Women are often maligned and labelled as “unreasonable, unrealistic, illogical and hysterical”, even when their statements are reasonable and logical. “Blame it on the hormones” is the usual explanation from a male-dominated society. Physicians (mostly male) in the 19th century, unaware of hormone levels, concluded that somehow all this behaviour was connected to the presence of a uterus (from the Greek word hystera which means womb). They sometimes recommended hysterectomy to remove the root cause of these problems and render these women “normal”.
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Unfortunately, some surgeons today, too, subscribe to this view. Women in the reproductive age are advised a hysterectomy to remove the uterus, once it has finished its reproductive function, to relieve them of all their physical and psychological symptoms.
Yet 15 per cent of women suffer from unreasonable anger, excessive sensitivity, paranoid thoughts, anxiety, depression, uncontrollable crying spells, and bizarre food cravings during the pre-menstrual period. In 0.4 per cent, the symptoms may be severe enough to be labelled psychotic. These symptoms are called pre-menstrual syndrome (PMS). They are not because of the presence of the uterus, but are attributed to the body’s response to normal changes in the hormonal (oestrogen and progesterone) ratios during the course of a menstrual cycle.
In PMS sufferers, there’s a lack of perfect synchronisation in the hormone levels, both at the pituitary-hypothalamic level in the brain and at the level of the ovaries (not uterus). Surges and dips cause changes in the biochemical neurotransmitters (serotonin) and precipitate the depressed “low feeling”. Attempts to alleviate the depression and push up neurotransmitter levels lead to food cravings and binge eating.
The mental changes can be disruptive to the family and in the workplace. By the time the distraught family persuades the woman to seek medical help, the onset of menstruation has restored the woman’s Jekyll-and-Hyde personality to normal. Unfortunately, the menstrual cycle and mood swings repeat themselves month after month.
PMS is commoner between the ages of 30 and 45. This led to the erroneous belief that it was in some way connected with approaching menopause. This isn’t true. However, this is the time when women experience the maximum stress in both their family life and career. They often fail to cope with the combination of stress and hormonal imbalances.
Some physical changes can be produced as a result of the hormones. Fluid retention can result in a measurable weight gain (1-2kg). This can make clothes tighter. There may be backache, joint pain, breast tenderness and palpitations.
Treatment becomes imperative when the mood swings make women depressed and suicidal, or psychotic and murderous. (Most murderesses committed their crime during their pre-menstrual phase). Also, job efficiency and interpersonal relationships may be affected because of tiredness, fatigue, sensitivity and ill temper.
It is difficult to convince women with PMS that they need help, especially since they are normal for around 20 days in a month. Also, the sensitivity varies from woman to woman. Some with mild forms may be acutely conscious of their problem, while others with severe degrees of PMS may rationalise their behaviour. To avoid PMS,
Try to maintain a body mass index (weight divided by height in metre squared) as close to 23 as possible
Instead of three large meals, eat six small meals at regular three-hour intervals. Add at least six helpings of fresh fruits and vegetables, one with each meal. These are high in fibre and beneficial antioxidants. Fibres delay digestion and absorption, helping to maintain a steady blood glucose level with no depression-inducing dips
Reduce the salt intake in cooked food to one teaspoon a day
Avoid fried, salted snacks and chocolate
Reduce the use of caffeine by cutting down on carbonated colas, tea and coffee
Do regular aerobic exercise such as an hour of walking, jogging, cycling, climbing stairs or swimming to reduce stress. Exercise improves blood circulation and reduces bloating and fatigue. It produces a sense of well being. It boosts the body’s natural production of endorphins, which acts as a mood elevator
Daily supplements of vitamins and minerals may be administered to relieve some PMS symptoms. A multivitamin capsule with B6 (100 mcg), B complex, vitamin E (400 IU) and vitamin C (100mg) and calcium (1,000mg) supplementation is beneficial
Capsules of evening primrose oil, oral contraceptive pills, low dose diuretic therapy, mild antidepressants and tranquilisers have been tried and have anecdotally helped some sufferers.
PMS tends to run in families. This may be because the hormone ratios are inherited, leading to similar behaviour. This becomes more likely because of a comparable lifestyle, with improper diet and inadequate physical activity.
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Source : The Telegraph ( Kolkata, India)