Dealing with Pre-menstrual Syndrome and Period Pain Content from the guide to life, the universe and everything

Dealing with Pre-menstrual Syndrome and Period Pain

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A pink hot water bottle

On occasions, it has been known for women to be slightly more emotionally and physically sensitive than their usual cheery selves. Some might even say 'touchy' and not in a touchy-feely way. Quite the opposite in fact... In this collaborative Community entry we're talking about (hushed whisper) 'the time of the month' otherwise known as PMS1.

We asked you the Community how you cope with the symptoms of PMS: anything that might include helping you through bloating, irritability, stomach cramps, breast tenderness, fatigue and headaches. This is what you came up with.

The Symptoms of PMS

To begin with, let's explore exactly what we're talking about here. PMS manifests itself psychologically with symptoms ranging from depression, mood swings and paranoia. Because sufferers are potentially tetchy and seemingly irrational, they can be difficult to be around, but women are not using these symptoms as an excuse to behave badly. If you're lucky enough not to experience the symptoms of PMS, here follows several insights into what it can be like:

In the week leading up to my period life loses all colour, everything seems pointless. I used to really suffer, but as I've got older, I find comfort in the knowledge that it is just PMT, and therefore I know it will end, and my joy of living will be back. I still feel like shit, but at least I don't feel depressed about feeling depressed.
I turn into a complete and utter control freak; telling everyone how to do things and wanting everything to be done perfectly and exactly how I want it, I must be a nightmare to put up with!
Personally I'm never prepared. I didn't even realise I was PMSing when I started crying about the fact that I'd bought the wrong sort of lined paper to write the rest of my revision notes on (I bought normal, rather than narrow lines). Then, I thought about it, and realised how irrational I was being and realised that it must be about to be 'that time of the month' and I was right.

When you're dealing with feelings like those, it doesn't help when partners or friends patronise or underplay the horrible symptoms you experience. When you're dealing with someone who is having hideous mood swings and miserable depression that's the worst thing you can do. At some point, though, a reality check kicks in (even though the realisation doesn't really help) as this Researcher describes:

I know exactly when I'm due and I am usually aware of exactly why I'm screaming at my other half. But the knowledge doesn't seem to make any difference. Sometimes it's like being outside myself, watching and thinking 'oh, for goodness sake, give the poor man a rest, it's just your hormones, he's not an insensitive bastard'. And even though I know paranoia is one of my symptoms, I still walk into my office one day a month and think everyone has just stopped talking about me.

There was a time when PMS wasn't a considered to be a medical condition. The lack of recognition seems almost medieval, when conditions such as epilepsy were explained by the possession by devils. Those that suffered from PMS were dismissed as difficult and irrational. Here's what one Researcher has to say about that time:

I suffered from the worse kind of PMT for almost ten years before it finally got recognised officially as a medical condition. I had really, really bad mood swings and very, very bad period pains. I was hateful and aggressive towards everyone. During these times I was very definitely not a nice person to know and no one wanted me around them. During those first ten years, before it was a recognised illness, you could not get any medical help for it and you had to try and help yourself. In sheer desperation I went to the doctor and, believe it or not, he told me to go and get myself pregnant. Now I'm talking about the days when it was still sociably unacceptable to live together and if anyone had a baby out of wedlock you were sent away. Needless to say I did not take his advice.
After watching a programme on it, my parents both felt very guilty because they thought I was just being an obnoxious brat all those years. Thanks to that programme they realised that I genuinely couldn't help my behaviour, they took the advice from the programme and finally got me the help I so desperately needed. It helped a bit but because I'd been suffering so badly for so long there wasn't a lot they could do for me until they found out that vitamin B6 helped a lot and I have to admit it did help to a certain degree.
But for me, for 28 years, all the problems of my menstrual cycle were so bad to the point that they were making me very anaemic and ill. And what is more, they had been interfering with my social life for all that time and in the end I had to have a hysterectomy. Then and only then did my illness cease.
So please don't belittle anyone with PMS. They need treating with the utmost compassion, love and the utmost consideration.

Diet and Supplements

A week before your period starts, make sure that your diet isn't too heavy in salts, alcohol and caffeine - this will keep water retention and bloating down. Also make sure you eat plenty of foods containing iron and vitamins. Certain foods seem to help alleviate the symptoms. Monitor closely and you could work out what's best for you:

Evening Primrose Oil, Starflower Oil and Blackcurrant Oil

Evening primrose oil, starflower oil and blackcurrant oil all contain gamolenic acid (GLA). You should be able to get any of them from most high-street pharmacies or health food shops. Starflower oil is more expensive than evening primrose oil, but has a higher concentration of gamolenic acid. GLA has been shown in a couple of studies to help with breast pain (or mastalgia if you want to give it a fancy medical name). For some women it can help with PMS. One of the advantages of it is that it has virtually no side effects.

