Experts Say: PMS

Premenstrual syndrome (PMS) is a collective term referring to various physical and emotional symptoms that may occur about two weeks before an anticipated menstrual period,” says Dr Ben Choey, a gynaecologic surgeon with the SBCC Women’s Clinic in Clementi. “These symptoms usually resolve just before or after the period arrives,” adds Senior Physician Zhong Xi Ming, a Traditional Chinese Medicine physician at Eu Yan Sang Premier TCM Centre at Paragon. Homeopathy Consultant Dr Manjusha Balekundri, who runs Satguru Homeopathy Clinic in Yishun, observes that some women may be troubled by these symptoms for just two to three days; others up to 10 days. Nobody knows the exact cause of PMS, although some studies link it to cyclical fluctuations in female sex hormones. Obesity and stress may worsen symptoms.

Symptoms

According to Choey, nearly all women will face some premenstrual symptoms, but about 5% of have symptoms severe enough to affect quality of life. Balekundri notes that it occurs more often in women between their late 20s and early 40s, typically worsening from their 30s onwards. Zhong says over 200 symptoms have been associated with PMS, including depression, irritability, anxiety, sore breasts and tiredness. Women may also grapple with acne or blackheads, constipation or diarrhoea, and even joint or muscle pain. If symptoms persist or are unduly severe, get it checked: premenstrual dysphoric disorder (PMDD) is a severe form of PMS. “As many as 50–60% of women with severe PMS may have an underlying psychiatric disorder,” warns Balekundri.

Treatment

Western Medicine: Antidepressants such as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) relieve PMS symptoms, but have side effects like nausea, insomnia and low sex drive, cautions Choey. Danazol alleviates PMS symptoms but has some nasty side effects that may become permanent. For those resistant to other treatments, doctors may prescribe GnRH (gonadotrophin-releasing hormone) analogues. These induce a state of temporary menopause. 

Traditional Chinese Medicine: Zhong explains that in TCM, treatment is focused on uncovering the root causes of the symptoms. “PMS happens when the yang is stronger than the yin right before your period. This will bring about health issues such as headaches, acne, eczema and red eyes,” says Zhong. Treatment depends on each patient’s symptoms.

Homeopathy: A form of alternative medicine practised since the late 1700s, homeopathy’s basic principle, known as the ‘Law of Similars’, is to let like be cured by like. “This means that homeopathic treatment focuses on the patient as a person, as well as her pathological condition,” Balekundri explains.

Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.1. Find  NATURA at Eu Yan Sang retail outlets, newsstands and major bookstores in Singapore.