Gynecology Q&A's women's health expert answers your most pressing concerns, starting with PMS

Sex + Health

Gynecology Q&A’s women’s health expert answers your most pressing concerns, starting with the dreaded PMS

-Lissa Rankin, M.D.

Lissa RankinI’m a complete mess each month around my period, what can I do to combat PMS?

I hear you, sister! This is such a common issue, and today’s women just can’t afford to suffer from premenstrual syndrome (PMS). Many of us have kids, high-pressure jobs, and the various demands of modern-day Superwomen. (You wouldn’t want your doctor to forget things, bloat, and lash out at you three days before her period, right?) So what’s a girl to do?

You can start by taking stock of your lifestyle and your health, to determine whether there are avoidable factors that may be contributing to your PMS. Are you bingeing on chocolate and caffeine to get you through the rough times? Are you being a couch potato because you feel too lousy to exercise? Is your PMS turning you into a stress monster? I know it’s tempting to loaf around in a vat of dark chocolate syrup while flipping through daytime talk shows, but if you want to feel better, this is the time to rally the troops and take care of yourself. Here are some tips for how you can improve PMS symptoms naturally:

• Eat a whole foods diet. You’ve heard it before, but it really does help. That means cutting back on sugar, refined carbohydrates, dairy, caffeine, processed foods, and saturated and hydrogenated (trans) fats, and instead adding fruits, veggies, and whole grains, especially during the luteal phase (second half) of your cycle. Sorry, but that means bye-bye chocolate.
• Increase essential fatty acids by eating nuts, seeds, and fish.
• Manage your stress effectively. Try yoga, meditation, massage, or guided imagery CD’s.
• Engage in regular aerobic exercise. A good, long hike helps regulate your hormones and your stress, and it builds up happy-making endorphins.
• Take a multivitamin and 1200mg of calcium/day.
• Talk to an integrative medicine doctor about how to use supplements to help your PMS symptoms. Alternative medicine therapies like acupuncture can also help.

If you’ve tried everything and nothing helps, don’t despair. Apologize to your boyfriend for chewing his head off, but blame your hormones. Talk to your doctor about how bioidentical hormones or birth control pills can help. If you have a more severe form of PMS called premenstrual dysphoric disorder (PMDD), you can blame your brain chemistry. If the serotonin levels in your brain are low, you may benefit from taking an anti-depressant, either daily or during the last two weeks of your cycle. To meet criteria for this diagnosis, you must experience five or more of the following symptoms during most of the week before your menses, and they must interfere significantly with your daily life and relationships. At least one of the first four symptoms must be present.

• Significantly depressed mood, hopelessness, self-deprecating thoughts
• Significant anxiety, tension, feeling irritable, uptight
• Sudden mood changes of sadness, weepiness, or easily feeling rejected
• Anger or irritability or increased conflict with others
• Lack of motivation for usual activities
• Difficulty concentrating
• Lethargy, easily fatigued, low energy
• Changes in appetite, overeating, food cravings
• Sleeping too much or insomnia
• Overwhelmed, feeling out of control
• Additional physical symptoms, such as breast tenderness, swelling, headaches, join or muscle pain, bloating, weight gain

Some theorize that PMS is nature’s way of making you slow down and take stock of your life. We can’t be Superwomen all the time, and maybe your body is telling you it’s chick-flick night, and you need some personal, quiet time. So if you can, take this time to listen to your body, write in your journal, and reflect. You don’t have to be a complete mess before your period. Take charge of your life and your health, and help your body help you by treating it well.

Lissa Rankin is a gynecologist and author. She blogs at, and you can follow her on Twitter at @lissarankin


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9 thoughts on “Gynecology Q&A

  1. I figure with my name I should leave a thought. I wish life would let us slow down to maybe shake off some symptoms, but the world doesn’t work that way. No wonder we’re all a mess once a month.

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