Q: My teenage daughter has mood swings with tearfulness and irritability, as well as bloating and breast tenderness before her period. Could it be premenstrual syndrome? Our GP is dismissive.
A: Those symptoms are common to premenstrual syndrome (PMS). In fact, more than 150 psychological, behavioural and physical symptoms have been identified, according to the National Association for Premenstrual Syndrome (NAPS ). The most usual are listed in the box below.
No one will experience every symptom, which may vary from cycle to cycle. Although the exact cause has still to be identified, experts agree the key factor is the rollercoaster of hormones during the monthly cycle.
PMS may affect the sufferer continuously from ovulation (when the egg is released) until her period starts ten to 16 days later, or for three to four days at ovulation then again before menstruation, or in other patterns. PMS lifts with menstruation so women are symptom-free for seven to ten days per cycle.
NAPS advises that keeping a menstrual chart is the only reliable method of diagnosis. Your daughter can download one from its website (pms.org.uk) and should fill it in for at least two cycles before consulting her GP again.
If she feels that another GP may be more receptive, she should ask to see a different one. A section called ‘Getting the most from your doctor’ by Dr Carol Cooper on the NAPS website is helpful. You will also find NAPS guidelines by consultant gynaecologist Mr Nick Panay on treating PMS , including a section on complementary therapies.
Mr Panay says evidence suggests magnesium, calcium and vitamin D supplements may help, and also isoflavones such as soy and red clover. Agnus castus, the fruit of the Vitex agnus-castus tree, is the best-researched option for PMS , he comments. It’s important to choose a quality-controlled product such as Agnus Castus PMS Relief by Higher Nature (£7.15 for 30 tablets) or Periagna Agnus Castus Fruit by Bio-Health (£10.75 for 60 capsules).
Moderate to severe PMS affects up to 30 per cent of women, according to Mr Panay, but is probably under-reported because talking about periods is still a taboo for many women.
A survey of 1,004 girls aged 14 to 21 by the charity Plan International UK found 79 per cent had experienced worrying symptoms but had not seen a doctor. Over half believed the symptoms were normal; 48 per cent felt embarrassed by their period.
Talking to a sympathetic GP about period problems is important because they may indicate an underlying condition such as endometriosis, where cells from the womb lining (endometrium) migrate to other parts of the body causing inflammation, pain and scar tissue, possibly leading to infertility. For more information, go to endometriosis-uk.org.
COMMON SYMPTOMS OF PMS
- Psychological/behavioural Mood swings, depression, anxiety, tiredness, fatigue, lethargy, feeling out of control, irritability, aggression, anger, reduced cognitive ability, sleep disorder, food cravings.
- Physical Breast tenderness, skin rashes, bloating, weight gain, clumsiness, headaches, backache.
TACKLING TPERIOD POVERTY
One in ten girls in the UK cannot afford sanitary protection, and it’s commonplace for women who are homeless or refugees, and those in disaster areas worldwide. To help women keep their dignity, you can donate to charities such as Actionaid (actionaid.org.uk), The Red Box Project (redboxproject.org) and The Homeless Period (thehomelessperiod.com). Also buy an extra packet of tampons or towels when shopping and give them to your local foodbank.
- Britain’s Got Talent judge Alesha Dixon is supporting the Always campaign to talk about menstruation and help #EndPeriodPoverty