Coping With PMS
Dr. Kate Dudek • January 20, 2021 • 5 min read
It’s not always easy being female. I remember getting my first period when I was 12 years old. My mum, ever supportive and loving, but also a realist; first congratulated me on reaching this big milestone, then dropped the metaphorical bombshell that this was it until I reached menopause (which at the time seemed a lifetime away!) A life mapped out in monthly cycles of approximately 28 days. The inconvenience, discomfort and expense of an existence dictated by my hormones!
Of course for many of us that is not strictly true; we get (in many cases) welcome relief from our periods whilst pregnant and breastfeeding; many contraceptives in use today cease, or significantly reduce, our periods; we learn to negotiate our monthly menstruation with minimal fuss and inconvenience. Ultimately, most of us do manage to take some control over our menstrual cycles. However, there is another hurdle that, as women, a high percentage of us have to navigate during our reproductive years, and that is premenstrual syndrome, or PMS.
Affecting as many as 3 out of 4 of us, PMS is a collection of physical and emotional symptoms that start just before your period does and ease off as it finishes. PMS is not pleasant; at best it causes mild pain and a disgruntled mood; however, at its worst, it can severely impact all areas of a female’s life and result in chronic depression and anxiety.
So what is PMS? What causes it? How can you manage it and what should you do if ‘that time of the month’ becomes a living nightmare?
Symptoms of PMS
PMS causes a plethora of symptoms, which broadly speaking, can be split into those that are physical and those that are behavioural or emotional. Symptoms not only vary between women, but can also change in number and severity in the same woman from month to month.
Physical:
- Bloating/tummy pain
- Breast tenderness
- Weight gain (fluid retention)
- Headaches/backaches
- Skin problems/acne
- Constipation/diarrhoea
Emotional:
- Fatigue
- Tearfulness
- Trouble concentrating
- Irritability
- Anxiety/depression
- Mood swings
- Difficulty sleeping
What causes PMS?
As a medical condition, PMS is not well understood. The fact that it typically correlates with the menstrual cycle and disappears during pregnancy and menopause suggests that it is caused by fluctuating hormone levels. However, the reason why some women are affected a lot more than others remains unclear.
How is PMS diagnosed?
There is no single test used to diagnose PMS. Many women never receive a formal diagnosis, they just learn to live with the monthly symptoms.
One option is to keep a symptom diary, tracking the frequency, duration and severity of any symptoms you have that you suspect may be linked to your monthly cycle. This will enable you to identify any trends or patterns. The Nabta app enables you to log any symptoms you have as well as the start and end date of your period. Anticipating and understanding any symptoms you are experiencing, can help to make them more tolerable, as well as enabling you to take preventative steps to manage them.
If you do visit your doctor, he or she may carry out a few tests to rule out other conditions. Thyroid disorders are relatively common in women of childbearing age and share a number of similar symptoms with PMS, including weight gain, depression and fatigue. Your doctor might recommend thyroid testing if you have these symptoms. He or she might also recommend that you undergo a mood screening test to ensure that you do not have clinical depression, which might require more intensive treatment and monitoring.
Treating PMS
Unfortunately, whilst you are still having periods, you are unlikely to find any miraculous cure for your PMS. If you do not wish to conceive, oral contraceptives are one option for the management of PMS. However, not all women want to rely on long-term synthetic hormones. Most treatment relies on managing the symptoms that you are experiencing. Alongside, educating yourself so that you better understand your own body, some at-home remedies you can attempt include:
- Exercise. Regular moderate-intensity exercise, such as walking, cycling or swimming, can improve your energy levels and reduce stress. It might be the last thing you feel like doing, but physical activity has also been shown to relieve the discomfort of period pain.
- Healthy diet. Increasing your daily intake of water and ensuring you get plenty of fresh fruit and vegetables will improve your overall health; likewise, limiting your alcohol intake and giving up smoking will also help. Eating smaller meals and reducing your salt consumption can help prevent bloating.
- Improving the duration and quality of your sleep can help you to feel better in the days leading up to your period. This may be easier said than done though, as there are few quick fix solutions to insomnia. Reducing stress and taking part in relaxation or meditation activities before bed can help. Yoga is a great stress reliever.
- Over-the-counter pain relief, specifically aspirin and ibuprofen can help to relieve some of the physical symptoms of PMS, including headaches, backache and cramps.
Many women take supplements including vitamin B6, vitamin E, calcium and magnesium or herbal remedies, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John’s wort. Unfortunately there is no scientific evidence supporting the use of these products and, in the case of herbal remedies, no monitoring of their safety or effectiveness. You should always speak to your doctor before attempting any complementary therapies.
