Dear Nuts,

Mood swings. Bloating. Crying jags. Inability to sleep. I am woman, hear me roar! PMS (aka premenstrual syndrome) — no matter how you experience it — can be a pill. The American College of Obstetricians and Gynecologists notes that while the cause of PMS is not clear, about 85 percent of menstruating women experience at least one premenstrual symptom — emotional, behavioral and/or physical. These commonly include:

• Depression
• Angry outbursts
• Being irritable
• Crying spells
• Anxiety
• Confusion
• Social withdrawal
• Poor concentration
• Sleep disturbance
• Thirst and appetite changes (food cravings)
• Tender breasts
• Bloating and weight gain
• Headache
• Swelling of the hands or feet
• Aches and pains
  List adapted from the article Premenstrual Syndrome from the American College of Obstetricians and Gynocologists.

A health care provider may give a diagnosis of PMS if a woman has these symptoms for a few days prior to three consecutive periods, if these symptoms end within a few days of her period beginning, and/or if these symptoms interfere with daily activites.

Although birth control pills may reduce the physical symptoms of PMS, they typically do not relieve emotional and behavioral symptoms. Still, you may consider discussing different treatment options with a healthcare provider. S/he may suggest antidepressants (especially selective-serotonin reuptake inhibitors — SSRIs) and/or dietary supplements such as calcium (approximately 1200 mg per day) or Vitamin B6 (up to 100 mg per day). In the days leading up to the flow, some women find it helpful to eat more fruits, vegetables, and whole grains, reduce their intake of fat, salt, and sugar, and avoid caffeine and alcohol. Relaxing activities such as yoga, massage, or tai-chi may also help relieve symptoms.

Some women who feel PMS-y may actually have premenstrual dysphoric disorder (PMDD). This condition affects about ten percent of women with PMS. For more information on PMDD, check out Testing for premenstrual dysphoric disorder (PMDD) in the Go Ask Alice! sexual health archives.

If you feel that PMS is affecting your life, see a healthcare provider, who can diagnose the cause of your symptoms and suggest appropriate treatment. If you are a student at Columbia, you can make an appointment to see a healthcare provider by either calling x4-2284 or visiting Open Communicator. You can also see any provider from Counseling and Psychological Services by calling x4-2878 to make an appointment.

Here's hoping that you feel a little less nuts after reading this,

Alice

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