved in feelings of calmness and pleasure. Endorphins also have the ability to ward off physical pain, so if you aren’t too crampy to get off the couch a few times a week and do 20-45 minutes of running, swimming, biking, or Sweatin’ to the Oldies, you might even find that your abdomen and your breasts thank you for it.
If your premenstrual pain stands up to attempts to curb it naturally, the best drugs for treating breast soreness, cramps, and headaches are usually nonsteroidal antiinflammatory drugs (NSAIDs). Many of the most common over-the-counter pain relievers fall into this category, including aspirin (Bayer), ibuprofen (Advil and Motrin), and naproxen (Aleve). NSAIDs work by inhibiting enzymes called prostaglandins that play a central role in producing inflammation. Most of the pains associated with PMS are the result of inflamed tissue, so NSAIDs work at the source of the pain. Thankfully, you can order any of these (like Aleve) from Amazon.
Reducing stress in your life may alleviate some of your PMS symptoms, not because stress causes those symptoms, but because premenstrual hormone fluctuations can amplify the emotional and physical effects of stress. Simply taking time to relax on a regular basis may be enough to calm you and stabilize your moods, whether you relax through meditation, breathing exercises, yoga, or just a hot bath. Or you may benefit from seeing a counselor or psychologist, who, in addition to giving you an outlet to talk about the things that stress you out, can teach you time management and stress management techniques.
Best Natural Remedies for PMS
Chaste Tree Berry
Chaste tree berry has a long history of helping women regulate their menstrual cycles. Like most herbal remedies, it hasn’t been extensively studied, so scientists aren’t entirely sure why it seems to work. There is some evidence that it increases dopamine levels in the brain, and that it alters levels of progesterone and estrogen, both effects that may in turn improve your mood. It may also reduce the amount of prolactin in the body, which in excess can lead to mood swings, sore breasts, and cramps. It is also known as Vitex and can be found in liquid extract and tablet form. As with any herbal remedy, only buy from a reputable source and use it carefully, according to the label.
Evening Primrose Oil
Evening primrose oil is an extract from the seed of the evening primrose plant. It contains gamma-linoleic acid, an essential fatty acid that the body can convert to a type of prostaglandin that limits inflammation. Many women claim that it lessens inflammation-based premenstrual pain, like cramps and breast tenderness.
Progesterone cream is used by some women to balance the hormone levels in their bodies. The idea is that many PMS symptoms, including bloating, irritability, breast tenderness, headaches, and fatigue, are the result of “estrogen dominance,” which occurs when the level of estrogen in the body exceeds the level of progesterone. Progesterone cream is made from a substance found in wild yams and soybeans, and when it’s applied to the skin, the natural progesterone in the cream is absorbed into the body to balance estrogen levels and reduce the symptoms of PMS.
What is PMDD?
Premenstrual Dysphoric Disorder (PMDD) is basically PMS’s tattooed, pierced, Harley-driving identical cousin. It’s PMS, but more intense. While a woman with PMS is irritable, weepy, and craving junk food, a woman with PMDD may be binge eating, having a panic attack, and feeling desperate or even suicidal. PMDD often, but not always, involves physical symptoms associated with PMS, such as bloating, breast pain, and cramps. But it’s characterized by such severe psychological symptoms that daily life as usual is not possible. Those of us who experience PMS can usually ignore or control our symptoms, but women with PMDD often feel out of control, and they may become so depressed that they withdraw from social life, or so irritable that they act aggressively around other people. While experts estimate that as many as 85% of women experience PMS symptoms, only 3-8% are affected by PMDD.
Medical Treatment for PMS
If your PMS symptoms interfere significantly with your life and the techniques described above don’t relieve them, it’s time to see a doctor. Your doctor will probably ask you to keep a calendar of your mental, emotional, and physical symptoms for at least two complete menstrual cycles. If your symptoms show a monthly pattern, the doctor may diagnose you with PMS or PMDD. However, some women who seem to suffer from PMS actually have other physical or psychological disorders that may be aggravated by premenstrual hormones, or that are entirely unrelated to the menstrual cycle.
If you are diagnosed with PMS or PMDD, you will probably be treated with one of two medications. The first is a category of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which includes Prozac, Paxil, and Zoloft. These work by slowing down the process by which the neurotransmitter serotonin is reabsorbed by the nerve cells that release it into the brain. With more serotonin left in the brain, nerve impulses travel more consistently and easily from one nerve cell to another, and the ultimate result is a calmer, more pleasant mood. SSRIs, obviously, are only effective against psychological symptoms of PMS and PMDD. If your symptoms are primarily physical, or if you suffer from a combination of severe physical and psychological symptoms, your doctor may prescribe the other common medication for PMS and PMDD.
Yaz is a unique type of hormonal birth control pill that has been FDA approved to treat both physical and psychological symptoms of PMS and PMDD. Two features set it apart from other kinds of birth control pills. First, Yaz uses a combination of estrogen and progestin. This combination is nothing special, except that Yaz uses a form of progestin called drospirenone, which is more like natural progesterone and—unlike progestin used in other hormonal birth control—is not made from testosterone. The special chemical composition of drospirenone gives it the ability to reduce fluid retention and breast tenderness, and its use of female rather than male hormones makes it effective in clearing up acne. The second difference between Yaz and other birth control pills is that while most packs of birth control include 21 hormone pills and 7 placebo pills (without hormones), Yaz provides 24 hormone pills and only 4 placebo pills. The extra three days of active pills help to keep your body’s hormone levels even in the week before your period, so your mood stays more even, too.