The kind that nearly bites off her husband’s or boyfriend’s ears at the slightest provocation, and her colleagues at work avoid her during that time of the month? Well, you have pre-menstrual syndrome (PMS).
One Kampala doctor says many women who suffer from PMS are unaware that they even have the condition. A few who are aware PMS exists, only recognise the attack when it is over and they see their menstrual blood. Then they realise: “So, that is what those anger episodes were about!”
“They come here, describe their symptoms and you realise that they are suffering from PMS,” the doctor says.
If their symptoms are severe enough to warrant treatment, it is prescribed. Just like some women are unaware that PMS exists or that it even ails them, others are aware of it but are unaware that treatment for various PMS symptoms is available in Uganda.
What is PMS and what treatments are available in Uganda?
PMS, according to the Internet, are the symptoms that occur between ovulation and the onset of menstruation. The commonest symptoms, according to mayoclinic.com, are tension or anxiety, depression, crying spells, mood swings, irritability or anger, appetite changes and food cravings, trouble falling asleep (insomnia), social withdrawal and poor concentration.
These symptoms are classified as emotional and behavioural symptoms. Physical symptoms include joint or muscle pain, headache, fatigue, weight gain related to fluid retention, abdominal bloating, breast tenderness, acne flare-ups and constipation or diarrhoea.
Dr Vincent Karuhanga who has treated patients suffering from PMS, says the most-complained-about PMS symptoms he has seen are anxiety and heaviness (weight gain related to fluid retention).
The symptoms, which may vary from month to month and may be more severe in some months, are commonest in a woman’s late 20s and early 30s, according to mayoclinic.com.
According to the website, causes of PMS include cyclical changes in hormones (hormonal fluctuations), chemical changes in the brain (fluctuations in serotonin levels which controls mood) and poor eating habits (a diet low in vitamins and minerals).
To treat PMS, therefore, the causes have to be addressed through lifestyle changes and where that fails, treatment.
What lifestyle changes can help one manage PMS?
Eating right: According to webmd.com, reducing on alcohol (which is a depressant) and caffeine intake, reduction on refined sugar intake (which may cause food cravings) and reducing salt intake (which contributes to water retention and can result in bloating or weight gain), at least during the premenstrual phase, is advisable.
Alcohol, caffeine, refined sugars and salt have been linked to physical and emotional symptoms like tension and anxiety, insomnia, pain, bloating and food cravings. A diet rich in whole grains, fruits and vegetables is particularly advised. Cabbage is said to help reduce symptoms of PMS.
Exercising: According to the website, regular exercise relieves tension, pain and depression.
Stress reduction: Stress does not cause PMS but it makes PMS symptoms worse.
Relief from symptoms will not occur soon after lifestyle changes have been made; it will take a few cycles before a woman will notice a reduction in symptoms. Should moderate to severe symptoms persist after two or three cycles after lifestyle changes, one may see a doctor for treatment.
Karuhanga says the most commonly used treatment option in Uganda is the contraceptive pill. Oral contraceptives aid in evening out hormonal fluctuations and they may relieve symptoms such as bloating, headaches, abdominal pain and breast tenderness. Not all women will respond positively to this treatment, though.
Primolut, which contains norethissterone (synthetic progesterone), may be given to relieve PMS because according to Karuhanga, it is believed that PMS occurs as a result of declining levels of progesterone.
Danazol, an ovarian suppressor, may be prescribed to suppress ovarian hormone production. However, prolonged use of this drug could result in side effects such as unhindered hair growth (hello hairy chest!)
Painkillers like mefenamic acid and ibuprofen aid in relieving headaches and menstrual cramps. Diuretics such as Midol PMS and Diurec PMS may be prescribed to eliminate excess fluids that cause bloating and weight gain.
Antidepressants such as Fluoxetine (Prozac) are prescribed for depression. Calcium and vitamin B6 supplements have been said to relieve physical discomfort and depressed mood respectively. Daily intake is advised for these two.
Don’t let a few days of PMS each month ruin your otherwise happy relationships. Get help. However, self-prescription is discouraged. Your doctor will decide what treatment option is best for you based on your symptoms.