Premenstrual Syndrome (PMS)

Prevention

Because doctors are not exactly sure what causes PMS, there is no way to prevent it. However, you may be able to alleviate some PMS symptoms by leading a healthier lifestyle.

Treatment

The treatment of PMS depends on the severity and type of symptoms, and how bothersome they are. For example, if your symptoms are mild and do not interfere with your daily life or personal relationships, then your doctor may suggest that you try one or more of the following lifestyle changes:

• Start a program of regular exercise (three to five exercise sessions per week).

• Do not skip meals. Follow a regular meal schedule to maintain a more stable blood sugar level.

• Eat a balanced diet that is low in refined sugars.

• Try to get a good night's sleep. Avoid staying up all night.

• If you smoke, quit.

• Cut down on caffeine, alcohol, red meat and salty foods.

• Practice stress reduction techniques. Take a nice long bath, or try meditation or biofeedback.

Your doctor also may suggest that you try taking supplements of vitamin B6, calcium or magnesium. Always follow the dosage recommended by your doctor. Do not take more than 100 milligrams per day of vitamin B6. Nerve damage has been associated with vitamin B6 at doses higher than 100 milligrams per day.

If your symptoms are moderate to severe and interfere with your normal daily activities, then your doctor probably will prescribe medications aimed at relieving specific symptoms. For example, if you are troubled by bloating and weight gain, then your doctor may prescribe a diuretic to help your body eliminate the excess water. Oral contraceptives, especially birth control pills containing both estrogen and progestin, may be used to minimize the severity of cramps and the length of your period.

If you have symptoms of irritability, social withdrawal, angry outbursts or depression that interferes with your work or home responsibilities or your personal relationships, then your doctor may suggest that you try an antidepressant medication. The most effective antidepressants for relieving PMS are selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac, Sarafem and others), sertraline hydrochloride (Zoloft) and clomipramine (Anafranil). Other antidepressants include nefazodone (Serzone) and venlafaxine (Effexor). These can be taken for two weeks prior to each period or can be taken every day.