However, despite anecdotal evidence that GLA works with other symptoms of PMS, no other study has proven that they are better than the placebo effect. On saying that, the studies carried out on the effects of GLA on the symptoms of PMS are small, and potentially, GLA can have a small beneficial effect, although, no study large enough, or good enough has been carried out to definitively show this. The reason it is believed to work is that it is a rich source of long-chain fatty acids, which are the precursors of prostoglandins. As PMS is associated with low plasma levels of prostoglandins, the theory is that if you increase what it is made of, more of the required stuff will be made. It's certainly doing something for some of us, as this Researcher tells us:

Ten minutes after taking evening primrose oil capsules I suddenly feel like sighing and everything is all right. It's magic. I suggest all sufferers give it a go.


Chocolate, a marvellous substance which deserves to be in a food group all of its own, can be a fantastic cure-all for everything from being dumped to exam stress - it also has it's enthusiastic supporters at times when PMS and period pain are rearing their ugly heads. Accompanied by caffeine and a good book there's no better comfort.

Some believe that you should give into the cravings leading up to your period. After all, if you're craving it, your body probably needs it. This feeling may be all in the mind, but denying yourself something you want doesn't help for those few days. Others say, avoid chocolate completely, as it only makes things worse.

But what is the magic ingredient in chocolate that your body needs? It contains iron and magnesium. Iron helps with tiredness and irritability and magnesium is said to regulate mood. Chocolate also contains milk, and consequently, calcium. Back in the 1930s it had already been noted that levels of calcium in the blood were significantly lower in the week preceding menstruation. Also, the symptoms of hypocalcaemia (low blood calcium) are remarkably similar to PMS. Large studies in the early 1990s were carried out to see if it did, indeed, have any effect, and to date, calcium is the only supplement which has been shown to have any positive effect on the symptoms of PMS2.

The Vitamin B6

The vitamin B6 has reportedly changed the lives of a number of h2g2 Researchers with regard to dealing with PMS:

Amazingly enough, a bloke told me about it first. I've been spreading the word ever since and swear it has saved a friends' marriage.

In high enough doses, vitamin B6 can suppress the actions of a steroid hormone called aldosterone. This results in a diuretic effect, making you wee and should consequently prevent bloating. In addition, as PMS is associated with an increase in blood oestrogen levels and low blood progesterone, high doses of vitamin B6 decrease blood oestrogen and increase blood levels of progesterone, providing symptomatic relief3.

You should start taking the recommended daily dose 5 to 7 days before your period begins (or as soon as you start getting symptoms) and can continue on until the end of your period, but then you must stop until your next period. B6 should not be taken continuously and there are a few poor souls, approximately 1 in 10,000, who are allergic to taking B6, so if you notice any big spots on your skin soon after taking it, please stop and consult your doctor. Marmite, brazil nuts and bananas contain significant levels of B6 if you would prefer to take the vitamin in a natural form, rather than as a supplement.


It has been suggested that you should eat carbohydrates every few hours in the week before and during your period. The theory goes that complex carbs help the body dispose of excess progesterone, which is the hormonal culprit of PMS. Carbohydrates may well be another food that you crave in the run up to your period. Pasta and any other foods which are high in carbohydrates also increase the levels of serotonin in the brain resulting in a calming effect.

Vitamin C

Vitamin C can also help. Take 1000mg a day instead of the recommended 500mg. It can't hurt you - excess Vit C is flushed out of the system automatically. Or you can boost your intake of foods containing high doses of vitamin C such as pineapple and strawberries.


Curling up with a bar of Dairy Milk and a bottle of red wine certainly makes you feel better. We've explored the benefits of chocolate already, but what about alcohol? In actual fact, alcohol acts in a very similar fashion to benzodiazapines and barbiturates, by potentiating the effects of a inhibitory neurotransmitter in the brain called GABA. Increased action of this transmitter in the brain has a calming and relaxing effect, as anyone who has downed a shot of vodka during a very stressful lunchtime will testify.


