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While not every woman gets premenstrual syndrome—the cramping, bloating, and general crabbiness that can strike around period time—about 85% of women report having at least one symptom each month.
And even though there’s no real "cure" for PMS, many treatments and lifestyle changes are available to help you cut down on the discomfort. Read on to find out how.
Improve your diet
A salt-heavy diet can cause bloating, caffeine can aggravate irritability or anxiety, alcohol may worsen depression, and too much sugar can destabilize your blood sugar and mood.
Try to eat more fruits, vegetables, and whole grains the week before your period.
And it’s not just what you eat, but how you eat. Aim to eat at regular intervals to avoid dips and spikes in blood sugar, says Joanne Piscitelli, MD, associate clinical professor of obstetrics and gynecology at Duke University in Durham, N.C.
"It is worth changing your diet habits before moving on to medical therapies, because you are less likely to have side effects," she says.
Exercise can fight both physical and emotional PMS symptoms, says Dr. Piscitelli.
"Even though women say they don’t have energy, this is probably when it is most important to exercise," she says.
Pick an exercise routine that gets your heart rate up and that you enjoy. For PMS, The National Women’s Health Information Center recommends two and a half hours of moderately intense activity, one hour and 15 minutes of vigorous aerobic activity, or a combination of the two each week, plus two muscle-strengthening sessions.
Vitamins may be beneficial for PMS, particularly B6 and E, says Petra Casey, MD, associate professor of obstetrics and gynecology at the Mayo Clinic in Rochester, Minn.
There’s not much hard evidence to prove that these supplements work. Still, they are worth trying.
Here are some suggested daily doses from the Mayo Clinic:
Calcium: 1,200 milligrams
Magnesium: 400 mg.
Vitamin B6: 50 to 100 mg.
Vitamin E: 400 international units (IU)
Check out herbal remedies
Herbal remedies are understudied (and unregulated when compared to prescription drugs), but there are some that may be effective in relieving PMS symptoms like cramping and mood swings.
You might consider using black cohosh, chasteberry, evening primrose oil, ginger, raspberry leaf, dandelion, or natural progesterone creams.
Your ob/gyn may be up-to-date on the best research regarding supplements; see if he or she has advice on which ones you can take and when.
Focus on your stress
First of all, it is important that you get adequate rest and plenty of sleep. Try to get as much sleep as you think you need so that sleep deprivation doesn’t ratchet up symptoms.
Then make a conscious effort to reduce your stress level. You can try deep breathing, massage, meditation, or yoga, which can soothe the mind and body.
But skip the meditation if you know your best stress buster is a girls’ night out or writing in your journal. Find what works for you and stick with it.
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Take pain relievers
For women who have PMS-related pain such as cramping, breast tenderness, backaches, or headaches, nonsteroidal anti-inflammatory pain relievers (NSAIDs) can provide some relief.
These include ibuprofen (Advil and similar drugs) and naproxen (Aleve).
Or you can try over-the-counter remedies specifically aimed at PMS like Pamprin and Midol. These often combine some sort of pain reliever with caffeine.
Consider birth control
If you’re not already using a form of birth control that you’re happy with, you might consider trying low-dose oral contraceptives, which may reduce PMS symptoms.
The medications work to even out hormones over the course of a woman’s cycle. Dr. Piscitelli says.
Some women use them continuously instead of in the typical cycle to avoid getting their period, which can also reduce PMS symptoms, though it can lead to breakthrough bleeding.
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Ask your doctor about antidepressants
Antidepressants aren’t the first choice for PMS-related mood problems. Still, they are an option if symptoms are severe and affecting your daily life (and nothing else is helping).
Selective serotonin reuptake inhibitors (SSRIs) like Zoloft and Prozac are often prescribed, says Dr. Piscitelli. They can be taken just for a week or two before your period or all of the time.
PMS can also aggravate underlying depression. Some women may think depression is cyclic and mistakenly attribute it to PMS, but they don’t realize it doesn’t really follow the patterns of their periods until they track it, says Dr. Piscitelli. Treating the underlying depression can help PMS symptoms, she adds.
Look into diuretics
Many women experience bloating in their hands, feet, face, or stomach with PMS. One way to combat thisif exercise and cutting back on salt don’t workis a diuretic.
These prescription drugs help the body get rid of excess water by boosting urine output.
One commonly prescribed diuretic is spironolactone (Aldactone). But diuretics aren’t for everyone. They can exacerbate urinary incontinence, constipation, lower blood pressure, raise potassium levels, and interact with other medications.
Chart your symptoms
PMS is real. But first you may need to chart your symptoms for several months to be sure that you are experiencing PMS and not another condition like depression, says Dr. Casey. An estimated 12 to 25 million women in the U.S. suffer from debilitating PMS. It includes both physical and emotional symptoms. These symptoms are varied and so are the treatments to relieve them, Dr. Casey says, so different treatments may need to be tried.
Dr. Casey advises women not to get discouraged or expect "a magic bullet" from the first treatment they try.