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Coping with Premenstrual Syndrome

Recording your symptoms

If you keep a menstrual diary to record physical and emotional symptoms during the month, you can see for yourself how you change, if you do. Women are often advised to record only the most distressing symptoms such as irritability, depression, tension or headaches, but this leads to a distorted picture. It is just as true to consider feelings of well being and highs in energy level.

It is very difficult to keep an accurate menstrual cycle diary when monitoring moods, especially when everyone is telling you to expect terrible things before your period. It is tempting to record an irritable day if it occurs premenstrually, but to have a 'legitimate' reason for the same irritability at other times and so not record it. There are many women who don't need to keep a menstrual cycle diary because their symptoms are so clearly connected with the premenstrual phase and disappear completely with bleeding. Rather than looking for anything in particular, just record what goes on for you. Compare your diary with other women's diaries and see the range of experiences that are cyclical in nature. See a sample of a menstrual cycle diary.

What is PMS?

The term PMS or Premenstrual Syndrome is used in this leaflet to mean both the physical and mental symptoms which occur before a period. The term PMT or Premenstrual Tension usually refers just to emotional changes.

Many women experience irritability, tension, aggression, anxiety or depression when they are premenstrual. If these feelings are not too severe, it usually helps to know that they will pass once your period starts. It also helps to know that they are normal human emotions. It is not a sign of illness to be tense or aggressive, even when you can't find an obvious cause. It is not always possible or necessary to look for explanations for mood changes.

But many women who suffer premenstrually are too badly affected to ride it through. They feel overcome, and express their anger despite their best intentions. When it gets to this state, most women start looking for solutions. First of all, consider yourself worthy of a healthier, happier life. You are not looking for a solution to PMS to improve your children's or your partner's lives but because you, yourself, deserve it. As a woman, you have been brought up to nurture others. It's just as important to nurture yourself.

Secondly, look at the things in your life which make you irritable premenstrually and try to do something about them. Are you under too much stress? Some women take on too much and have an unrealistic idea of what they can achieve. But most have no choice about the amount of stress in their lives. For example, raising children is a very demanding job with little support and recognition from partners and society.

"I need more time or else I become very aggressive. The children have to spend more time with their father. When I first suggested it, I felt I was being selfish but I'm only asking him to come home on time and put in a bit more effort and commitment a few days a month."

Many women crave time on their own premenstrually. Some find it a creative time. The irritability and tension experienced may be a reaction against the invasion of work, school, children or other people when they are desperate to be alone. Yoga, meditation, sleeping, listening to music, reading or just sitting are some of the things which give you time on your own.

You may not need time on your own but time for yourself, without being interrupted to care for others. Identifying and meeting your needs is difficult, sometimes nearly impossible but it's crucial to try and organise your life so that your needs are met.

"I can't afford to work part time so I have to put up with being tired three or four days a month. I cope by making sure (where possible) that I don't have any extra activities during those days. It sounds like Greta Garbo but I really do want to be alone."

Thirdly, don't be too quick to dismiss your anger. Just because it occurs cyclically doesn't mean that it's not valid. You may be able to suppress your irritation during most of your cycle but not premenstrually, when you are in a more sensitive and vulnerable state. Would anger be a more appropriate reaction the rest of the time? Women are conditioned to be caring, sensitive, responsive to others, reasonable and responsible. The forces in society are powerful enough to make women feel guilty, abnormal and sick if they do behave irrationally or angrily. But the reality for many women is that, like it or not, they feel angry. And there are enough difficult, trying and stressful situations in most women's lives to justify anger.

"He was late home again. It was becoming so regular and I didn't just yell at him, I threw his dinner in the bin then threw the plate at him. When he said he was sorry and he understood that I was so upset because I was due to come on, I went berserk. I know if I hadn't been feeling tense I would only have yelled at him but it doesn't make my feelings any less real or what he was doing right. He still doesn't understand. It's as though anything I say for a week a month has no meaning because I'm due to come on. I feel like I'm on a short fuse during that week but my feelings are just as real. I'm beginning to think that my responses during the other three weeks may be the wrong ones because I put up with too much."

Support

Many women find that the support they get from friends, family and fellow sufferers is crucial. If possible, join or start a support group where you can talk about what is going on in your life without being dismissed. In a support group, you can compare information about PMS remedies and talk about ways you are affected by your menstrual cycles.

If you go to your GP, Well Woman Clinic or a complementary practitioner, only talk to those who listen to you, believe what you say and are caring and flexible in their approach. If you find that your doctor is insensitive, impatient, unsympathetic or disbelieving (as many are), don't waste your time. Look around for someone else who will take you seriously.

Exercise

Exercise is good for PMS. It is said to help counteract fluid retention. It also helps the release of endorphins, the body's chemicals which are responsible for increased feelings of well being.

The type of exercise is not important; more important is a routine that you can maintain even when beset by premenstrual depression or tension. If you're not into sport, you can exercise by walking. The goal is to walk briskly (your pulse rate needs to be raised) for half an hour at least three times a week.

If exercise is new to you, build it up slowly. It shouldn't be painful or tiring. If you are at home with small children or not able to get out and walk for any reason, try another form of exercise that suits you better. Yoga, relaxation exercises, dancing, and swimming are just a few of the types of physical activity which women with premenstrual symptoms find helpful.

In order to benefit, you do need to make regular exercise part of your life. There's not much point in just exercising for half an hour when you're premenstrual.

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SOME OF THE INFORMATION ON THESE PAGES HAS NOW BEEN SUPERSEDED

Based on a leaflet written by Lisa Saffron. This edition revised by Women’s Health, April 1999.

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