5 Things You May Not Know About PMS

In the days leading up to your period, you might experience premenstrual syndrome, more commonly known as PMS. Physical symptoms often include cramping, headaches, breast tenderness, bloating, fatigue, and constipation. PMS can also cause emotional changes such as irritability, anxiety, mood swings, and depression. Because PMS is so common, many women are familiar with these symptoms and have come to expect them every month. However, there are some facts about this condition you might be surprised to learn. Check out these five things you may not know about PMS.

PMS Can Get Worse as You Age

Although you might assume that PMS symptoms would ease up as your reproductive years wind down, sadly that’s not the case. For some women, PMS symptoms worsen in their late 30s and 40s as they start to enter perimenopause, which is a slow transition to menopause. The body’s changing hormone levels are less predictable during these years, which can cause some or all PMS symptoms to be more pronounced.

Women who are sensitive to changing hormone levels during their menstrual cycles are more likely to experience worsened symptoms during perimenopause. Once menopause occurs, however, you’ll no longer experience PMS.

PMS Can Make Other Health Problems Worse

Certain health conditions, particularly those with symptoms similar to PMS, might worsen in the days leading up to a woman’s period. About half of all women seeking treatment for premenstrual syndrome have a disorder that PMS can exacerbate.

Health issues that PMS can affect include:

• Depression: Symptoms such as anxiety, despair, irritability, and fatigue are associated with both PMS and depression. While women with depression might experience these symptoms all month, they can worsen during PMS.
• Irritable bowel syndrome: IBS is associated with cramping, gas, and bloating, all of which might worsen during PMS.
• Bladder pain syndrome: Painful cramps are more likely to occur during PMS in women who have bladder pain syndrome.
• Chronic fatigue syndrome: Women with CFS often have heightened symptoms right before their periods. In addition, research suggests that women with CFS are more likely to experience heavy menstrual bleeding and early menopause.

There’s a Severe Form of PMS Called PMDD

If your PMS symptoms seem especially bad, you might be experiencing premenstrual dysphoric disorder (PMDD). With this condition, symptoms commonly associated with PMS are more pronounced, particularly those affecting mood. A woman with PMDD might experience severe irritability, anxiety, or depression. Some even experience panic attacks or thoughts of suicide.

Around 5% of women experience PMDD during their reproductive years. Symptoms of PMDD typically begin to appear in a woman’s 20s, and the condition is most common in women in their late 20s to mid-30s. Besides age, other risk factors for PMDD include stress, personal history of mood or anxiety disorders, and family history of premenstrual mood dysregulation.

Hormonal Birth Control Can Ease PMS and PMDD Symptoms

Birth control pills might be able to relieve some symptoms experienced during PMS or PMDD. Some medical providers prescribe birth control pills containing a hormone called drospirenone, including Yaz and Yasmin, because it helps regulate progestin levels. Because progestin fluctuations can interfere with a mood-regulating hormone called serotonin, drospirenone can reduce irritability and other mood changes associated with PMS and PMDD. Drospirenone also has diuretic benefits, which can decrease fluid retention in the days leading up to your period.

Another way to potentially ease the symptoms of PMS and PMDD is to take birth control pills continuously so you skip your period. Just dispose of the sugar pills at the end of the pack each month and start on the next pack immediately. By keeping hormones in the body at steadier levels, this strategy might help prevent or lessen some PMS and PMDD symptoms.

Talk to your medical provider about taking the pill or other forms of hormonal birth control such as the patch or the ring. They’ll discuss your symptoms and concerns in more detail to help you find the best birth control fit for your needs.

Antidepressants Might Help With PMDD

If you have PMDD, you might want to consider using antidepressants to help manage the condition. Research shows that 60-90% of women with PMDD respond to treatment with drugs that block the reuptake of serotonin, including selective serotonin reuptake inhibitors (SSRIs) like Prozac and Celexa. In many cases, women who use antidepressants to treat PMDD only need to take the medication in the days leading up to their periods, not every day.

Women should talk to their medical providers to find out if antidepressants might help them get PMDD relief. Keep in mind that these meds might have some side effects, including nausea and reduced libido.

The more you know about PMS and PMDD, the better you’ll be able to manage your symptoms. The most important thing to know: You don’t have to suffer!  If PMS is really bringing you down, talk to a provider about a prescription for hormonal birth control or an antidepressant (or both) and end your premenstrual misery.

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