Breaking the cycle: lifestyle changes can eliminate PMS and cramps - Healthy by Choice

Vegetarian Times, July, 1996 by Lauri M. Aesoph

Celebrating qualities that symbolize the feminine has become an important part of holistic women's health care. Physicians and philosophers alike urge women to honor their intuition, creativity and reproductive cycles, which wax and wane with the moon, giving us a special bond with Mother Nature. But if you're among the many women who endure premenstrual syndrome or menstrual cramps each month, then menstruation is a uniquely female experience you'd probably rather forget about.

Fifty percent of premenopausal women suffer from premenstrual syndrome (known as PMS) or cramps--or both. If you've tried various drugs to cope with these conditions, you may have found temporary respite but been frustrated by the seeming impossibility of achieving lasting relief. Adopting lifestyle changes could be the answer.

UNDERSTANDING PMS

Because so many women suffer from both PMS and cramps, they're often thought to be the same condition. Although many of the treatments for these conditions overlap, they are in fact separate syndromes. PMS has been attributed to a variety of causes, including an imbalance in hormones or serotonin (a body chemical thought to be involved in mood), as well as nutritional problems. For many women, PMS is most severe during their 30s and 40s, though the reasons are unclear.

With more than 15 0 symptoms characterizing PMS--including anxiety, headaches, food cravings and bloating--figuring out how to treat it can be a challenge, says Susan Lark, M.D., who has used lifestyle changes to treat more than 3,000 women with PMS and cramps. She is an advisory board member of the Woman's Health Promotion Unit at Stanford University and author of Menstrual Cramps: Self Help Book (CelestialArts, 1995) and PMS:Self Help Book (Celestial Arts, 1984).

An important first step in treating PMS is figuring out whether you even have it. Ninety percent of menstruating women say they have at least one premenstrual symptom each month, but one symptom does not necessarily mean you have PMS. True PMS involves either several symptoms that can range from mild to severe or just one or two symptoms that are severe; symptoms begin after ovulation, usually 10 to 14 days before menstruation. To make matters confusing, the intensity, timing and even type of PMS symptoms can change monthly.

To try to make some sense of symptoms, many physicians use groupings developed by Guy Abraham, M.D., former clinical professor of obstetrics and gynecology at University of California-Los Angeles. Abraham divides PMS symptoms into the following four categories: PMS-A for anxiety and mood swings, PMS-C for food cravings and fatigue, PMS-D for depression and insomnia, and PMS-H for bloating and breast tenderness. You may find these groupings helpful in developing your treatment plan.

Not everyone finds Abraham's guide necessary, though. Tori Hudson, N.D., a naturopathic physician from Portland, Ore., and noted researcher on women's health care, has had greater success following the work of Katharina Dalton, M.D., a British physician who concluded that PMS is often due to progesterone deficiency. In fact, says Hudson, 49 out of every 50 PMS patients she treats with "natural" progesterone cream--including those whose symptoms indicate elevated progesterone levels--respond well. (Although these creams are available over the counter, they can have side effects; consult your healthcare practitioner before trying them.)

WHAT ARE CRAMPS?

For women who are made miserable each month by cramps, it may seem outrageous that many doctors consider them to be a minor complaint. Their financial impact certainly isn't minor: They cost companies about 140 million lost work hours each year, says Lark.

Most women suffer from one of two kinds of cramps, both of which have no clear-cut cause. Childless women tend to suffer more from spasmodic dysmenorrhea, which eases with age and is characterized by vise-like pain, backache, nausea, vomiting, fatigue and headaches. Women who have given birth are more likely to have congestive dysmenorrhea, which gets worse with age and includes achy cramps, bloating, breast tenderness and irritability. (Yet another type of cramp, secondary dysmenorrhea, is actually the result of disease, such as endometriosis, a condition in which fragments of uterine lining are found elsewhere in the body, mainly the pelvic area. This type of cramp may come with pelvic and back pain, spotting, fever and possibly pus-like vaginal discharge.)

Tampons, IUDs, bladder and vaginal yeast infections, a sedentary lifestyle, poor posture and stress can exacerbate cramps. For reasons not completely understood, spasmodic and congestive dysmenorrhea seem to be made worse by certain hormone-like substances called prostaglandins, whose levels in the uterus peak when menstruation begins. There are different types of prostaglandins. Some increase inflammation and uterine contractions, while others reduce inflammation; one goal in cramp treatment is to reduce the pain-causing prostaglandins and increase antiinflammatory ones.