Premenstrual syndrome: how to alleviate the symptoms
Premenstrual syndrome corresponds to a set of manifestations that precede the onset of menstruation . Affecting 20 to 40% of women of childbearing age, these hormonal disorders are frequent but trivialized. If some women never suffer from it, others, on the other hand, experience this period of the cycle in a very uncomfortable way with significant physical and psychological symptoms that impact the quality of life. Like many other inconveniences related to the biological life of women, this premenstrual syndrome is often experienced as a fatality. Women rarely report the existence of these disorders to their doctor, perhaps thinking, wrongly, that there are no means to alleviate them. But effective solutions do exist. Before exposing them, let's already see what this syndrome corresponds to and what its signs are.
What causes premenstrual syndrome?
Causes still obscure
Menstrual cycles being an eternal restart (the average duration of a cycle is 28 days in general), each month can have its share of difficult days. Varying from a few hours to a few days before the onset of menstruation , this set of symptoms disappears quickly after the onset of these. The gradation goes from a simple temporary inconvenience to a priesthood of several days.
This syndrome involves hormonal factors although the exact mechanisms are still difficult to specify and are not all well identified.
Even if the hypothesis of a link with physiological hormonal fluctuations seems expected, it appears that a genetic predisposition can also be considered.
Other assumptions have also emerged such as serotonin deficiency (1) or magnesium and calcium deficiency, but these have yet to be documented.
A common syndrome
Despite its frequency, this problem is too often overlooked. As women do not open up about the subject, no cause will be sought and therefore no treatment will be put in place. However, a woman has menstrual cycles for about 38 years of her life!
Indeed, 20 to 40% of women in the fertile period (in other words of childbearing age) are affected by premenstrual signs, and this until the menopause (2) . In a third of them, we speak of premenstrual syndrome because they suffer from unpleasant manifestations that reduce their quality of life.
Finally, in 5% of cases, these disorders represent a real handicap, impacting personal, professional and social life. In this case, we speak of Premenstrual Dysphoric Disorder (PMDD) because it represents a severe form of premenstrual syndrome which is unfortunately still too often underdiagnosed.
How can premenstrual syndrome manifest itself?
The most common signs can be classified into 2 main categories: psychological symptoms and physical symptoms . They are mostly nonspecific , that is to say they are not characteristic of premenstrual syndrome, and of variable intensity . They are important to compile because the diagnosis relies solely on them and when they occur. The intensity of the symptoms is variable.
Unpleasant physical phenomena
Pain in the lower abdomen , also called dysmenorrhea , is a classic sign (3) of the imminent arrival of menstruation. These pains can take on the appearance of cramps or heaviness or even be global on the lower part of the abdomen. They can also be located in the lower back or the sacral region .
Headaches (or headaches), sometimes invite themselves to the rest of the celebrations and for some women, can even represent the only embarrassing sign that they perceive.
This term refers to a feeling of heaviness or tension in the breasts commonly described by many women. The chest may be sensitive spontaneously or only to the touch.
This retention leads to edema as well as transitory weight gain but possibly explains the fact that the breasts are tense and painful.
Some women describe nausea that can lead to vomiting in the days before the onset of menstruation. Bloating, heartburn are sometimes part of the cocktail of inconvenience.
Confusing emotional vagaries
Premenstrual syndrome can also result in psychological disorders. Among the panoply regularly described by a large number of women (and potentially by those around them!), we find difficulty concentrating, irritability, emotionality, anxiety, agitation, anger, insomnia, even outright depression. These sometimes intense emotional variations show that the nervous and hormonal systems are linked in their functioning. The more medical term dysphoria is also used to refer to these mood swings . It can also go as far as transient but intense psychic disorders such as depressed mood.
Concerning vitality, it is generally altered ranging from intense fatigue to lethargy.
A purely clinical diagnosis
Additional examinations are not necessary unless certain symptoms point to other hypotheses such as endometriosis or polycystic ovary syndrome. On the other hand, to confirm the diagnosis of premenstrual syndrome, the women are invited to write in a dated manner the inconveniences they present within the framework of this hypothesis.
