Premenstrual syndrome: how to recognize and deal with it

The term premenstrual syndrome defines a set of physical and emotional symptoms that occur in the second half of the menstrual cycle, usually 4-7 days before menstruation, and improves or disappears with the onset of the period.

The most frequent emotional symptoms are:

• irritability;
• mood changes;
• depression;
• hypersensitivity;
• episodes of crying;
• tendency to isolation;
• lack of concentration, interest and memory.

Physical symptoms include:

• abdominal bloating;
• breast tenderness;
• increased appetite;
• swelling of the extremities;
• muscle aches;
• asthenia;
• sleep disorders;
• headache.

For centuries, premenstrual irritability and mood swings have been underestimated by men and accepted by women with resignation. In 1953, however, something changed: for the first time Premestrual Syndrome was spoken of.

In 1994, another step forward was made. Premenstrual syndrome accompanied by dysphoric disorders (mood alterations) is included in the DSM-IV (Statistical Diagnostic Manual of Mental Disorders) and therefore recognized in its complexity.

Finally, in 2000 the American College of Obstetricians and Gynecologists (ACOG) published a practical bulletin on premenstrual syndrome including the criteria for the diagnosis and treatment of this disease.

The factors involved in the origin of the various disorders related to premenstrual syndrome are not known with certainty. Several hypotheses have been advanced, but none of which has been proven. These include a progesterone deficiency in the luteal phase (phase of the cycle following ovulation, during which the uterus prepares for a possible conception), or an increase in stress or an altered hydro-saline turnover.

What we do know, however, is that the hormone levels of estrogen and progesterone also influence the production of serotonin, which in turn affects mood: women who develop the typical symptoms of PMS are probably more sensitive to monthly hormonal changes.

To relieve premenstrual symptoms, some precautions can be taken, such as:

Exercise and relaxation

Regular physical activity helps to reduce stress, tension and anxiety. One of the first things to do to relieve PMS symptoms is to increase physical activity; on the other hand, you can also practice relaxing disciplines such as meditation and yoga which have the same function as well.

Nutrition and supplements

It is very important to choose carefully what you eat and introduce into the body. In particular, it is useful to increase the intake of Calcium, Magnesium and Vitamin B6, both through nutrition and with special supplements, which enhance the metabolism of the neurotransmitter serotonin that regulates mood.

Good sources of calcium are:

• milk and its derivatives (favoring, however, those with low fat content),
• almonds,
• spinaches,
• green leafy vegetables.

Magnesium can be found in:

• whole grains,
• dried fruit,
• green leafy vegetables.

Vitamin B6 is widespread in foods of both animal and vegetable origin and is found in:

• milk,
• fish,
• cereals,
• potatoes,
• cheeses,
• spinach,
• beans,
• carrots.