PMS versus PMDD
PMS can be challenging enough to deal with, but for some women the condition interferes with their work, their relationships and their day-to-day social interactions. 3-5% of menstruating women will be diagnosed with severe PMS, or PreMenstrual Dysphoric Disorder (PMDD). This is a debilitating version of PMS that, in its most severe form, can result in suicidal thoughts. If you suspect that you are suffering from PMDD contact your doctor for help, support and advice. Click here to read more about PMDD.
Try Nabta’s PMS Pack and see if it will help you on your day to day activities.
Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and menopause.
Get in touch if you have any questions about this article or any aspect of women’s health. We’re here for you.
Sources:
- “PMS & PMDD: Causes, Symptoms, Treatments & Relief.” Cleveland Clinic, my.clevelandclinic.org/health/articles/9132-premenstrual-dysphoric-disorder-pmdd.
- “PMS (Premenstrual Syndrome).” NHS Choices, NHS, www.nhs.uk/conditions/pre-menstrual-syndrome/.
- “Premenstrual Syndrome (PMS).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Feb. 2020, www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780.
Download the Nabta App
Related Articles
A Beginner’s Guide to Menstrual Cups: A Sustainable and Practical Alternative
Menstrual cups have gained popularity in recent years as a sustainable and cost-effective alternative to traditional menstrual products. Made of medical-grade silicone or latex, these reusable cups collect menstrual fluid rather than absorbing it, offering numerous benefits for those who choose to use them. If you’re new to menstrual cups and considering making the switch, this beginner’s guide will provide you with essential information to help you get started. #### What is a menstrual cup? A menstrual cup is a bell-shaped device designed to collect menstrual fluid. It is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects the flow, holding much more liquid than a tampon or pad. The cup is reusable, offering a more sustainable option compared to disposable products. #### Advantages of menstrual cups: **Eco-friendly:** Menstrual cups reduce waste as they can last for several years with proper care. By using a cup, you can significantly decrease the number of disposable pads and tampons that end up in landfills. **Cost-effective:** Although menstrual cups have a higher upfront cost than disposable products, they are a long-term investment. Over time, using a menstrual cup can save you money since you won’t need to regularly purchase [pads or tampons](https://nabtahealth.com/articles/what-type-of-sanitary-product-is-right-for-me/). **Extended wear time:** Unlike pads and tampons, which typically require changing every few hours, menstrual cups can be worn for up to 12 hours, depending on your flow. This makes them convenient for overnight use and allows for uninterrupted activities during the day. **Lower risk of leaks and odor:** When inserted correctly, menstrual cups create a secure seal that reduces the risk of leaks. Additionally, since the fluid is collected rather than absorbed, menstrual cups do not cause the same odor issues that can arise with other products. **Health benefits:** Menstrual cups are made of hypoallergenic materials, making them suitable for people with sensitive skin or allergies. They also do not disrupt the natural pH balance of the [vagina](https://nabtahealth.com/glossary/vagina/), reducing the risk of infections. #### How to use a menstrual cup: **Choosing the right cup:** Menstrual cups come in different sizes and shapes. Consider factors such as your age, flow, [cervix](https://nabtahealth.com/glossary/cervix/) position, and whether you’ve given birth when selecting the appropriate cup. It may take some trial and error to find the perfect fit. **Sterilize the cup:** Before using a menstrual cup for the first time, sterilize it by boiling it in water for a few minutes. Ensure the cup is clean and dry before insertion. **Insertion:** Wash your hands thoroughly. Fold the cup using one of the various folding techniques available. Insert the cup into your [vagina](https://nabtahealth.com/glossary/vagina/), aiming towards the base of the spine. The cup will unfold and create a seal against the vaginal walls. **Removal:** To remove the cup, wash your hands and find a comfortable position. Gently pinch the base of the cup to break the seal, then carefully pull it out. Empty the contents into the toilet, rinse the cup with water, and reinsert if desired. #### Caring for your menstrual cup: **Empty and clean the cup:** Depending on your flow, you may need to empty the cup every 4 to 12 hours. Rinse it with water or wipe it with unscented, mild soap. Sterilize the cup between cycles by boiling it for a few minutes. **Store properly:** Keep your menstrual cup in a breathable bag or container when not in use. Avoid storing it in an airtight or plastic container to prevent odor and bacterial growth. Menstrual cups offer a sustainable, [cost-effective](https://www.lizzom.com/collections/lizzom-products), and convenient alternative to traditional menstrual products. While there may be a learning curve when initially using them, many people find them comfortable and reliable once they get accustomed to the process. By following the tips and techniques outlined in this beginner’s guide, you’ll be well on your way to a more sustainable and hassle-free period experience.
What are Sanitary Pads?
