and Managing the Struggles of Premenstrual Syndrome (PMS)

Q: and Managing the Struggles of Premenstrual Syndrome (PMS)

Hello： Your symptoms may be a combination of premenstrual syndrome and somatic symptom disorder. <br>This condition is more commonly encountered in obstetrics and gynecology. <br>It is recommended to have a detailed discussion with an obstetrician-gynecologist, who may prescribe

The troubles of premenstrual syndrome (PMS)?

Hello, Doctor: Every time my menstrual period arrives, it becomes a torment for both my body and mind, and each time the symptoms are different.
Sometimes I experience several days of excessive sleepiness (with a high body temperature, but no night sweats), and other times I suffer from severe migraines that even cause swelling around my eyes.
The pain often radiates from one side of my head to the other, accompanied by lower back pain and extreme fatigue, making me just want to lie in bed and do nothing, which is impossible.
After my period ends, I find myself in a state of insomnia, unable to sleep on my side at night.
Coupled with emotional fluctuations, my interpersonal relationships are also under stress, creating a cycle that seems to leave me with less than a week of calm in an entire month.
I have sought medical help before, but I am unsure if seeing a gynecologist was the right choice, as I felt uneasy from the doctor's troubled expression.
The doctor only prescribed birth control pills, but I did not feel any effect, and I was concerned about long-term side effects, so after six months of treatment, I gave up! With Western medicine not providing a solution, I turned to Traditional Chinese Medicine.
The TCM doctor advised me to exercise more, but he also said he couldn't help if I didn't.
So, I tried running and yoga when my body felt good, but whenever my period comes, I can't even step out of the door.
Thus, my exercise efforts ended without results.
At this point, I am unsure what to do.
I sincerely ask the doctor what is wrong with my body and how I should take care of myself.
Is it advisable to supplement with phytoestrogens? I have heard that premenstrual syndrome falls under the domain of psychiatry, and if that is the case, I might not be able to accept it.
I kindly ask for your guidance, thank you! Sincerely.
P.S.: My menstrual cycle is relatively stable, and I do not have issues with lower abdominal pain; it only occasionally arrives at the beginning of the month, and then less than two weeks later, it comes again.
Due to my frequent mental fatigue and headaches, I have a habit of drinking coffee (low caffeine).

Lisa, 40~49 year old female. Ask Date: 2010/10/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello: Your symptoms may be a combination of premenstrual syndrome and somatic symptom disorder.
This condition is more commonly encountered in obstetrics and gynecology.
It is recommended to have a detailed discussion with an obstetrician-gynecologist, who may prescribe progesterone or low-dose contraceptives based on your condition, along with medications for autonomic nervous system regulation and integration with traditional Chinese medicine, in order to improve these complex and troubling issues.
Thank you! Dr.
Zhang

Reply Date: 2010/10/11

More Info

Premenstrual Syndrome (PMS) is a complex condition that affects many women in the days leading up to their menstrual period. The symptoms can vary widely from person to person and can include physical, emotional, and behavioral changes. Your description of experiencing severe fatigue, headaches, back pain, and emotional fluctuations is consistent with the symptoms of PMS, which can significantly impact daily life and well-being.

PMS is thought to be related to hormonal changes that occur during the menstrual cycle, particularly fluctuations in estrogen and progesterone. These hormonal changes can affect neurotransmitters in the brain, such as serotonin, which plays a key role in mood regulation. This may explain the emotional symptoms you are experiencing, such as anxiety and irritability, as well as the physical symptoms like headaches and fatigue.

In terms of management, it is essential to adopt a holistic approach that includes lifestyle modifications, dietary changes, and possibly medical interventions. Here are some strategies that may help alleviate your symptoms:
1. Dietary Adjustments: A balanced diet rich in whole foods, including fruits, vegetables, whole grains, and lean proteins, can help stabilize blood sugar levels and reduce PMS symptoms. Some women find relief by reducing their intake of caffeine, sugar, and salt, which can exacerbate bloating and mood swings.

2. Regular Exercise: While you mentioned that exercise can be challenging during your menstrual cycle, finding a routine that works for you is crucial. Regular physical activity can help reduce stress, improve mood, and alleviate physical symptoms. Even gentle activities like walking or yoga can be beneficial.

3. Stress Management: Techniques such as mindfulness, meditation, and deep-breathing exercises can help manage stress and emotional symptoms. Engaging in activities that you enjoy and that help you relax can also be beneficial.

4. Supplements: Some studies suggest that certain supplements, such as calcium, magnesium, and vitamin B6, may help alleviate PMS symptoms. Phytoestrogens, like those found in soy products, may also provide some relief, but it's essential to consult with a healthcare provider before starting any new supplements.

5. Medical Treatment: If lifestyle changes and over-the-counter remedies do not provide sufficient relief, it may be worth discussing other medical options with your healthcare provider. Hormonal treatments, such as birth control pills, can help regulate hormonal fluctuations and alleviate symptoms. However, it's crucial to have an open dialogue with your doctor about your concerns regarding side effects and the effectiveness of these treatments.

6. Cognitive Behavioral Therapy (CBT): If emotional symptoms are significantly impacting your quality of life, consider seeking support from a mental health professional. CBT has been shown to be effective in managing PMS-related mood symptoms.

7. Monitoring Symptoms: Keeping a symptom diary can help you and your healthcare provider identify patterns and triggers related to your PMS. This information can be valuable in tailoring a treatment plan that works for you.

It's understandable to feel frustrated with your current situation, especially if previous treatments have not provided the relief you seek. If you feel that your current healthcare provider is not addressing your concerns adequately, it may be beneficial to seek a second opinion or consult a specialist in women's health or a reproductive endocrinologist who may have more experience with PMS.

In conclusion, while PMS can be challenging to manage, a combination of lifestyle changes, dietary adjustments, and appropriate medical interventions can help alleviate symptoms. It’s essential to advocate for your health and seek a treatment plan that aligns with your needs and preferences. Remember, you are not alone in this, and there are resources and support available to help you navigate your symptoms.

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