How to Deal with PMS

QUESTION: PMS is driving me crazy. What can I do?
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ANSWER: Janet (I've changed the name, of course) was a tall, slender,
attractive woman in her early thirties. She held a job as an office manager
in an accounting firm, and was happily married with two children. But each
month like clockwork she was in my office, physically bloated, anxious, quick
to anger, and depressed. She too was at wits end, apparently a victim of her
monthly rhythms, and her sex.
But we've come a long way, and we now know that premenstrual syndrome is
a definite and partially physically caused phenomenon. It causes women before
their monthly periods untold grief and anxiety, for themselves as well as
their family and friends. It is a problem that must be attacked from three
angles: the biologic, the social, and the psychologic.
The first thing I did for Janet was listen; she described a monthly
syndrome and I listened. This in itself seemed to relieve her. Acknowledging
PMS as a disease entity seems to ease the burden for many women. They are not
crazy, mean, or selfish; they really are suffering. Their experience is
validated and somehow also their worth as a person.
Our next step together was educational. We discussed the possible
symptoms of PMS and why it can't account for all feelings of depression and
anxiety. What to actually do when PMS actually struck was next discussed.
Much has been proposed: a program of aerobic exercise for 20 to 30 minutes a
day for three to seven days a week, a diet watch to see that the fiber and
protein content remain high while the sugar and carbohydrate content low--a
modified hypoglycemic diet. We talked about getting the cooperation of her
family and friends during these times of the month, as we also spoke of her
learning new mechanisms of coping and dealing with the blows of life.
Finally, we came to medication. Much research needs to be done in this
area. We tried a vitamin, in this case a Vitamin B complex, and a diuretic to
reduce fluid retention, and that seemed to work for her.
It's important to realize that each patient must be treated in ways that
seek to alleviate their unique problems. Your situation deserves its own
personalized workup, and a therapeutic strategy that you and your family
doctor can work out together. Take courage in the fact that you can be helped
and find relief.