1. Premenstrual
syndrome
(PMS)
Presented by
Sunita vidhate

2. Introduction
 Premenstrual syndrome (PMS)
 pre:Before
 menstrual : periods
 Condition involving Cyclic and recurrent episodes of behavioral ,
psychological, and physical symptoms associated with latter half of
menstrual cycle (luteal phase) of symptoms before in 2 or more cycles
 Symptoms occur at the end of luteal phase and symptoms resolve after
initiation of menses
 Six days of symptoms on average
 PMS is also sometimes known as Premenstrual Tension (PMT). One in three
women suffers discomforting symptoms in the days before their period

3. What is premenstrual syndrome
(PMS
premenstrual syndrome (PMS or PMT-
premenstrual tension.
Refers to a wide range of physical or emotional
symptoms that typically occur about 5 to 11
days
Before a woman starts her monthly menstrual
cycle
It is a collection physical and emotional
symptoms related to a women's menstrual
cycle.
The symptoms may range from mild to severe.

4. Definition of premenstrual syndrome
 Is a combination of physical, psychological emotional and mood disturbances that
occur after a woman's ovulation and typically ending with the onset of her
menstrual flow

6. Day 1 of your cycle, estrogen levels are at
an all-time low. Estrogen is a good thing;
it's associated with increased activity of
serotonin, a feel-good chemical in the
brain.
Map Your Menstrual Cycle Day-by-Day

7. As your estrogen levels slowly increase, you may feel
more relaxed
Day 7, your period is probably gone, and your mood
should have returned to normal.
Estrogen levels will continue to rise from Days 8-11, and
by Days 12-13, they're at an all-time high. These high levels
of estrogen give you more confidence, make your skin glow,
and probably make you feel flirtier.
The egg's only goal is to get fertilized, so all kinds of
things are happening with your mind and body around
ovulation. Keep in mind that your libido is extra high,
increased estrogen and progesterone levels often leads to
breast tenderness
If the egg hasn't been fertilized, your ovaries will slowly stop
producing estrogen and progesterone near the end of Week 3.

8. As progesterone and estrogen levels drop, some
women experience symptoms of premenstrual
syndrome, which can include irritability, anger or
sadness. Some women experience mild PMS, others
severe and some not at all.
Your body may be more susceptible to pain, so you'd be wise
to avoid waxing, tweezing or getting tattooed at this time.
Hungry? At this point in your cycle, your estrogen
— and therefore serotonin — levels are bottoming
out. That means you're craving carbohydrates,
which increase serotonin. Luckily, your metabolism
is working a little faster leading up to your period,
which means you may consume 100 to 200 more
calories guilt-free — but don't overdo it.
Many women experience menstrual cramps a day or
two before their period begins. help as can heating pads
and hot water bottles.

9. Symptoms
Physical symptoms
 Breast swelling and tenderness
 Acne
 Bloating and weight gain
 Headache
 Joint pain
 Backache
 Constipation or diarrhea
 Food cravings
Emotional symptoms
 Irritability
 Mood swings
 Crying spells
 Depression
 Anxiety
 Sleeping too much or too little
 Trouble with concentration and memory
 Less interest in sex

11. Risk Factors for PMS
Stress
Depression
Dietary factors
Lack of exercise
High caffeine intake
Alcohol abuse

12. High caffeine intake Increasing Age Overweight, obesity

14. PMS (premenstrual syndrome) treatments
Depends upon severity
• Mild : Lifestyle changes: diet Severe : medicines
• Small meals
• Fluid
• Stress relief
• Exercise

16. Modify your diet
 Eat smaller, more-frequent meals to reduce bloating and the sensation of
fullness.
 Limit salt and salty foods to reduce bloating and fluid retention.
 Choose foods high in complex carbohydrates, such as fruits, vegetables and
whole grains.
 Choose foods rich in calcium. If you can't tolerate dairy products or aren't
getting adequate calcium in your diet, a daily calcium supplement may help.
 Avoid caffeine and alcohol.

17. Health Tips
 Eat soaked raisins and 4 soaked almonds every morning after waking up.
 To cool the intestines, soak coriander in water at night and drink it after waking up in
the morning.
 Avoid eating sour, fried, processed food in the diet for 2 weeks before menstruation.
 Start consuming healthy seeds 2 weeks before menstruation.
 Consume 1 teaspoon each of sunflower and pumpkin seeds for the first week and 1
teaspoon of sesame seeds for the second week.
 It is necessary to exercise and meditate daily to avoid premenstrual problems.
 It is necessary to get enough sleep every day to prevent the imbalance of hormones.
 Avoid waking up at night.