Magnesium is actually good for paranoia and all sorts of fears as it is involved in the activation of the neurotransmitter serotonin; which helps regulate mood. Natural magnesium occurs in all the foods you 'should' eat - green veggies, fruit, wholewheat stuff, nuts and seeds. There is also a fair amount of magnesium in comfort foods such as bananas, chocolate and peanut butter.


Not to put too fine a point on it, you lose some blood during your period, which can contribute to making you anaemic. The symptoms of anaemia are tiredness, weakness and, in severe cases, breathlessness and dizziness. It can make you more prone to picking up infections, and it may also explain that feeling of not quite being with it:

The other morning I stood in line trying to order a bagel and couldn't think of the word for 'capers'. Fortunately my boss understands when I tell her that I'm in a temporary state of hormonally-induced idiocy.

To combat this, eat some foods that are rich in iron such as red meat, offal, fish, pulses and grains. Red wine is also a good source of iron.

Water and Fluids

Drink plenty of water to get rid of that bloated feeling. Your body will retain water, if your intake is short of what your body needs. If you drink loads, your body will flush through and you won't feel bloated.

Why not drink replacement plasma? It's recommended for other types of fluid loss. You could buy a bottle of isotonic sports drink, but making your own is much cheaper. Mix 5 teaspoons of sugar and 1 teaspoon of salt with 1 litre of water. It tastes grim, but it doesn't taste too bad mixed with orange juice and that way you can replace fluid and give yourself a valuable hit of vitamin C, too.

And if None of Those Do the Trick...

... why not follow the advice of one Researcher?

I find peppermint creams helps hugely. I'm almost purring by the time I get to the end of the bar.

Go with the Flow (and Yes, that is an Intentional Pun)

There's no getting away from PMS and period pain, so to some extent you have to live with it. To help you do this, there are so many ways to help you feel better.

Loving Yourself

Oh yes, all right, yuk, yuk, yuk, but the misery angle brought on by PMS is all about resentment and not feeling understood or appreciated so if you feel like crap go out and do some pampering even if it's just picking flowers by a railway line or giving yourself a pedicure.

Retail Therapy

Can do wonders. Even if all you're doing is going round charity shops. Go for swanky areas like Golders Green, Hampstead, Cheltenham and Chester for really good finds. It's even better if the things for sale just make you laugh.

Alternative Therapies

Get some advice from an alternative health practitioner. Read up on the subject, get books from the library or go to your local homeopathic store and ask what they recommend. They should be able to offer you several alternatives depending on your symptoms. To start you off, though, here are a few suggestions:

  • Rescue Remedy from the Bach Flowers range contains clematis for the dreamy not-there state and cherry plum and impatiens for preventing you from losing it completely.

  • From the same range try willow for resentment and holly for anger, suspicion and jealousy. Beech works for the 'it goes there and nowhere else but there and I've told you that a million times!' kind of pickyness.

  • Fringed violet from the Australian Flower Remedies range is good for coping with the feeling that you are being invaded or that people can get at you too easily.

You could try chiropracty, which helps for severe pain and backache. Aromatherapy is great, try lavender for relaxation, about six drops per bath should do the trick, but be careful as oil makes the bath slippery.


Relaxation takes many forms and it really does do something for you, releasing all those lovely endorphins that affect the pleasure centre of your brain. Set aside some time to do nothing. Or at least do something that you want to be doing: watch a really stupid video, preferably one that is either soppy, meant for children or one you've seen a billion times before.

Another thing you can do is practice relaxing your stomach muscles, the ones that really feel chewed up. Relax, lie or sit down (whatever suits you) and clear your mind, soothing music can help, concentrate on relaxing your entire body, giving your blood flow free passage, no constrictions.


Make sure you get plenty of sleep. If you're lucky, you'll sleep through the worst of the cramps, and wake with nothing more than a slightly bloated feeling. It will also give you energy for later on in the day.

Stop Fighting and Do What Your Body Wants

If you're getting angry because all you want to do is sit down and rest and instead you're fixated on the idea of doing the hoovering, which is potentially just going to turn into a fight, listen to your body and sit down. The wrestle with the vacuum cleaner can wait. Or if you feel that all you want to do is curl up in bed and have a good cry, then do it. You'll be getting that emotion out of your system. Here's what another Researcher has to say:

One thing that's helped a lot is that I make it a point to avoid making big decisions, not schedule important meetings, and deal with touchy situations by phone or email on those days rather than letting people see 'the brow' in action. I've mostly learned to keep my mouth shut, but my face still manages to make my feelings perfectly clear.

