While many jokes have been made about Premenstrual Syndrome (PMS), it can
be very debilitating. Changes in mood, especially irritability, is perhaps
the most undesired of the variety of symptoms that an affected woman complains
about and likewise people in her immediate circle. A few years ago this
component even received its own psychiatric diagnosis, Premenstrual Dysphoric Disorder.
Usually at a woman’s first visit regarding PMS we recommend nonprescription
remedies, then follow-up in about 3 months to monitor response.
- Exercise: Regular cardiovascular exercise has multiple studies demonstrating benefit
- Calcium: 1000-1200 mg per everyday for a minimum of 3 months duration before
- Magnesium: 250-400 mg per day improves mood and decreases constipation
- Vitamin B6: 50-100 mg per day during PMS (don’t exceed as risk of
peripheral nerve problems)
- Chasteberry (Vitex agnus-castus): Improves breast tenderness, constipation,
and mood. Dose varies depending on product. Take during PMS.
Low dose birth control pills can also be helpful and soon this will be
specifically marketed as a lower dose version of Yasmin®. Should these
interventions fail, we would strongly encourage the use of prescription
anti-depressants. They raise serotonin levels in the brain that are cyclically
decreased. Prozac® even comes as a convenient weekly formulation.
This can be life changing, easing intolerable tensions, and allowing productive
participation in daily activities.
It takes great patience to help patients realize that they no longer have
to struggle under the cloud of PMS. It takes an open minded woman to embrace
such interventions. In the end you and those you care about most will benefit.