18. Reduce salt
Eating less salt is
particularly recommended
for patients with bloating,
breast tenderness or swollen
hands.
Eat a variety of fruits
and vegetables
Drink plenty of water.
water daily to help reduce
bloating and aid in
digestion
Diet and PMS

19. Eat more
calcium/low–fat dairy- Eat complex carbs
Eat iron-rich foods
such as lean meats
reducing mood disorders during PMS

21. Nutritional supplements
Vitamins B6 and B1
 May help with PMS.
 Reduces pain, cramps and mood disturbance.
 Do not exceed 50 mg of vitamin B6 daily or 100 mg vitamin B1.
 Best if combined as a multi-B vitamin, not as single nutrients.
 Avoid high doses of vitamin B6 (more than 50 mg per day) and prolonged
use, as this can cause nerve toxicity such as tingling, burning and shooting
pains.

22. Vitamin E (natural alpha-tocopherol)
 May help reduce pain and menstrual blood flow.
 Dose: 200 IU vitamin E daily; commence two days prior to periods and
continue for three days from onset of periods.
 May cause gut upset.
 Avoid high doses over 400 IU daily

23. Vitamin D
 May help regulate your cycle, relieve muscle pains, improve moods.
 Dose: 1000 IU daily or more; check with your doctor, who will advise a suitable
dosage for your needs.
 Vitamin D toxicity is rare and may occur when taking very high doses of vitamin
D. This results in raised blood calcium levels leading to feelings of malaise, loss of
appetite, feeling thirsty, constipation or diarrhoea, abdominal pain and muscle
weakness, fatigue, confusion.

24. Magnesium
 Relieves menstrual cramps.
 Improves premenstrual mood changes, especially irritability and anxiety.
 May help with muscle relaxation, muscle cramps and sleep.
 Dose: 300 mg one or two times daily (best taken at night with calcium).
 May cause diarrhea and loose stools; reduce dosage if this occurs.
 May cause palpitations.
 Avoid if you have renal problems.
 May lower blood pressure and cause heart arrhythmia, drowsiness and
weakness in high doses.

25. Calcium
 May help with PMS.
 Reduces menstrual cramps, fluid retention, mood disorders and food
cravings.
 Dose: 1200 mg daily.
 May cause constipation and flatulence.
 Avoid if you have renal disease or suffer high blood calcium levels.
 May interact with blood pressure and heart tablets.

26. Zinc
 May help relieve menstrual pain, cramping, depression.
 May aid immune system.
 Dose: 30 mg one to three times daily.
 May cause nausea, gastrointestinal upset, metallic taste in mouth.
 Avoid long-term use.

27. Fish oils
 May relieve menstrual pain, cramping, depression.
 Dose: 1 g taken one, two or three times daily.
 May cause nausea and gastrointestinal upset.
 In high doses, may ‘thin’ period blood (this may be useful if you suffer dark,
thick menses).
 Avoid if allergic to seafood.

28. Relaxation technique
 yoga
 tai chi
 stretching
 taking a bath
 going for a walk
 journaling
 speaking with a close friend or
loved one
 meeting with a mental
health counselor or therapist

29. Medications & Surgery for PMS Relief
Medication
 Antidepressants-fluoxetine (Prozac)
sertraline (Zoloft)
 Nonsteroidal anti-inflammatory drugs
(NSAIDs)-naproxen sodium (Aleve) can
ease cramping and breast discomfort.
 Diuretics-Spironolactone (Aldactone)
Surgery
A hysterectomy with removal of both
ovaries to prevent ovulation may be
necessary for a few women who suffer
from severe PMS.

30. Lifestyle modification advice
 Drink plenty of fluids (to help reduce bloating, fluid retention, and other symptoms.)
 Eat a balanced diet that includes plenty of fruits, vegetables, and whole grains.
 To avoid sugar, salt, caffeine, and alcohol,
 To take supplements like folic acid, vitamin B-6, calcium, and magnesium to help
reduce cramps and mood symptoms.
 Try getting more vitamin D via natural light, food, or supplements.
 Aim to get 7 to 9 hours of sleep each night to help relieve fatigue and improve overall
well-being.
 Try to get at least half an hour of physical activity each day, if you’re able.
 Set aside time each day for self-care, which might include exercise, relaxation, time to
yourself for hobbies, or time for social interaction.

31. Thank you