We feature Dr. Swathi Kapadia, who completed her MBBS from Amaravathi Medical College, Maharashtra, Post Graduation (DGO) from Kolkata University and DMR from Germany.

Her area of special interest is Laparoscopic surgeries.

The most common problem faced by women in the reproductive age is PMS or Premenstrual syndrome. Please let us know what is PMS?

Women’s life is divided into three stages.

Premenstrual period.-1-15 years; Reproductive – 15 -45 years; Post Menopausal- Above 45 years.

Most problems are confined to the reproductive age.

The term PMS or Premenstrual Syndrome means both the physical and mental symptoms which occur before a period (menstrual cycle).

Women's experiences of PMS don't fit into neat categories - they are far too varied. There is no single remedy and not all women are successful in finding solutions. There is controversy within the medical profession about how to define and treat PMS.
The reason for this confusion is that PMS is not a disease like diabetes or a viral fever. It is a mixed bag of individual responses to an ordinary event: the menstrual cycle. The word PMS sums together a vast collection of symptoms which have little in common besides their timing.

The symptoms of premenstrual syndrome can range from mild cramps to severe depression, as well as mood swings, fluid retention, headache, breast swelling, tenderness, bloating, weight gain and others being fatigue, depression, tension, irritability and craving for sweet or salty food.

These symptoms usually clear up once the bleeding starts, but for some women they persist for a day or two into the period. There are many changes during the menstrual cycle but they are only labeled as PMS when they are distressing or disabling.

Period pain is not included in the definition of PMS.

Since you say it includes the emotional symptoms, Does this affect their psychological well being?
To have a better understanding of the psychological aspect of PMS, we need to look at the woman holistically and see how stress, a long history of negative social attitudes towards menstruation, women's roles, jobs, relationships, nutrition and lifestyle interact with hormonal changes and other bodily processes.

Existing conditions such as depression, asthma, allergies, and epilepsy can become worse premenstrually.

How can one tackle this?
The PMS can be tackled by maintaining a diary for recording symptoms you experience.

1200 mg of calcium intake daily through food and supplements can reduce 50% of all PMS symptoms, from moodiness, depression to menstrual cramps. . Vitamin B6 helps reduce the symptoms of PMS for some women. Magnesium supplements of 300 mg to 500 mg during the days you experience symptoms may reduce sugar cravings, and help reduce breast tenderness.

A low-fat, vegetarian diet is useful for reducing the length and severity of menstrual cramps and many symptoms of premenstrual syndrome. Small frequent meals will stabilize the blood sugar and prevent it from dipping and hence avert mood swings.

Exercise is an excellent way to reduce the symptoms of PMS. It also benefits you by reducing your stress level, lowering your risk of many diseases and helping you to maintain overall good health.

Reducing the amounts of refined sugar, salt, red meat, alcohol and caffeine consumed and increasing the intake of complex carbohydrates, leafy green vegetables, fruit, cereals and whole grains will be helpful.

Does one have to meet a gynecologist if the monthly cycle gets postponed? or preponed?
A delay or preponement by a week to ten days is normal. It could be because of anxiety, stress, and mild hormone imbalance or over work.If it is beyond ten days then one should consult a gynecologist.

Is it alarming if there is a change in the bleeding pattern or duration?
The stress, anxiety, hormone imbalance can also lead to a change in the bleeding. One can wait for two or three cycles before consulting a gynecologist.

What is the common cause for irregular periods?
I would say PCOD or Polycystic ovary disease is one of the most common female endocrine disorders affecting approximately 15 -20% of women of reproductive age. It is thought to be one of the leading causes of female sub fertility.

The symptoms of PCOD are obesity, irregular menstruation, acne, hirsutism (excessive hair growth on the face and body), and difficulty in getting pregnant.

Thinning of scalp hair which include growth o the symptoms and severity of the syndrome vary greatly among women. While the causes are unknown, insulin resistance, diabetes, and obesity are all strongly correlated with PCOD.

Not all people who suffer from polycystic ovary syndrome will have all of these symptoms. Different women have different symptoms, and in differing levels of severity. Also, individuals may find that they have different symptoms at different times in their life. Symptoms usually develop around the late teens and early twenties. For some women, however, the only sign that they have the condition is when they have difficulties when they come to have children.

Maintaining a healthy lifestyle and remaining stress free can go a long way in tackling the monthly menstrual menace.


Doctor: You're in good health. You'll live to be eighty.

Patient: But, doctor, I am 80 right now.

Doctor: See, what did I tell you.

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