“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.
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.
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.
Our experts in Western medicine, TCM and homeopathy all recommend lifestyle changes to reduce PMS symptoms:
Western Medicine — dietary supplements TCM — meditation, light exercise, avoiding ‘heaty’ foods, well-balanced diet, regular meals, adequate rest
Homeopathy — exercise, warm baths, smaller and more frequent meals
Insomnia refers to difficulty falling asleep, waking up frequently during the night, or the inability to sleep soundly. Short-term insomnia may be caused by jet lag and stress, but chronic insomnia is usually associated with underlying psychiatric conditions such as depression, explains Choey. Other conditions include primary sleep disorders like apnoea (cessation of airflow during sleep), physical conditions like malnutrition, or emotional problems like grief.
TCM, however, also looks into the concept of ‘root and branch’. Zhong describes insomnia as the branches of a disease. The root is a dysfunction or imbalance of the fundamental substances (qi, blood, yin, yang, jing, shen), or of the major organ systems (lungs, heart, spleen, liver, kidneys).
Balekundri notes that insomnia also tends to be more common among women than men. This is partly due to the hormonal changes intrinsic to females, such as PMS, menstruation, pregnancy and menopause.
Besides problems like poor concentration and memory, irritability and impaired social interaction, there are different types of insomnia with different symptoms.
“For instance, tension insomnia is common among executives who worry about work or business. Fatigue insomnia happens when she gets tired during the day and naps in the early afternoon, then cannot fall asleep at bedtime. A patient who has in-discomfort insomnia often complains of stomach upsets, toothache and arthritis that cause her to wake up during the night. In-and-out insomnia occurs when she only stayed in the first stage of light sleep and woke up frequently throughout the night,” lists Balekundri.
A TCM practitioner will also look out for symptoms that are characteristic of a particular disorder. “For example, people with the Liver Fire pattern get angry easily and show ‘heat’ signs such as a red face, dark yellow urine and dry bowel movements; people with spleen or heart deficiency tend to be forgetful, have poor concentration and appetite, tire easily, and are always worrying about something,” explains Zhong.
Western Medicine: Removing the underlying cause or precipitating factors will usually cure transient or acute insomnia. Sedative drugs may be used, but Choey cautions against long-term use. “Maintaining good sleep habits is essential; regular exercise, avoiding caffeinated beverages and alcohol in the evening, keeping to a regular sleep and awakening schedule, and going to bed with a contented stomach all help,” adds Choey.
Traditional Chinese Medicine: Different types of insomnia point to problems in different parts of the body. For example if you suffer from nightmares that keep you awake, this indicates a gall bladder meridian disorder; difficulty in falling asleep could point to an excess condition of the liver, or liver and gall bladder; and waking up easily from sleep could mean you have a deficiency in a particular part of your body.
A combination of acupuncture and Chinese herbal formulas offer the quickest and most effective results. One of the most popular Chinese herbs for insomnia due to a liver or heart imbalance is the sour date seed, which is said to nourish the liver and qi, calm the spirit and combat stress. For overworked students with a spleen or heart disorder, the gui pi wan is an effective herbal formula.
Homeopathy: Homeopathy also treats the root cause of illness. Choosing the right medicine will depend on the patient’s medical history and constitution. Different remedies will be offered for different conditions. “For example, if the patient’s insomnia is due to grief, Ignetia Amara or Natrum Muriaticum will be prescribed,” says Balekundri. Other homeopathy remedies include Aconite, Arnica, Nux Vomica, Belladonna and Chamomilla.
THE COMMON COLD AND THE FLU
Both are respiratory diseases that you can catch after inhaling infected air droplets from a sick person’s cough or sneeze, but they are caused by different types of viruses. The common cold is caused by viral infection of the nose, throat and upper respiratory tract. The flu is caused by three types of flu viruses—types A, B and C—that attacks the respiratory system.
Cold symptoms tend to be milder and include low-grade fever, chills, tiredness, muscle aches, cough and a runny nose. Flu symptoms tend to develop fast (within three to six hours) and are usually more severe.
Although cold and flu symptoms generally resolve themselves in one to two weeks, look out for complications. If you have a high fever accompanied by aches and fatigue lasting more than 10 days, vomiting, abdominal pain, severe headache, difficulty in breathing and persistent cough with coloured phlegm, make sure you consult a doctor.
Western Medicine: Treatment for colds usually targets the symptoms. The doctor may prescribe antipyretics, antihistamines and antitussives to relieve fever, runny nose and cough respectively. Occasionally, antibiotics may be necessary.
Flu causes more severe symptoms than the common cold. Besides these medicines, the doctor may also prescribe antiviral antibiotics such as Tamiflu. Choey suggests other non-medicinal remedies: hot liquids to relieve nasal congestion, gargling with salt water to relieve sore throats, and flushing your nasal passages to ease congestion.
Traditional Chinese Medicine: The symptoms of colds and flus are actually a result of the battle between the protective qi and pathogenic factors, which fall into six groups, namely Wind, Heat, Dampness, Fire, Dryness and Cold.
Colds and flus are differentiated by patterns of disharmony and root causes. The most common patterns are Wind-Heat (symptoms include high body temperature, difficulty in sweating and yellowish phlegm), Wind-Cold (slight fever, itchy throat and a cough with clear mucus) and Dampness (feeling ‘heaty’ with mild sweating, fatigue, lethargy and occasional chest tightness).
This article first appeared in NATURA magazine issue No.1