Between 20 and 45 minutes of aerobic exercise at least three times a week has been found to decrease depression, anxiety, and fluid retention associated with PMS.
Take steps to reduce stress in your life.
Stress can worsen PMS symptoms, so consider doing 20 to 30 minutes of meditation, yoga, or other relaxation exercises daily. Try to identify stressors in your life, and take steps to modify or eliminate your exposure to the stressor, when possible.
Try to get regular and adequate sleep.
To help you sleep better, maintain a regular sleep schedule. Go to bed at the same time each night, and wake up at the same time each morning. Avoid intense activity, food, and caffeine 2 to 3 hours before bedtime. Make it a priority to get 8 to 9 hours of sleep nightly.
Decrease your caffeine intake.
Caffeine may worsen tension and irritability and increase the occurrence of sleep difficulties. Avoid caffeine-containing foods and beverages (such as coffee, tea, colas, and chocolate). It is especially important to avoid caffeine during the time of your cycle when you typically have PMS symptoms.
Consider changing your diet.
Food cravings are common for women with PMS. Be sure to eat frequent, regular, well-balanced meals with adequate amounts of protein, fiber, and complex carbohydrates. If you feel the need to binge on sweets, try increasing your intake of foods high in healthier complex carbohydrates instead. Examples of food rich in complex carbohydrates include pasta, whole wheat breads, cereal, and potatoes. Foods high in salt should be avoided, as they increase bloating and ankle swelling.
Try over-the-counter pain medication.
Pain relievers may help alleviate premenstrual or menstrual pain. If you have mild to moderate pain with your premenstrual symptoms, take an over-the-counter pain medication (such as naproxen). If your pain is severe or is accompanied by a fever, notify your clinician.
Your doctor is the best source of information on the drug treatment choices available to you.
Women with very severe symptoms that have been unresponsive to other treatments may opt to have their ovaries removed.
Removing both ovaries stops the hormonal changes of the menstrual cycle that may cause PMS. Removing both ovaries causes the immediate onset of menopause. Estrogen replacement therapy may be needed following surgery. Women should choose surgery only as a last resort. Women who have their ovaries removed but would still like to bear children should consider freezing their own eggs or creating embryos in the lab using their eggs and freezing the embryos for future use.
Nutritional supplements are sometimes helpful Table 03.
Some physical and emotional symptoms of PMS may be eased with nutritional supplements. Supplements that may be helpful include calcium, magnesium, and vitamin B6. Herbal supplements may also be helpful Table 03. Since nutritional supplements can be harmful at higher doses, consult your clinician for the supplements and dosages that are right for you.
Women who are pregnant or breastfeeding need to avoid some medications and herbal remedies. Consult your clinician or pharmacist before taking
any medicine or supplement if you are breastfeeding or think you may be pregnant.
Table 3. Additional Minerals and Herbs That Have Been Used for PMS
Black cohosh (Cimicifuga racemosa) Black cohosh is used to treat menopause symptoms and menstrual cramps. Do not take black cohosh if you have a history of breast cancer or estrogen-responsive tumors. Black cohosh is dangerous if taken in large quantities, so consult your clinician for the dose that is right for you. Limit self-treatment with this herb to no longer than 6 months. Chaste-tree berry (Vitex agnus-castus, chasteberry, monk's pepper) Chaste-tree berry is an herb that has been used to treat menstrual problems including premenstrual symptoms, breast pain, painful periods, irregular menstrual cycles, and hormonal regulation. You should not use chaste-tree berry if you are taking hormone replacement therapy, birth control pills, or sex hormones. Dandelion (Taraxacum officinale, lion's tooth) Dandelion acts as a diuretic (causes you to urinate more). This may help decrease water retention and bloating. Do not use it if you have gallbladder problems, irritable bowel syndrome (IBS), or stomach problems. Check with your clinician before using dandelion if you are taking an antibiotic or potassium supplements. Evening primrose oil (GLA, gamma-linoleic acid) Evening primrose oil may ease breast swelling and help ease other symptoms of PMS. Do not take evening primrose oil if you have a history of seizures. Ginkgo biloba extract (Ginkgold, Ginkoba) Ginkgo has not been well studied for PMS, but it is often used to relieve PMS symptoms. The plant contains various compounds, some of which may have mood-elevating properties. Do not use ginkgo without your clinician's supervision if you take blood thinners or medicine for depression or high blood pressure.
Alternative therapies should not be used as a substitute for medical care. You should always tell your clinician or pharmacist what medicines you are taking, such as prescription or nonprescription medicines, herbs, vitamins, or other supplements.
Alternative therapies may react poorly with some prescribed or nonprescription medicines. Taking herbs, vitamins, or other supplements may interfere with lab tests or healing after surgery or illness, or may worsen some illnesses and health conditions. Your clinician and pharmacist can help you choose the complementary therapies or supplements that are right for you.
Women with PMS are likely to also suffer from clinical depression.
Studies show that approximately 57% of women with a history of major depression experience PMS or more severe depressive symptoms in relation to their menstrual cycle.
Most women suffering from PMS can be helped.
Most women can find relief with a healthier lifestyle, including improving diet and increasing exercise, doing relaxation exercises and reducing stress, and using medications to treat more severe symptoms.
Notify your clinician if your PMS symptoms worsen or do not improve.
You will need to work with your clinician to find treatments effective against your most troublesome symptoms. PMS is treated by trial and error, and some women must try many methods before determining which treatment is the most effective. A medical disorder other than PMS must also be considered if symptoms worsen or change.
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