Understanding PMS, That Time Of The Month

Dr. Madiha Haque

PMS that time of the month

Menstruation is a crucial part of every woman’s life that brings with itself a phase of discomfort and mood swings. It is easy to label them as mood swings or a feeling irritable but in reality it involves our bodies’ chemical imbalances that need serious attention. Most of the times these changes are gradual and women try to compensate with more exertion, and other times they are so sudden that it’s easy to identify that something is majorly wrong. Whatever it may be, it needs attention and treatment so a woman doesn’t have to compromise her quality of life.

What is PMS?

Pre-Menstrual Syndrome (PMS) is a series of symptoms that occur consecutively every month just before menstrual cycle. The pattern is predictable, hence easily diagnosed. Characteristically the symptoms are diminished just when bleeding starts. If the feeling persists throughout the cycle, then problem is somewhere else. On average every 3 in 4 women experience this at least once in her lifetime, with its peak in late 20s and early 30s and it tends to get worse with increasing age.


In order to figure out if what is happening to a woman just before menstruation is really a disease to be treated, one has to know what supposedly the symptoms are:


  • Exaggerated Mood swings
  • Irritability and depression
  • Difficulty to focus
  • Depression


  • Fatigue
  • Bloating
  • Change in eating and sleeping patterns
  • Headaches and backaches
  • Tender breasts


To start with, the patient is requested to keep a ‘menses diary’ to identify a regular pattern. The symptoms necessarily are a hindrance for the woman in carrying out her routinely activities. Before one is labelled with PMS, all other possible diagnosis have to be excluded. These conditions may include thyroid disease, depression, migraine headaches and irritable bowel syndrome. Sometimes the doctor may prescribe medicines that stop ovarian function, if that stops PMS symptoms as well, that will serve as a diagnosis.



After firm diagnosis of PMS, treatment is planned according to patient’s needs. Doctors mostly want to start with less compromising measures as medications.
Regularity check: Once patient is aware of the pattern she can regulate her life events accordingly. Not much is  controllable but a number of studies have shown that when person is aware of the upcoming problems she is able to cope up better with it.
Dietary regulation: Emphasis on stress relieving is the key. Food that increase stress level such as alcohol, caffeine, high salt and sugar are to be avoided.  And ones that are good for your body including minerals like calcium and magnesium, and vitamins especially B6 are to be increased.
Pain medications such as Tylenol, Advil or Aleve will work for headache, backache, breast tenderness and other cramps.
Contraceptives that just regulate menstruation or ones that stop ovarian function, have a good control but are avoided because of side effects.
Diuretics like spironolactone work well to reduce fluid retention that might cause swelling of hands, feet or face.
Antidepressants like fluoxetine are considered most effective psychological therapy but have no effect on physical symptoms, also these have a number of side effects making them less compliant.



It is best considered treatment as it gives more fruitful result both physically; in making your heart and body stronger and mentally; by releasing endorphin that boost up your good mood.
No matter how much impediment goes on with your mind and body you have to fight back good, stay positive and don’t let any bodily or brainy deterioration overcome your good sense of being woman.


About the Author: 
Dr. Madiha Masood is the mother of four children, two of which are twins. She has previously worked as an obstetrician/gynecologist at Lady Dufferin Hospital and has now undertaken the task of simplifying health issues in accordance with Islamic values.