1. Premenstrual syndrome (PMS)
PMS includes a variety of physical and emotional symptoms that occur within 14 days of the start of your period. At least 85 per cent of menstruating women have at least one symptom, says Dr. Margaret Burnett, a gynecologist and professor of medicine at the University of Manitoba in Winnipeg. They include trouble sleeping, fatigue, breast swelling and tenderness, acne, irritability and mood swings. Also, you're more prone to PMS during perimenopause and stressful life events, such as a divorce, family illness or death.
Solutions: If you're having trouble sleeping, give yourself time to wind down before going to bed. Hélène Charlebois, an Ottawa-based registered dietitian, suggests drinking a soothing concoction of chamomile tea and warm milk with a hint of honey just before you turn in. You can also try dabbing lavender oil under your nose at night to help you relax.
To avoid water retention – which may cause abdominal bloating, weight gain, and breast swelling and tenderness – curb or forgo caffeine and unhealthy foods that are high in fat, which may increase breast pain. Taking B complex vitamins (50 milligrams [mg], twice a day) as well as vitamin E may also reduce breast discomfort, says Marika Berni, a doctor of naturopathic medicine in Toronto.
When it comes to your skin, "the diet that is good for [preventing] acne is the low glycemic index diet," says Dr. Anne Curtis, a dermatologist in Toronto. But if you change your diet and you're still having premenstrual acne flare-ups, your dermatologist may suggest a cleansing and moisturizing routine for your skin-care needs. There are also medicated treatments, such as topical antibiotics, that have an anti-inflammatory effect. If all this fails, your doctor may suggest taking an oral antibiotic, such as tetracycline, or a birth control pill. "Sometimes I will suggest a pill that contains a male hormone–blocker, such as Diane-35. Those tend to be particularly effective for acne," says Curtis.
How else can you beat PMS? Restrict your intake of refined foods (such as white flour and sugar). They can make you more vulnerable to depression, anxiety and irritability, says Berni. "I usually find that changing my patient's diet and supporting her liver function with herbs and nutrients improves her mood." However, do not take herbs if you are, or think you may be, pregnant.
Berni also recommends taking a 5-HTP supplement (50 mg, twice a day) to help increase your production of serotonin (your body's "happy" hormone), which drops the week before your period. If you are taking an antidepressant, don't take 5-HTP without talking to your doctor. Another cause of depression, irritability and anxiety could be a calcium deficiency, says Berni, who recommends taking 400 mg of calcium three times a day. A low-dose antidepressant may also be effective. Taking it only during the days leading up to your period, when symptoms peak, may be all you need.
Acupuncture may ease general PMS symptoms, but for effective, long-term relief, treatment needs to be done on a regular basis, says Chris Di Tecco, an acupuncturist in Mississauga, Ont. "In a clinical setting I will often see a woman once a week for four to eight weeks, then space out treatments to twice a month." The severity of your symptoms and length of time you have had PMS also affect how long treatment will take to work.
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2. Constant cravings
Your period can affect what you eat and vice versa, says Charlebois. During the first few days of bleeding, you lose water and may crave salt. During the second half of your cycle (days 14 to 28), your hormone levels start decreasing and you may crave sugar and chocolate because your brain feels it needs more fuel.
Solutions: Keeping your blood sugar stable helps ensure your hormone levels are in check. Eat three small meals and two healthy snacks a day, says Charlebois. Smart snack choices combine a healthy carbohydrate (for example, a piece of fruit or multigrain crackers) with a protein (yogurt or a piece of cheese). Eating high-fibre foods such as fruit, veggies and whole grains will also stabilize your blood sugar level.
Burnett says most women experience some cramping and lower-back and leg pain before their periods; for about 17 per cent of women, these symptoms may be debilitating.
Solutions: Reduce your consumption of dairy products and meat. They contain hormones called prostaglandins, which can cause cramping. Get moving – women who exercise regularly have milder cramping and pain. And butt out. Smoking aggravates cramps.
Taking ibuprofen at the first hint of cramps helps block prostaglandins. Burnett advises you to take 400 mg (with food) every four to six hours if you have heavy cramping. If ibuprofen doesn’t work, talk to your doctor about taking longer-acting prescription medication or the birth control pill.
If you opt for the natural route, try acupuncture and dietary supplements. In addition to taking calcium supplements (400 mg, three times a day), Berni also recommends taking magnesium (200 mg, three times a day) and omega-3 fatty acids (2,000 mg, divided throughout the day).
If cramps strike, you can also place a heating pad or hot water bottle on your stomach. And there’s evidence that transcutaneous electrical nerve stimulation (TENS) machines help decrease your perception of pain. They can be rented from medical supply stores.
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5. Irregular periods
It's not uncommon to miss a period now and then. A bad cold or flu may throw your cycle off, as can stress and irregular sleep patterns. Other triggers include being obese or having an eating disorder, a thyroid problem or a major illness. As well, breast-feeding may put your period on hold.
Solutions: Take a pregnancy test to rule out that possibility. Maintain a healthy weight but don't overdo it on your workouts; too much exercise can stop your period altogether. Try a chasteberry supplement, suggests Berni. Visit your doctor if the problem persists for more than two months.
Low-dose birth control pills often cause spotting. Some women also spot when they ovulate because of a rapid rise and fall in estrogen midcycle. Polyps (an overgrowth of normal tissue in the uterus or cervix) are another culprit. Occasionally, spotting can be a sign of something more serious, such as an infection of the cervix.
Solutions: Visit your doctor to have an exam and talk about the birth control methods you are using. If you have polyps, your doctor can remove them.
7. Premenstrual dysphoric disorder (PMDD)
A severe form of PMS with disabling symptoms of depression, anxiety, panic attacks, mood swings, persistent irritability, low energy and food cravings. It has been linked to clinical depression. Doctors differ on how common it is, but Dr. Shaila Misri, director of reproductive and mental health at B.C. Children’s Hospital and St. Paul's Hospital in Vancouver, says up to eight per cent of women suffer from PMDD.
Solutions: Talk to your doctor as soon as possible if your PMS symptoms are so severe that you can't function in your job, family or daily life, says Burnett. Ask your doctor for a medical evaluation to determine if your symptoms are a result of your period or some other condition, such as depression.
The good news is that making changes to your diet – eating more fruit, vegetables and complex carbohydrates and less animal fat – can help alleviate your symptoms. So can taking calcium, magnesium and essential fatty acids supplements, as well as a B complex vitamin. Medications that may help ease PMDD include antidepressants or the birth control pill.
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