Sanitary pads are recognised worldwide. They are a [menstrual hygiene product](https://nabtahealth.com/what-type-of-sanitary-product-is-right-for-me/), designed for use by women during their monthly periods and also known as sanitary napkins or sanitary towels. #### **From simple beginnings…..** Sanitary pad designs in the 1960s incorporated flexible, thin, leak-proof polyethylene as the back sheet. Over time, sticky, elastic plastics were used, allowing the sanitary pads to be attached to a woman’s underwear directly, rather than hanging off a belt-type device. Later in the 1970s, designers grasped the idea of making plastic “wings” to be used to wrap around panties and place the pad exactly where it is required. #### **……to widespread use in the 21st century** Which brings us, more or less, to the present day, where sanitary pads are still very widely used globally by women during their monthly periods. They can also be used after childbirth when it is normal to have vaginal bleeding for a week or two. In fact, any flow of blood from the [vagina](https://nabtahealth.com/glossary/vagina/) can be easily absorbed and contained within a sanitary pad. Many young women choose to use sanitary pads when they initially start their periods, as it can take time to develop the confidence to use a [tampon](https://nabtahealth.com/what-are-tampons/). Today’s sanitary pads are produced from various materials, based on the brand, country of origin, and even style of pad. #### **How to use sanitary pads** Sanitary pads are worn externally, unlike menstrual cups and tampons that are worn internally. Sanitary pads should be changed regularly, depending on the period flow, i.e. how light or heavy the bleeding is. Provided the right absorbency of the pad is selected, leakage should not occur, meaning menstrual blood does not reach clothing and furnishing Sanitary pads are wrapped individually for easier usage and can be easily carried in your purse. #### **A pad for every flow type** Some of the most common types of pad are: • Regular: it is a middle-range sponginess pad. • Maxi/Super: A spongy bumper pad routinely used by women with heavy periods. • Overnight pads: Longer than regular pads, allowing more protection while lying down.Suitable for use during the night. • Maternity pads; Longer and thicker than maxi/super pads. Designed for women to use after childbirth, can also absorb urine. • Ultra-thin: A thin pad that may be as spongy as a Maxi/Super or Regular pad, but with a reduced amount of bulkiness. It is important to remember that, regardless of type, sanitary pads cannot be flushed down the toilet as they might cause a blockage. #### **The environmental impact of disposable sanitary pads** Establishing exactly how much plastic waste comes from sanitary pads is tough, as it is labeled as medical refuse. The plastic used in sanitary pads is not eco-friendly and can [lead](https://nabtahealth.com/glossary/lead/) to environmental and health hazards as one pad takes hundreds of years to decompose. An increased environmental awareness is one reason why, recently, women have been looking for alternative, more eco-friendly sanitary products. [Reusable pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) and washable [menstrual cups](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) are both becoming more widely used. Both have actually been in existence for a long time, but improved designs make them a viable alternative for the modern woman. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#1960787575785977787b6d78717c78756d71377a7674) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “What Is a Sanitary Pad?” _Menstrupedia_, [www.menstrupedia.com/articles/girls/sanitary-pad](http://www.menstrupedia.com/articles/girls/sanitary-pad).
What Type of Sanitary Products is Right for me?
From the time that a female starts her periods when she enters [](https://nabtahealth.com/what-is-puberty/)[puberty](https://nabtahealth.com/glossary/puberty/) until she reaches [](https://nabtahealth.com/about-the-three-stages-of-menopause/)[menopause](https://nabtahealth.com/glossary/menopause/) and stops having periods, menstrual hygiene will become something that she has to carefully consider. Most women menstruate for about 40 years and regular periods are a good indicator that a female is reproductively healthy. Although, unfortunately there are exceptions to this, for example women with [](https://nabtahealth.com/what-is-endometriosis/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/) often have periods that appear normal. As menstruation is such a fundamental part of being a woman of reproductive age, taking the time to explore and sample the available sanitary products can help make periods more manageable. Deciding on which sanitary products to use can be influenced by a range of factors, including: * Cost * Environmental impact * How often the product will need changing throughout the day * Local availability * Heaviness of flow * Personal preference and/or recommendations by friends and family. The range of sanitary products available today means that the majority of women are able to manage their periods safely, comfortably and with dignity; in contrast to days gone by when old rags and sheep wool were commonly used to soak up menstrual blood. **Sanitary pads** ------------------- A common choice for girls who have only just started their periods. [Sanitary pads](https://nabtahealth.com/what-are-sanitary-pads/) are also known as sanitary napkins and sanitary towels. They are narrow pieces of absorbent material that fit directly into the underwear. Easy to use and change, they are available in different absorbencies to suit differing flow rates and times of the day. Some have wings attached to help secure them in place and reduce the risk of stains or leaks. Disposable sanitary pads were first used in the early 1920s, they gave women the opportunity to manage