Being a woman comes with a few perks, but having a period certainly isn't one of them (except for bodily confirmation you're without child). As if that bloody week wasn't already enough torture, your PMS cycle might take the cake as your worst week of the month. But just what are the common symptoms of this prevalent pre-period syndrome, and should you be consulting with your doc and gyno about it? We spoke with Dr. Gil Weiss, Assistant Professor of Clinical Medicine at Northwestern Memorial Hospital and Partner at The Association for Women's Health Care in Chicago and Dr. Nieca Goldberg, Medical Director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center, to find out more about what's normal about your PMS--and maybe what's not.
Premenstrual syndrome refers to the host of symptoms that occur in between the weeks of ovulation and the menstrual cycle. This hormonal shift in the body occurs due to the symbiotic relationship between the ovaries and the brain, and if an egg isn't fertilized after ovulation, your body then prepares for an influx of emotional and physical changes. It can take a few months for a woman to truly encounter realized symptoms of premenstrual syndrome and these symptoms change and mature over time.
According to both Weiss and Goldberg, a vast majority of women tend to experience abdominal cramping, mood swings, breast swelling, bloating, fatigue as well as emotional and physical changes before their periods. The bulk of these symptoms is manageable with a well-balanced diet, daily exercise and limited intake of caffeine and sodium. However, if a woman's symptoms are impeding her daily activities and overall livelihood, she should consult her gynecologist for a personalized treatment plan. Weiss advises against self-treatment for severe premenstrual syndrome symptoms, as very few over the counter treatments are truly effective.
Weiss and Goldberg both recommend low-dose birth control pills as a first defense against the unpleasant effects of PMS, and if a woman is experiencing significant psychological distress or emotional imbalances, Weiss recommends low-dose antidepressants and Goldberg prescribes SSRIs (selective serotonin reuptake inhibitor). When a woman starts a course of these types of medication, Goldberg advises her to coordinate with both her primary doctor and her gynecologist to ensure she's receiving best, most communicative treatment possible.
So what if you're experiencing different kinds of pain not typical of premenstrual syndrome? If you're frequently in pain during your period and you have very heavy menstrual cycles on a regular basis, talk to your doctor about an endometriosis diagnosis. Endometriosis is a debilitating condition where the lining of the uterus grows outside of the uterus, often resulting pelvic pain and even infertility in severe cases. Goldberg has her patients undergo various types of imaging to determine if endometriosis is contributing to worsening premenstrual and menstrual pain. Weiss warns it can take multiple attempts to diagnose endometriosis, but non-invasive treatments are available and steroid therapy has proven to be effective in conquering pain management.
As you prepare to consult your primary or gynecologist about your premenstrual syndrome, Weiss stresses how important it is to be as open with your doctor as possible. "PMS can worsen preexisting health concerns, especially those with emotional side effects, and we need to able to treat both symptoms and underlying conditions."
It's very normal for premenstrual symptoms to change over time as your own body grows and matures. If your symptoms alter dramatically or are inhibiting your quality of life, consult your gynecologist or primary for advice and for the best treatment plan catered to your needs.
Remember, you're the boss of your own body and PMS doesn't own or control you. And remember, having lady problems just makes you stronger in the end!