Understanding premenstrual syndrome and menstrual cramps

You're depressed, tired, and cranky, and if your husband hollers at the ref one more time, you're breaking the television. Your breasts hurt, you're bloated, and in a week or so you'll get your period if you're not there already.

1. Premenstrual syndrome.  PMS is no picnic for anyone, but for some women it's debilitating. About 85%  of women from their late twenties to early forties have at least one symptom every month, including acne, insomnia, cramping, constipation or diarrhea, headache or backache, food cravings, joint or muscle pain, trouble concentrating or remembering, irritability, mood swings, and crying fits. However, about three to eight percent of women have a more severe form called premenstrual dysphoric disorder, or PMDD.
2. Premenstrual dysphoric disorder. PMDD is PMS turbocharged. Experts believe fluctuating levels of hormones and neurotransmitters, brain chemicals, such as serotonin may be at the root of PMS.  Add stress and anxiety, and your symptoms bloat just like your stomach. You don't have to suffer endlessly. There are a number of ways your doctor can help, from antidepressants to birth control pills to diuretics. You can make relatively small changes in your diet, vitamin intake, and exercise habits that make a big difference.  Selective serotonin reuptake inhibitors, or SSRIs, are antidepressants that work extremely well for severe PMS.

Cramps usually result from the contractions of the uterus as it rids itself of the endometrial lining every month. The contractions are triggered by prostaglandins, hormone-like substances that can cause pain and inflammation. Other inflammatory compounds within the pelvis, called leukotrienes, also increase cramps. The cramps get worse as clots of the shed lining pass through the cervix.

Cramps can also stem from other causes:

• Endometriosis is the growth of uterine lining tissue outside the uterus.
• Adenomyosis is the growth of uterine lining in the muscle walls of the uterus.
• Pelvic inflammatory disease is an infection of the fallopian tubes and ovaries as the result of a sexually transmitted disease.
• Fibroids are benign growths on the inside and outside of the uterus.
• IUD, or intrauterine device, is a birth control device placed in the uterus that can cause cramps, especially in the first months after placement. The women at highest risk include those younger than 20 (about 90% report cramps), women whose periods began at age 11 or younger, women with heavy periods, women who suffer from anxiety or depression, women who have never had children, and women who smoke.

Fortunately, for many women who experience cramps without secondary causes such as those listed here, cramps tend to lessen after age 30 or childbirth. Seventy percent of women who take low-dose contraceptives find their cramps abate.

The perfect homemade recipe for relief is a low-carbohydrate diet, anti-inflammatories, exercise, plenty of sunshine, and 1200 milligrams of calcium every day for women who don't want to rely on hormones or stronger medications.