How to reduce the symptoms related to premenstrual syndrome?
Although no specific treatment has yet been developed, it involves trying different strategies to determine what may work for one woman better than another.
Try Some Classic Tricks and Treatments
Ibuprofen (non-steroidal anti-inflammatory drug) (4) and paracetamol are the painkillers most frequently used to relieve premenstrual pain. Beyond these medications, solutions to relieve symptoms are aimed at hormonal regulation. Thus, the oral contraceptive pill can be prescribed with the intention of regularizing menstrual cycles and alleviating the associated pain. If you are not in favor of conventional medications, be aware that a study has shown that the use of local heat applied to the lower abdomen (with a hot water bottle for example) is sometimes enough to relieve dysmenorrhea (5) .
Use a dietary supplement
Some food supplements are formulated with plants and vitamins to promote better comfort at the end of the cycle. These supplements allow hormonal regulation throughout the cycle but their composition also acts on pain and the nervous system. Certain natural components , identified as having an action on the female sphere, can provide a global response to the main inconveniences.
Potentilla anserine , for example, is known for its calming properties for painful menstruation. Magnesium contributes to the balance of the nervous system. PEA (Palmitoyl Ethanol Amide) is a molecule naturally produced by our body in painful situations and intervenes at the level of the receptors of the pain circuit to reduce it (6) . Studies have shown that Japanese knotweed extract contains an interesting content of polydatin and that the latter would interact with PEA. A few serious studies have shown that their association would be relevant to menstrual pain and discomfort (7) .
Change your lifestyle
To alleviate certain symptoms, in some women, it is sometimes enough simply to change eating habits. All recommendations for a healthy and balanced diet are valid, but in particular the reduction in the consumption of fast fats and sugars can be beneficial (8) . In addition, stress , as well as lack of sleep and physical activity , can negatively influence the intensity of premenstrual symptoms. Even if it is not always easy to control these parameters, taking them into account can really improve the few delicate days which precede the period.
Serotonin is a neurotransmitter that acts in the loop that conditions our mood. Serotonin deficiency is known to contribute to depression. It seems that this mechanism also comes into play in premenstrual syndrome and its psychological symptoms detailed above.
Studies have shown the efficacy of selective serotonin reuptake inhibitors on severe premenstrual syndrome (9) , provided there is a good indication. Also, some general practitioners and gynecologists sometimes use it as a prescription for women whose mood disorders are very marked a few days before the onset of menstruation.
Premenstrual discomfort doesn't have to be inevitable. It can be relieved by various means which concern lifestyle habits as well as allopathic or natural therapies. By speaking with your doctor or your gynecologist, you will be advised so that you no longer suffer from this sometimes very unpleasant period of the cycle.
1. Recommendations_glaucoma.pdf https://www.sfo-online.fr/files/medias/documents/Recommandations_glaucome.pdf 2. Jünemann AGM, Grieb P, Rejdak R. Bedeutung von Citicolin bei der Glaukomerkrankung. Ophthalmol. 2021;118(5):439-48. 3. Ottobelli L, Manni GL, Centofanti M, Iester M, Allevena F, Rossetti L. Citicoline oral solution in glaucoma: is there a role in slowing disease progression? Ophthalmol J Int Ophthalmol Int J Ophthalmol Z Augenheilkd. 2013;229(4):219-26. 4. Rossi GCM, Rolle T, De Silvestri A, Sisto D, Mavilio A, Mirabile AV, et al. Multicenter, Prospective, Randomized, Single Blind, Cross-Over Study on the Effect of a Fixed Combination of Citicoline 500 mg Plus Homotaurine 50 mg on Pattern Electroretinogram (PERG) in Patients With Open Angle Glaucoma on Well Controlled Intraocular Pressure. Front Med. 29 Apr 2022;9:882335. 5. Aydin B, Onol M, Hondur A, Kaya MG, Ozdemir H, Cengel A, et al. The effect of oral magnesium therapy on visual field and ocular blood flow in normotensive glaucoma. Eur J Ophthalmol. 2010 Feb;20(1):131-5.