Part of being a woman is experiencing the physical and emotional craziness that happens 1 to 2 weeks before your period. Also known as premenstrual syndrome or PMS, symptoms start 1 to 2 weeks before your period. The cause of these physical, emotional and psychological symptoms is thought to be caused by the hormonal changes and fluctuations during the menstrual cycle.
Most PMS symptoms caused by normal cyclic hormonal changes include bloating, weight gain, menstrual cramps, headaches, crying spells and irritability, quickly go away once Aunt Flo comes into town.
If these symptoms don’t go away when your period arrives you need to think about other potential medical conditions and not blame it all on PMS.
Emotional changes with PMS
Emotional changes including depression, mood swings, irritability and anxiety are common and normal symptoms associated with PMS. When these emotional changes become disruptive with work or your personal life, the diagnosis of Premenstrual Dysphoric Disorder (PMD) is made. Medications that treat depression and anxiety are often given to women suffering from this debilitating diagnosis.
Women experiencing depression every day would not fall into the PMS diagnosis although there is overlap during the weeks before a period. Depression causes sleep problems, loss of energy, feelings of worthlessness, weight changes, losing pleasure with almost all activities and having suicidal thoughts is medically concerning. Depression affects many women and if undiagnosed and treated, women are more at risk for suicide, drug and alcohol use, problems having healthy relationships and missing more days from work. Finding women with depression and mood changes as their primary symptom happening throughout the entire month is a sign of a more serious mental health problem. Anti-depressants and therapy are the most helpful and reliable treatment options in this group of women.
Bowel Changes and PMS
Bowel changes including gas and diarrhea occur during this time of the month and are caused by the hormonal effects on your gastrointestinal tract. Abdominal bloating can be a true nightmare for women and is a common problem. There are many causes of abdominal bloating unrelated to PMS.
If bloating persists throughout the month this could be caused by lactose intolerance. Lactose intolerance is when the body cannot easily digest or absorb the natural sugar, lactose, found in milk and dairy products.
Bloating occurring throughout the month unrelated to a period can occur for a number of common reasons associated with lifestyle behaviors. Dietary rituals including many “B” and C vegetables are classic causes of gas and bloating and include beans, broccoli, Brussels sprouts, cabbage and cauliflower. Other dietary culprits include rich and fatty foods, whole grains, apples, peaches, pears, lettuce, onions, sugar-free foods containing sorbitol, mannitol and xylitol are directly associated with this frustrating symptom.
Irritable bowel syndrome (IBS) is defined as “recurrent abdominal pain or discomfort that occurs in association with altered bowel habits over a period of at least 3 months”. The 3 ways the “altered bowel habits” can present is with constipation, diarrhea or the double whammy, both constipation and diarrhea. Bloating is another painful symptom associated with IBS suffering. Constipation without an IBS diagnosis also contributes to agonizing bloating.
Gastroesophageal reflux (GERD), small bowel bacterial overgrowth and diverticulitis are other intestinal abnormalities that cause bloating.
Stimulant laxatives, such as Ex-Lax and Senokot are the hardest on your intestines creating painful bloating and intestinal upheaval.
Period Cramps
For many of us cramps can be completely debilitating and stop us from doing our daily routine. Women suffering from PMS may have severe cramps along with the other typical symptoms of emotional chaos, bloating and weight gain. If severe cramps are the main symptom that occurs before and during your period, the cause could be related to endometriosis. With endometriosis, severe cramps can cause temporary numbness in your legs along with nausea and vomiting. Endometriosis is important to be aware of since it is a progressive disease-causing infertility, ovarian cysts, severe menstrual cramps, painful sex and lower back and pelvic pain. 40 % of women with infertility have endometriosis. Surprisingly, some women don’t have any symptoms at all! Since symptoms vary between women, so does the time it takes to make the diagnosis. It’s important to discuss symptoms of pelvic and period pain with your health care provider. Diagnosis can be tricky, even for specialists.