Premenstrual Syndrome (PMS) encompasses a variety of uncomfortable symptoms that occur in the days leading up to menstruation and typically subside once menstruation begins or shortly thereafter.
Mechanisms Behind Discomfort
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| Women experience the most discomfort around the age of 40 (Image: Netmode) |
Symptoms of premenstrual syndrome vary among individuals in terms of onset and intensity. However, there are common signs that women experience, which are related to hormonal fluctuations following ovulation: estrogen and progesterone levels drop, while aldosterone (a male hormone also present in women) increases, leading to physical changes such as water retention and a sensation of bloating.
Low estrogen levels increase the activity of monoamine oxidase (MAO) — a molecule involved in the depression process — and decrease serotonin levels, another molecule affecting mood and behavior. These changes explain why women may lose their characteristic gentleness during the premenstrual phase. Hormonal levels normalize as menstruation begins.
Symptoms
Even for a single individual, PMS can vary each month. Approximately 90% of women experience hormonal fluctuations at any age, including during adolescence; however, symptoms tend to be most uncomfortable around the age of 40. Most women experience PMS mildly, but about 2-5% endure significant hardship.
The impact of hormonal fluctuations can be intensified when accompanied by stress and emotional upheaval. Not only are there discomforts in the days leading up to menstruation, but pre-existing conditions such as asthma, psoriasis, lower back pain, and migraines may also worsen during this time. Effective treatment for PMS can mitigate the cyclical exacerbation of these conditions.
Common symptoms of PMS include tissue swelling due to water retention, breast swelling and tenderness (pain can occur even without touch, such as during bicycle or motorcycle rides), abdominal bloating, noticeable water retention in the ankles, a feeling of heaviness in the lower limbs, fingers swelling, and while many women may feel heavier and bloated, not all experience weight gain (some may notice weight gain). Many also experience an increased appetite, particularly for sweets, along with feelings of nausea and vomiting.
Sensitivity is the primary psychological symptom of PMS, manifesting in various forms: increased emotional sensitivity, irritability (crying, anxiety, mood swings), feelings of fatigue, and difficulty sleeping. Some women may exhibit signs of depression, and in extreme cases, thoughts of self-harm.
Treatment Issues
For effective treatment, dietary adjustments are crucial: it is advisable to reduce salt intake to prevent water retention, leading to swelling (in the face, hands, etc.). Whole grains containing complex carbohydrates can help increase serotonin levels (beneficial for sleep) and are rich in magnesium, which alleviates stress. It is best to avoid animal fats, fast-absorbing sugars (candies, jams), and stimulants such as tea, alcohol, and coffee. Drinking plenty of water daily is recommended.
Physical activity is essential as it can alleviate many PMS symptoms; activities like walking or cycling promote relaxation, reduce stress and depression, and increase endorphin release, enhancing mood and well-being. Exercise also improves blood circulation and can help reduce menstrual cramps.
Avoid physical and psychological stress, and refrain from making significant decisions during this time. Communicating with your partner about the discomfort changes women face monthly can be helpful. Understanding partners often empathize with their spouse’s mood variations leading up to and during menstruation.
Today, there is a trend to assist women suffering from PMS through dietary changes, lifestyle adjustments, and natural methods such as homeopathy, herbal remedies, and acupuncture. If these approaches do not yield results, hormone therapy may be prescribed.
Natural progesterone in pill form can positively impact sleep, reduce swelling in the lower limbs and abdomen, and alleviate breast tenderness, compensating for hormonal deficiencies in the body. Synthetic progesterones also have similar effects and are used in the latter half of the menstrual cycle, though they may have side effects such as weight gain, increased blood pressure, and elevated cholesterol. If hormone therapy is still ineffective, ovulation suppression (using birth control pills) may be necessary.
Dr. ĐÀO XUÂN DŨNG
