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PMS: What Causes It, How to Avoid It & How to Deal


Each month, Keara from Hamilton College experiences the same series of miserable events.

“First I send a text to a friend, and when they don't respond right away I start wondering ‘What if none of my friends like me?’ ‘What if I have no true friends?’” she says. “Then I look in the mirror and think that I'm getting fat and need to start a diet, but can't fulfill my hunger. I get extremely clumsy, get a pimple right next to my nose, and then start to piece together that I must be PMSing. But after about a week of PMS and cramps, I usually still haven't gotten my period and begin to worry that I'm pregnant (even when I haven't been having sex – my PMSing brain is reasonable, right?). And then finally one night I am impossibly hot and can't sleep at all even though I'm exhausted, and the next morning I get my period. It’s brutal.”

All of Keara’s symptoms are a part of a little something we like to call PMS, or Premenstrual Syndrome. Over-exaggerated emotions, uncomfortable cramps, pimples and mood swings make us groan and complain about our womanhood as we snap at our boyfriends and best friends and down the nearest chocolate bar. So what gives? What causes these oh-so-lovely symptoms? And is there anything we can do about it?

What Is PMS, Exactly?

PMS, or Premenstrual Syndrome, is a variety of symptoms that are part of your menstrual cycle. The symptoms usually occur about one week before your period begins and they often disappear when you start your period. PMS affects menstruating women of all ages, but the effects can be different for each woman. The American College of Obstetricians and Gynecologists estimates that at least 85% of women experience one or more PMS symptom as a part of their monthly cycle. And while most women have fairly mild symptoms, about 3-8% of women do need treatment and prescription medication, as their symptoms are more severe.

Dr. Jennifer Wider, the author of The Doctor's Complete College Girls' Health Guide and the medical adviser to Cosmopolitan magazine, believes that a number of factors can play into the severity of a woman’s PMS.

“Some women seem to be more vulnerable to the hormonal changes that accompany the menstrual cycle,” she says. “There is also some evidence that certain brain chemicals are affected by the hormonal fluctuations. Stress can make PMS worse in some women, and diet and vitamins may play a role too. In short, a variety of causes are at play in PMS.”

Certainly, the changes in hormones that women experience during their menstrual cycles are an important cause of PMS, as the changing levels of those hormones can leave women feeling overly emotional, struggling with breakouts and pimples, or craving certain foods like chocolate.

What are the Symptoms of PMS?

Dr. Wider notes that most women experience a variety of symptoms during the week before their periods.

“Mood swings, swollen, sore breasts, cramps, bad skin, headaches, bloating, difficulty sleeping and digestive issues are among the most common symptoms,” she says.

While some women experience a combination of all of these symptoms, others will experience only one or two. As Dr. Wider explained before, these differences could be for a variety of reasons including diet, exercise and stress levels.

An anonymous collegiette from San Francisco experienced almost all of these symptoms each month before she decided to start using birth control.

“I'm pretty sure that I used to have every [PMS] symptom in the book, especially when my body really got in the regular schedule of things,” she says. “By my senior year in high school, I was experiencing backaches, headaches, severe cramps, breast tenderness, breakouts, bloating and fatigue regularly with every period. I would usually get a combination of two of the symptoms in the days leading to my period, and like clockwork they all happened at some point in the early stages of my period.”

So you’re feeling bloated, highly anxious, your skin is breaking out and you’re mad at your boyfriend for no reason. You know that you’re probably PMSing, but what now? Is there anything you can do about it?

Short- and Long-Term Remedies

There are a few different routes you can take to help deal with PMS symptoms. The first is a preventative route. Dr. Wider recommends getting plenty of exercise, cutting caffeine from your diet and finding a way to ease stress in your life as preventative measures for PMS. PMS symptoms are often worsened by high stress and high levels of caffeine, so cutting down on those things, plus using exercise and a healthy diet to de-stress and energize yourself, can go a long way to prevent those pesky PMS symptoms. Dr. Wider also recommends cutting salt from your diet, as it may aid in decreasing bloating.

The second route to eliminating, or at least reducing, the discomfort associated with PMS involves using NSAIDS, or non-steroidal anti-inflammatory medications, such as Advil, Motrin, Alleve and Midol. Dr. Wider explains that these medications can help reduce the discomfort of cramps and headaches. If your period is on a fairly regular schedule, you could even take a dose of one these anti-inflammatory medications before the symptoms actually start in order to prevent or at least lessen them.

Many collegiettes also choose to use non-medication remedies like hot pads for reducing cramps, or monthly massages to eliminate headaches. And we all know that there’s nothing better than a bowl of Ben and Jerry’s ice cream to help satisfy those wacky food cravings you’ve been having all week!

The third route that you can take to reduce your PMS symptoms is to use oral contraceptives, or birth control pills. Dr. Wider explains that birth control pills may make the hormone levels in the brain more stable. Because of this, only hormonal forms of birth control will help to reduce PMS symptoms.

“In PMS, hormone levels go up and down,” she says. “This fluctuation is thought to cause some of the symptoms of PMS, so being on the birth control pill may stop those fluctuations.”

The anonymous collegiette from San Francisco found that birth control pills helped her PMS symptoms significantly.

“I used to rely on Midol, but then I finally switched to the Pill,” she says. “At first the Pill didn't work too well. I still had severe cramps and other symptoms that it was supposed to fix. However, after about my fourth month on the Pill, I realized my cramps began to calm down into dull pains every other period or so, my face cleared up and although I still experience bloating and fatigue, most of the other symptoms have not come back which is great! Before the Pill I was miserable – I usually had to lay low for a few days which definitely interrupted the other important things going on in my life. Being on the Pill means that I am able to feel more energized and less bothered by aches and pains!”

All of these options can be helpful for eliminating the annoying and often painful symptoms associated with PMS. “The way that you choose to ameliorate the symptoms of PMS definitely depends on what those symptoms are,” says Dr. Wider.


The Bottom Line

PMS sucks, yes, but as with most things in life, living in a healthy, stress-free way can actually help to prevent the worst of those symptoms. And when a long run, a chocolate bar and some meditation still leave you feeling uncomfortable, grab a bottle of Midol, or even stop by the doc’s office to talk about switching to birth control pills. PMS might be a drag, but thankfully there are some quick fixes.

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