Here are the nuggets of knowledge of which most people are aware -- PMS creates numerous problems for women experiencing the emotional and physical fallout associated with the condition. It is estimated to have some effect on 75 percent of women. Of those, at least 50 percent of the females afflicted with PMS will deem it an interruption of daily life.
But the most startling statistic is that 5 percent will have symptoms so severe, they become incapable of functioning normally. Adding insult to injury, recent findings suggest that the headaches, abdominal cramping, fatigue and other issues associated with PMS may be a precursor to an even more serious health issue: high blood pressure.
Premenstrual syndrome can start at any age when a woman begins menstruating, and ends at menopause, producing an estimated 150 symptoms that include weight gain, bloating, breast tenderness and swelling, mood swings, anxiety, depression, changes in appetite, skin problems, food cravings, changes in sex interest, cramps, headaches, backaches, inability to concentrate, confusion, loss of interest in normal activities, irritability and fatigue.
Although much research has been done, the cause of premenstrual syndrome is still unclear. Researchers believe that it may be tied to hormonal issues (including not enough progesterone or too much estrogen), low levels of certain nutrients, a lack of vitamin B5, an abnormal metabolism and inability to produce a hormone substance called prostaglandins, and lower levels of the brain chemical serotonin. However, the exact cause is still speculative.
Women most at risk for PMS include those who have early-onset menstruation, a family history of extreme premenstrual syndrome symptoms, dysmenorrhea (a painful menstruation), bipolar disorder, general anxiety, or depression, high stress levels, postpartum depression or psychotic episodes, high body mass, and high consumption of alcohol or caffeine.
THE STUDY THAT LINKED BP AND PMS
A recent study by the University of Massachusetts Amherst and Harvard School of Public Health has linked PMS with a late-in-life chance of high blood pressure.
That study, published in the American Journal of Epidemiology, evaluated 1,257 women who had the clinical symptoms of PMS from 1991 to 2005. These subjects were compared to a group of age-matched women who had minimal menstrual-related symptoms.
The clinical symptoms group experienced such PMS signs as dizziness, nausea, forgetfulness, insomnia, depression, hot flashes, cramping and acne. They were studied for hypertension diagnoses until 2011.
The evaluation of the women indicated that moderate to severe levels of PMS had a higher risk of developing hypertension. The group had a 40 percent greater risk of getting high blood pressure over a 20-year period compared to those who had few menstrual symptoms, according to the study.
The study’s authors accounted for differences such as body mass, alcohol consumption, cigarette smoking, exercise, postmenopausal hormone use, family history of high blood pressure and the use of oral contraceptives. Even accounting for those, there was a still a higher risk among the PMS-afflicted.
What the study also showed is that those who had high blood pressure that manifested before age 40 had severe PMS. That group was three times more likely to develop high blood pressure than those without PMS.
The good news emerging from the study’s results is the potential to modify risk factors in order to reduce the chance of developing high blood pressure in the future. The steps include increasing B vitamins riboflavin and thiamine intake, which seem to reduce PMS symptoms by as much as 30 percent. By upping the B vitamin and modifying certain lifestyle factors like weight and exercise, doctors to reduce the instances of high blood pressure.
DIAGNOSIS AND TREATMENT
A diagnosis of premenstrual syndrome requires monitoring and charting symptoms for one to two months. A detailed history and physical and gynecological examination will typically be performed to rule out other medical conditions. Testing may also include a psychological evaluation along with laboratory tests and imaging tests.
Once a patient is diagnosed with premenstrual syndrome, doctors will recommend several treatments. These treatments aim not only to reduce PMS symptoms, but can also work to help reduce high blood pressure or may reduce risk for future development of it.
The first involves reducing stress and increasing exercise combined with dietary changes, all in the hopes that the existing premenstrual syndrome conditions will not get worse. Typical supplement recommendations include added vitamin B6 and vitamin D, extra calcium, and added omega-3 fatty acids.
In addition, doctors may also advise a drug regimen. This can include diuretics, which can curb water retention and bloating; nonsteroidal anti-inflammatory drugs (NSAIDs) for cramps and headaches, including Advil, Motrin and Aleve; antidepressants; birth control pills, which can stabilize hormone levels and stop ovulation; and in some cases, Depo-Provera, a birth control method that halts ovulation. While Depo-Provera stops ovulation, it may also trigger worse PMS symptoms, including weight gain and depression.
Some doctors will also recommend stress reduction using complementary and alternative medications and techniques. Treatments such as acupuncture, meditation and yoga have been shown to reduce stress levels and may help with PMS symptoms.
CH-CH-CH-CHANGES
Doctors will typically test for food sensitivities that may trigger PMS, including dairy, wheat allergies, corn, soy, preservatives and food additives. In addition, added calcium-rich foods like almonds, beans, dark green spinach and kale are often recommended to boost the calcium levels in the body. Doctors may also advise cutting back on red meat and integrating more fish, beats and lean meats for protein, as well as using healthy cooking oils.
Cutting back on salt, alcohol, coffee, tobacco and other stimulants is typically part of the dietary change recommendations. Eight glasses of filtered water are usually recommended, as is 30 minutes of moderate exercise.
Although there are no guarantees, women who increase exercise, lose weight and generally modify their lifestyles to include healthier choices generally do better than those who do not. That can help with PMS issues, as well as limit the potential for high blood pressure in the future.