6 ways to beat PMS

Are the weeks leading up to your period always hard going? Finding ways to reduce PMS symptoms and stablise your system may involve trial and error. The following treatments may help beat PMS.

 

Antidepressants

For women who feel their lives are hijacked by hormones every month, antidepressants can provide enormous relief. “The antidepressants stabilise the level of hormones, such as serotonin, so that some women with PMS or PMDD no longer experience those huge mood swings from hormonal fluctuations,” says Sonia Davison, an endocrinologist and clinical fellow of the Jean Hailes Foundation.

A new approach to this treatment is to take the antidepressant intermittently. “It may be taken for one week or 10 days of each month when symptoms occur,” says Prof Kulkarni. “To ensure the dose and type of antidepressant suits your system, speak to your GP about having a blood test or swab to get background on your metabolic system and guide the choice of antidepressant.”

If antidepressants are not effective, women who suffer severe symptoms of PMS may choose to undergo a ‘chemical menopause’, where strong hormones are used to stop ovulation and give women a break from the terrible hormonal and mood swings. “This approach sometimes needs to be permanent but can also have a kind of resetting effect on the brain,” Prof Kulkarni explains. “If women choose to come off the hormones, their impact is usually reversible and even when no longer on the therapy, the hormonal-related moods swings may be greatly reduced.”

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Setting healthy habits

Skipping meals, not getting enough sleep and living on the run are likely to exacerbate symptoms of PMS. Aim to choose the right foods to help stabilise your blood sugar, which in turn can boost energy and moods. “Grains that have a low glycaemic index, which means that they provide longer lasting energy, can also help to increase the hormone serotonin in the brain, so try some chickpeas, brown rice or quinoa,” says Melanie McGrice, an accredited practising dietitian and spokesperson for the Dietitians Association of Australia (DAA).

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Stress

Do some women use their PMS time of month as a window to express negative emotions? Yes, according to professor of women’s health psychology at the University of Western Sydney Jane Ussher, who caused great controversy when she recently discussed this on Australian website The Conversation. “For three weeks of the month, some women silence their irritation and unhappiness, conforming to societal expectations of the ‘good woman’,” says Ussher. “Premenstrually, this self-silencing is broken, but their expression of negative thoughts and feelings is invariably dismissed as PMS.”

To break this cycle and reduce PMS distress, Ussher believes it would help women to learn to express their feelings throughout the month and also prioritise their own self-care instead of always focusing on the needs of their family first. Support from partners is also pivotal. “Women in lesbian relationships, who report partner empathy, also find premenstrual change less distressing, and are better able to cope,” Ussher points out.

Undeniably, stress hormones like adrenalin and cortisol can affect everything from sleep and digestion to thinking and mood. So a stressful job or juggling too many responsibilities can also exacerbate symptoms of PMS. That’s good reason to adopt some extra ‘stay calm’ strategies from the middle of your cycle until menstruation. They may include daily progressive relaxation (tensing and relaxing muscles from head to toe) or writing a daily journal. Daily exercise is also critical for stabilising hormones, and debriefing about feelings over a coffee with a close friend can help women feel better and supported. Meditation can also help – studies show that it helps activate the prefrontal cortex of the brain, which is associated with calmer emotions and improved impulse control. 

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The Pill

When treating both premenstrual syndrome and the more severe PMDD, manipulating hormones with contraceptive pills can help. But not all pills are equally effective. “Women should not take older-style progesterone pills as these can actually contribute to emotions like anger and depression,” cautions Prof Kulkarni. “However, some of the newer varieties of pill such as Zoely, Diane and Juliet can be very beneficial.” 

To establish a more stable hormonal pattern, women may take the pill with the active hormones for three cycles then go on to a sugar pill for one week only, so that within a three-month cycle they only have one week of bleeding.

If there’s no improvement, Prof Kulkarni suggests other hormone therapy approaches, including oestrogen patches to provide the ongoing cover of oestradiol (a form of oestrogen hormone) or a combination of oestradiol patches and progesterone. “For some women who are very sensitive to hormones, another alternative is to deliver the progesterone via the Mirena IUD, which is placed in the uterus. This allows the hormones to go directly into the surrounding organs rather than passing through the bloodstream first, where they may cause more side effects,” Prof Kulkarni adds.

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Supplements

“Before I suggest the contraceptive pill as a treatment for women with PMS, I always try some supplements first,” says Prof Kulkarni.  “The two I suggest are vitamin B6 and evening primrose oil, which has healthy essential fatty acids. Both supplements have been shown in studies to help alleviate some symptoms in women with PMS and many women benefit from them.”

One study published in 2010 found that the combination of magnesium and vitamin B6 was particularly helpful for decreasing PMS symptoms. “Nuts are rich in both magnesium and B6, so I’d recommend taking 30 grams of unsalted nuts daily in the week prior to your period,” says McGrice.

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Iron

If you’re short on iron in your diet, you may have higher risk of suffering PMS. Research at the University of Massachusetts found that women with higher non-heme iron, which comes from plant sources, are 30 to 40 per cent less likely to experience PMS. This is possibly because low iron affects levels of serotonin, the hormone that elevates mood. Good sources of non-heme iron include silverbeet and spinach, broccoli, bok choy, soy beans, and lentils.

6 ways to beat PMS