PREMENSTRUAL SYNDROME
What is PMS? PMS, or premenstrual syndrome, is a mixture of physical and
emotional symptoms experienced by many menstruating women.
Contrary to some societal notions, PMS is not an imaginary or "psychological"
condition. In truth, PMS is a very real, physical condition, with very real
and often debilitating symptoms.
In any discussion of PMS, it is important to note that this condition differs
from dysmenorrhea, or painful menstrual flow. PMS typically occurs two weeks
prior to the onset of menstruation itself.
SIGNS AND SYMPTOMS
Premenstrual syndrome is characterized by clusters of signs and symptoms,
which may include the following:
- Weight gain
- Abdominal bloating
- Breast enlargement and tenderness
- Peripheral edema (Swelling of surface of body, i.e. hands, feet, etc.)
- Constipation
- Headache
- Increased appetite
- Cravings for sweet or salty foods
CAUSES
Possible causes of and contributing factors in PMS may include:
- Progesterone (hormonal) insufficiency or withdrawal
- Endogenous hormonal allergy (allergy to a self-produced hormone)
- Increased amount of Prolactin (milk producing hormone)
- Muscle imbalances
- Fluid retention
- Hypoglycemia
- Vitamin B6 deficiency
Physical therapy is particularly effective in treating menstrual disorders
that are exacerbated by muscle imbalances or musculoskeletal dysfunction
(problems). The pelvis is a key player in the intricate relationship between
such dysfunction and the pain symptoms associated with PMS. Hence,
treatment often concentrates on the pelvis and surrounding areas.
The pelvis is made up of bony and muscular components. The bones of the
pelvis join to form a "basin" that encloses the reproductive organs. More
than 40 muscles attach along every available surface inside and outside this
bony basin. Muscles run in every direction, each with its own function.
Some of these muscles include:
- The abdominal muscles, which attach at the lower front of the pelvis
and run up and to the sides.
- The spinal muscles attach to the back of the pelvis and run upward
to attach to the vertebrae at different levels.
- The hamstrings start at the back, lower portion of the pelvis and
run down the back of the thighs to attach near the knee joint.
- The "pelvic floor" muscles, which run across the opening at the
bottom of the basin and support the internal organs and structures.
In addition, each bone of the pelvis is joined to the adjacent bones by
ligaments that help control the motion of the bones and help support the
entire structure of the pelvis. An imbalance or dysfunction in any of
these structures affects the other structures to which they are to
intimately connected.
When the muscles and ligaments attaching near the pelvis, abdomen, low back
and/or legs are stretched, strained or tightened, the result is pain in
those areas. For example, tight hamstrings and weak abdominals can set up
an imbalance that causes abnormal movement and stress on the pelvis and
its joints. Stiffness, inflammation and pain result, as well as strain
of surrounding muscles and ligaments because of the abnormal alignment of
the pelvis.
Imbalances can also occur when ligaments have been stretched or damaged
from surgeries or childbearing; joints have been injured; or bones and
joints have been jarred out of alignment.
WHAT CAN I DO ABOUT MY SYMPTOMS?
Many women fail to report symptoms and problems because they erroneously
believe that such symptoms are a "normal" part of womanhood. If you think
you may be suffering from premenstrual syndrome, you are encouraged to seek
treatment.
Medication and surgery have traditionally been considered treatment options
for PMS. Medication is not always effective, and surgery should always be
a last resort.
Physical therapy is a realistic option for most cases of chronic pain and
PMS. Your physical therapist at Family Physical Therapy Services
will conduct an individualized evaluation of your condition, including a
full medical and menstrual history, to help identify any imbalances in bony
alignment, ligaments, and muscles. Her or she will then develop a program
tailored specifically for you.
You will be a key player in your treatment program, as we at Family
Physical Therapy Services emphasize the importance of home
exercises. Your therapist also may recommend:
- Electrical stimulation to augment muscle strengthening
- Pelvic stabilization belts
- Other modalities such as heat and massage for pain relief
Just as PMS is very real, so are your opportunities for relief. You do
not have to simply "put up with it".
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