Premenstrual syndrome is a common problem for women in their reproductive years, it encompasses physical symptoms including weight gain, fluid retention, breast tenderness, abdominal bloating, headaches and pain and emotional symptoms such as anxiety, depression, anger, irritability and crying.
About 90% of women manifest at least one of the PMS signs at some point in their reproductive years.
Although there are no lab tests that can confirm PMS there are 3 elements that can be helpful in the diagnosis of PMS. 1. Symptoms being consistent with PMS 2. The symptoms should occur only during the luteal phase of the menstrual cycle and 3. It is negatively impacting a woman’s function and lifestyle. This makes a woman’s own recalled experience and tracking of her menstrual cycle very important for the accurate diagnosis of PMS.
A significant symptom noticed by women during their pre menstrual weeks is the changes to the amount of fluid retention or bloating experienced. Women often feel lightest or feel the least bloated during their early to mid- follicular phase (day 1 to day 11 of the menstrual cycle) during this time oestrogen levels are moderate and progesterone levels are low.
Women can experience increased fluid in certain areas of the body including the face, breast, abdominal, pubic area, upper arms and lower legs, occurring predominantly in the second phase of the cycle after ovulation when oestrogen and progesterone levels rise. This phase of the cycle can cause an additional 2 -2.5kg of weight fluctuation in women who experience severe PMS.
Progesterone in this phase is much greater and this hormone impacts the tone of the venous system, causing a sagging effect on the venous wall, this impairs drainage and causes water retention. Progesterone also influences parts of our blood pressure system that controls sodium and water balance causing women to retain more fluid than at other points in the menstrual cycle.
Even though it is thought that these fluid changes are caused by hormones there is no difference in the blood tests of women who experience fluid retention in women who don’t. It is possible that some women are more sensitive to these hormone changes and suffer greater symptoms after ovulation.
It is natural to have some weight fluctuation throughout the month and women may observe different weight on the scale between the follicular and luteal phase of their menstrual cycle this can be frustrating when working on a weight loss plan to see numbers fluctuating each week especially with the effort that is put into the weight loss plan.
Women with PMS may want to focus on dietary changes to reduce fluid retention. The modern diet generally has excessive sodium and a deficiency of potassium. Women who suffer from PMS often have higher levels of sodium and sugar in their diet which although may not cause PMS but may worsen the fluid retention during the luteal phase of cycle. Sodium can sneak into a woman’s diet through condiments, cheeses, processed meats, and other package foods.
Women who eat a higher amount of fruits and vegetables per day have a reduced risk of PMS including the symptom of bloating because these foods are richer in potassium. Women may benefit from tracking their fruit and vegetable intake and pay attention to their sodium intake during their menstrual cycle to get a better handle on how their dietary habits may be influencing how they feel.