Dear Alice,

Once a month I get PMS-y. I can deal with the bloating and cramps, (usually), but, honestly, I go crazy, loony, wacky. My emotions are completely out of control, from extremely happy to totally miserable and crying, with lots of grumpy behavior in between. I actually don't usually realize when I'm behaving irrationally, so when my boyfriend tries to point out that maybe my bouts of anger and tears are caused by hormones I attack him for telling me I'm just an irrational woman. Basically, is there any way to help these mood swings? I'm on birth control pills, which is supposed to help, but it doesn't really seem to do anything.


Dear Nuts,

Mood swings, bloating, crying , and inability to sleep, oh my! PMS (a.k.a. premenstrual syndrome) — no matter how you experience it — can be a pill. Most women experience PMS at some point in their lives and it is different for every woman. The American College of Obstetricians and Gynecologists (ACOG) notes that while the cause of PMS is not clear, about 85 percent of menstruating women experience at least one premenstrual symptom — emotional, behavioral or physical. These commonly include:

  • Depression
  • Angry outbursts
  • Being irritable
  • Crying spells
  • Anxiety
  • Confusion
  • Social withdrawal
  • Poor concentration
  • Sleep disturbance
  • Thirst and appetite changes (food cravings)
  • Tender breasts
  • Bloating and weight gain
  • Headache
  • Swelling of the hands or feet
  • Aches and pains

A woman who experiences the above may be diagnosed with PMS if these symptoms:

  • Are present in the five days before her period for at least three menstrual cycles in a row.
  • End within four days after her period starts.
  • Interfere with some of her normal activities.

Although birth control pills may reduce the physical symptoms of PMS, they typically do not relieve emotional and behavioral symptoms. Still, you may consider discussing different treatment options with a health care provider. S/he may suggest antidepressants (especially selective-serotonin reuptake inhibitors — SSRIs) and/or dietary supplements such as calcium or vitamin B6. In the days leading up to their period, some women find it helpful to eat more fruits, vegetables, and whole grains, reduce their intake of fat, salt, and sugar, and avoid caffeine and alcohol. Relaxing activities such as yoga, massage, or tai-chi may also help relieve symptoms.

Some women who feel PMS-y may actually have premenstrual dysphoric disorder (PMDD). According to the Mayo Clinic, this condition affects about ten percent of women with PMS.

If you feel that PMS is affecting your life, see a healthcare provider, who can diagnose the cause of your symptoms and suggest appropriate treatment.  

Good luck in finding what works for you!


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