Managing the symptoms of PMS
Most women experience pre-menstrual syndrome (PMS) in some form, with the Mayo Clinic in the US estimating that around three quarters of all women are affected.
The term PMS is used to describe the symptoms women can experience in the days or weeks leading up to their period. Common physical symptoms include abdominal cramps, tender breasts, headaches, acne, fatigue and changes in appetite. PMS also often affects the mind – with women experiencing mood swings and feeling upset, anxious or irritable, having problems with memory or concentration, or having trouble sleeping.
PMS is still not very well understood, beyond the fact that it’s due to a drop in levels of the hormones oestrogen and progesterone. It’s not clear exactly what causes many of the symptoms, and they can be unpredictable in their arrival or severity. Nor is PMS talked about very much, which can lead to women feeling a sense of shame and embarrassment. An element of stigma remains around the condition; the symptoms are sometimes described as ‘only PMS’ or ‘women’s problems’, while those experiencing them can be dismissed as over-sensitive or over-emotional.
The fact is, PMS can have a significant impact on someone’s life, putting a strain on relationships, causing difficulties at work, and leading to lost time and opportunities.
This is especially true for those who experience the most severe form, known as PMDD (pre-menstrual dysphoric disorder). It’s categorised as an endocrine disorder, but because it causes mental health symptoms it’s recently been listed in one of the main manuals psychiatrists use to diagnose mental health problems. The Mind website has some useful descriptions of women’s personal experiences with PMDD. Some people struggle for years before being diagnosed, which can lead to loss, anger and frustration.
It’s not possible to ‘cure’ PMS, but herbal or pharmaceutical medicines can help with relieving symptoms – for example painkillers could be used to control cramps, aches and soreness. GPs will sometimes prescribe birth control methods to regulate hormones, or anti-depressants to help those whose mental health is badly affected.
Advisory bodies including the NHS recommend following a healthy lifestyle for managing PMS – including:
- exercise, which can boost mood and energy levels
- taking B vitamin supplements
- cutting down on salt, sugar, caffeine and alcohol, and
- getting enough sleep.
It can also help if you change how you view your symptoms, and the approaches you take to responding to and coping with them. Let’s look at a few ideas you could try.
Figure out what helps – and what doesn’t! Do a quick ‘audit’ of the behaviours and coping strategies you use. Are they helpful? Or do they have other consequences? For example, eating a whole box of doughnuts might be comforting at the time but may make you feel worse later on! Do some research into the ways other women tackle their PMS, and perhaps try some new ideas you think might work. This could be getting a punchbag you can hit to relieve tension, taking supplements, or simply going to bed and sleeping it off if that’s what you need to do. If it helps, put it in your PMS toolkit.
Track your symptoms. Charting your symptoms day by day can help you to spot patterns, and learn when in your cycle you tend to feel more energetic or positive. You can then make plans around how your feelings ebb and flow. For instance, if you have particularly debilitating symptoms the day before your period arrives, and you feel able to, you could explain this to your manager and discuss how you can work around this.
Challenge assumptions which might be limiting you. Don’t automatically rule things out because you believe you’re not up to it. You don’t necessarily have to rollerskate around town in white shorts (unless you want to)! But if you find yourself thinking ‘I can’t do this while I feel so tired and cross’, try an experiment; for example, if you avoid exercising give it a go and see if you feel better afterwards.
Try CBT to manage the psychological symptoms. The hormonal shifts associated with PMS can lead to feelings of anxiety, stress and low mood. These can also happen as a knock-on result of the impact and disruption PMS has on your life. The NHS specifically recommends talking therapies as a way of tackling stress, anxiety and depression, including cognitive behavioural therapy (CBT).
CBT helps with breaking the ‘vicious cycle’ of thinking that can often make you feel worse. For instance, someone who gets spots every month might think “I look and feel awful, I can’t go out”. Avoiding social contact and staying at home could lead them to feel sluggish and low, or to worry that they’re missing out or letting people down. This can affect their self-esteem and make them even less inclined to do things. By recognising this cycle and making some changes you can turn things around.
Read more about how CBT works here.