Q: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?
A: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings.
In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.
Diet and lifestyle strategies can help alleviate some symptoms of PMS:
Heat: Apply heat (a heating pad, hot water bottle or a hot shower) to your stomach or back to temporarily relieve pain.
Avoid skipping meals: Regular meals and snacks help maintain a balanced mood and better energy level. Pair carbohydrates with protein or fat to help you feel full longer. Eat an apple with peanut butter, low-fat cheese with crackers or vegetables with hummus.
Increase your calcium intake: Women who get at least 1,000 milligrams of calcium a day have fewer PMS symptoms compared with women who do not get the recommended calcium intake. Good food sources of calcium include low-fat dairy products, canned salmon, kale and bok choy.
Watch your caffeine intake: Caffeine may increase moodiness and anxiety.
Limit salty foods: Excess salt can worsen bloating and weight gain.
Get enough B vitamins: Women who get more of the B vitamins thiamine and riboflavin from their food are less likely to have PMS. Good food sources of these B vitamins include sunflower seeds, beans, oats, dairy products, dark green vegetables and eggs.
Manage your stress: Stress can increase the number and severity of PMS symptoms. To relieve stress, exercise regularly, or try yoga.
Acupuncture: There is limited but promising evidence that acupuncture can help relieve menstrual pain.
Indulge in a little chocolate: Many women crave chocolate around their periods. If you do, choose dark chocolate, which has less sugar, over milk chocolate.
Mild PMS is common. Talk to your doctor if you experience severe symptoms. These include:
• Inability to carry out your usual daily activities.
• Symptoms that interfere with your relationships.
• Sudden onset of new PMS symptoms or increase in severity.
PMS is one of those many conditions that some doctors ignore or dismiss, either because it is not life-threatening, or because there are no diagnostic tests or objective abnormalities when the doctor performs a physical examination. Some doctors are frustrated when a patient says she has a symptom, yet the doctor has no way of objectively verifying it.
Such an attitude is unfortunate. PMS produces very real suffering for millions of women. There are drug-free ways that can help alleviate the symptoms.
• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.