Internal Narration

When I'm snapping at people and feeling emotional, and generally even shocked at my own behaviour, as I am often at that time of month, I always feel that a bit of internal narration helps a lot. In the style of Mike 'The Man', in the early Doonsebury days, I just keep up a running internal monologue to narrate everything I do - it distracts me from my grumpiness, and it makes me feel more rational.


It may feel like the last thing you want to do, but regular exercise will help with circulation and will prevent cramps. Any sort of active sport will do, whether it's swimming, running, aerobics or tennis. For maximum benefit, you can combine exercise with relaxation and go for yoga. It really helps with both the mental and physical afflictions of PMS and period pain.

Stand up Straight

If you are having a particularly bad cramp then it helps to stretch all the relevant muscles. You do this by standing up very straight. Imagine that there is a thread running from your heels, up through your spine and out through the top of your head. Imagine that somebody is gently pulling the thread upwards so that you are stretched very tall and at the same time pull in you tummy muscles and take deep breaths in.


If your partner can bear to be in the same room as you and if you can bear to be in the same room as him/her, the exercise of a good sex session will do you the world of good, plus orgasm relaxes all the right muscles and releases some helpful hormones. Otherwise, do it yourself.


Staying on a regular schedule of birth control pills, won't stop your periods altogether, but it has two advantages. First of all you'll know exactly when to expect the symptoms of PMS. Secondly, the Pill is known to help with particularly heavy periods, painful periods and their associated symptoms and is likely to be beneficial in the treatment of endometriosis as well as probably reducing the function ovarian cysts (and hence their symptoms) and is associated with a reduced risk of ovarian and endometrial cancer.

To deal with mild period pain take an over-the-counter painkiller, such as ibroprofen or paracetamol. For more severe pain, you'll have to ask your doctor about prescription only drugs such as Ponstan.

To combat breast tenderness, there are a number of prescription drugs which help to modulate your hormones, which are thought to have an effect. Danazol works by having an antioestrogenic and antiprogestrgenic effect - oestrogen and progesterone being the hormones that dictate the menstrual cycle. Also, a drug called bromocriptine, which inhibits the release of prolactin from a gland called the pituitary gland. Prolactin stimulates the milk glands in the breast to enlarge, and this is thought to be one of the reasons for cyclical breast pain. However, both danazol and bromocriptine do have notable side effects, and really only ever used as a last resort. Unfortunately, these drugs don't work in all women.

If You're on the Receiving End

PMS is a subject that men often give a very wide berth, but there are ways you can make sure your other half feel better and consequently it will help you keep any emotional clashes at bay.

The first thing to do (like any good boy scout) is be prepared. If you are in a long-term relationship there are a number of ways to do this. After all, it is a regular occurrence, usually, but not always on a cycle of 28 days) so mark it in your diary when the next one is due. Alternatively, if she is on the contraceptive pill, take notice when the packet is getting towards the end, as this signals the time when she's about to come on. Also, since the lunar cycle and the cycle of your loved one are very close to being the same length, pay attention to the moon's phase. When the moon is approaching a certain phase you'll know that your loved one's PMS will soon be approaching.

The very worst thing you can do is dismiss everything with the comment that it 'must be that time of the month'. There's no getting away from the fact that women are more sensitive at this time and if you even remotely criticise them, saying that they're being unreasonable, that really is a red rag to a bull. Don't be self-centred you can't both be demanding and expect to avoid arguments. Instead, even though she may appear to be irrational, try to smile and forgive (but don't be patronising, as that doesn't help matters either).

You will win bucketloads of brownie points if you make available the things she needs: whether it's chocolate, banana smoothies or a massage. Above all, providing these things is thoughtful, which always goes down well. Do try to avoid the temptation to point out the obvious and say 'I know you're on love, so I got you this' and hand over a huge bar of Toblerone. The fact that you may even be remotely aware that she's not her usual cheery self could well be taken as criticism, and will seriously outweigh the lovely and well-intended gesture.

Remember that PMS is not predictable, so a tactic that worked last month won't necessarily work next month. Take each one as a new experience.

(As a final point, take note that it's pre-menstrual tension. Not during menstrual tension.)

1Pre-menstrual syndrome, or PMT (pre-menstrual tension) as it was previously known. The change in name came when the PMT became a recognised medical condition.2This is not to say that a high-calcium diet has no side effects - overdosing yourself on calcium supplements can result in the very opposite - hypercalcaemia, which has its own bunch of problems, too.3On saying this, you can have too much of a good thing - you can overdose on vitamin B6, leading to neurological problems.

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