their periods discreetly, as there was no longer the need to wash and dry the bulky homemade versions publicly. Now, with advancements in manufacturing and material availability and a general public who are becoming increasingly environmentally driven, there is renewed demand for reusable sanitary pads, to avoid the high plastic wastage that comes from most disposable variants. [Reusable sanitary pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) are made from new or old materials such as sheets, pillow cases, and towels. They are made from pure cotton, as it is the best material for absorbing and also the most comfortable to wear. **Tampons** ----------- Often preferred over sanitary pads by dancers, athletes and swimmers, [tampons](https://nabtahealth.com/what-are-tampons/) are worn internally. A simple concept, they are devised of a wad of cotton attached to a string. Some come with a plastic applicator for ease of insertion. Once inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), they expand slightly to absorb menstrual blood. They will typically need changing every 4 to 6 hours and, as such, are not ideal for wearing overnight. In the 1980s, an association between tampon use and Toxic Shock Syndrome (TSS) was reported. Whilst the overall risk of developing TSS remained very low, the link between it and tampon use was enough to put some women off using them for prolonged periods of time. Like disposable pads, tampons incur significant plastic waste and many women today strive for alternatives that are more environmentally friendly. **Menstrual cups and disks** ------------------------------ A [menstrual cup](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) is a reusable hygiene product. The cup is made from medical-grade rubber or silicone, it is small and funnel-shaped and is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects menstrual blood. There are disposable menstrual cups, but it is the reusable ones that have really been growing in popularity in recent years. The menstrual cup holds up to 38 ml fluid, meaning it requires changing less often than a sanitary pad or tampon; it also has fewer of the negative associations with TSS that tampons have. Whilst it can take a few attempts to master the [art](https://nabtahealth.com/glossary/art/) of insertion, leakage rates are low once the cup is in position. Reusable menstrual cups should be washed and wiped clean before each use and sterilised at the end of your period. Modern menstrual cups are very durable and can last for up to 10 years with proper care. Menstrual disks and cups are similar as both are inserted into the [vagina](https://nabtahealth.com/glossary/vagina/) and both collect blood rather than absorbing it. Disks typically sit higher up, where the [vagina](https://nabtahealth.com/glossary/vagina/) meets the [cervix](https://nabtahealth.com/glossary/cervix/) (the [vagina](https://nabtahealth.com/glossary/vagina/) fornix). Unlike cups, disks are usually not reusable and will need to be discarded after use. They can also be slightly messier to remove than cups. ### **_Advantages of menstrual cups and disks_** * They are affordable. * Potentially safer than tampons * Hold more blood than other sanitary products, meaning you can go longer without changing them or emptying them. * The reusable varieties are more eco-friendly than disposable pads or tampons. ### **_Disadvantages of menstrual cups and disks_** * Emptying them can be messy. * In very rare cases, may cause an allergic reaction. However, most modern varieties are made from hypoallergenic materials. * Vaginal irritation, particularly if not accurately inserted. * Hard to remove or insert. **Period pants** ---------------- Period underwear ([period pants](https://nabtahealth.com/what-are-period-pants/)) are a relatively new addition to the portfolio of sanitary products. These are more like normal underwear, except that they have additional layers of material built in to absorb any period blood. There are different types of pants available for light, medium, and heavy flow days. They can be worn alone, or as a back-up alongside tampons or menstrual cups. Fully reusable, they are another of the more environmentally-friendly options and, because there is no need for any internal insertion, they are a good option for those who are hesitant to use tampons, cups or disks. These special pants can also provide welcome relief for those who experience urinary incontinence. In conclusion, there are now a large selection of products that allow you to go about your normal life whilst on your period each month. Selecting the right product will minimise the risk of leaking, discomfort, embarrassment and inconvenience. Consider a women health test to learn more on your health. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#146d75787875547a757660757c717578607c3a777b79) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Eijk, Anna Maria Van, et al. “Menstrual Cup Use, Leakage, Acceptability, Safety, and Availability: a Systematic Review and Meta-Analysis.” _The Lancet Public Health_, vol. 4, no. 8, 1 Aug. 2019, pp. E376–E393., doi:10.1016/s2468-2667(19)30111-2. * Hajjeh, Rana A., et al. “Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961.” _Emerging Infectious Diseases_, vol. 5, no. 6, 1999, pp. 807–810., doi:10.3201/eid0506.990611. * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “Menstrual Cups vs. Tampons: Things You Might Not Know.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, [newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/](https://newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/). * “Tired of Tampons? Here Are Pros and Cons of Menstrual Cups.” _Health Essentials from Cleveland Clinic_, Health Essentials from Cleveland Clinic, 15 Nov. 2019, [health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/](https://health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/).