Expert Answers: How can I deal with nightmare of PMT?

The pain during pre-menstrual tension, or pre-menstrual syndrome as it is often called, is caused by contractions of the womb which are similar to "normal" pains during labour.

These contractions temporarily cut down the blood supply to the womb causing the blood vessels of the muscle wall to be compressed.

During this process, the tissue is starved of oxygen and chemicals called prostaglandins are released, which trigger pain.

The lining is shed (hence the loss of blood during a period) so that a new lining can grow ready to receive a fertilised egg. If this doesn't happen, the process is repeated on a monthly basis.

Alongside this, difficulties with hormones occur, and it's hardly surprising that the whole thing can produce a variety of symptoms as you describe.

PMS often increases at times of hormonal turbulence, for example, puberty, childbirth, after miscarriage or pregnancy termination or changes in contraception.

Women who experience postnatal illness are more prone to PMS.

Women aged 30-45 often experience most severe PMS.

PMS often affects successive generations, although a genetic predisposition has yet to be established.

PMS often makes pre-existing conditions worse. About 90 per cent of menstruating women get advance warning of an approaching period because of physical and/or psychological changes in the days before their period begins. For most women, the symptoms are mild, but a small proportion find their symptoms so severe they dread this time of the month.

The terms mild and severe in respect of PMS are arbitrary, but relate to the extent of disruption to your home and work life that's attributable to the monthly cycle.

About a third of women say PMS significantly affects their life, with five to 10 per cent classifying their PMS as severe.

It is not exactly known what causes PMS. Common sense indicates it must somehow be linked to the fluctuating levels of female hormones experienced after ovulation. But the subtleties of why some women are more affected than others are not understood.

Normal fluctuations in hormone levels are responsible for some of the symptoms most commonly associated with the monthly cycle, such as bloating, breast tenderness or headaches.

Women who suffer from PMS may possibly have a lower than normal level of a certain chemical in their brain (serotonin), which may explain some of the non-physical symptoms such as irritability, depression and mood swings.

PMS is not caused by any underlying abnormality with the pelvic organs.

Paul Charlson

GP from Brough

Of course there is. It is time to consult your GP. He or she can help you with the various symptoms you are experiencing.

One method is to take the contraceptive pill which can change the hormonal balance and the associated symptoms.

If you cannot take this for some medical reason, there are progesterones which can help some of the symptoms. This can be delivered using a contraceptive rod or injection or pills. Sometimes, GPs use Prozac or vitamin B6 for the irritability symptoms.

The key thing is to act now and get it sorted out. Do not have preconceived ideas about what you should and should not take, but be guided by professional advice.

Herbal remedies are trendy but, in my experience, fairly useless.

Elaine Douglas

A chartered psychologist who specialises in family and child relationships

I think that thousands of women suffer bad period pains (dysmenorrhoea), and some almost from the time that they reach puberty.

There are things that you can try to alleviate the discomfort you are feeling. Gentle exercise such as swimming, walking and cycling can help as exercise releases endorphins which help us to feel better. Painkillers such as Ibuprofen and aspirin can be useful.

Various relaxation techniques or something like hypnotherapy may enable you to train your mind into coping more effectively with the problems you are experiencing.

However, there can be other explanations for the discomfort you are feeling. I am not a doctor, but I do know that a woman's internal mechanism is very complicated.

It occurs to me that if you have only recently started to experience the symptoms you describe then there may be another explanation for them.

I would be tempted to go to your GP and explain what's been happening.

Cary Cooper

Professor of Organisational Psychology and Health at Lancaster University

I am not a medic and don't know what pharmacological products there are that can help but if your friends and partner/spouse are aware of this, they will be able to understand and tolerate this behaviour.

I suspect what troubles you is the way you treat others or behave in front of them, so letting it be known to those around you who you really care about is the first step.

If this does not work and it gets worse, go to see a trained counsellor who may be able to come up with some suggestions about what you might do to mediate the impact of pre-menstrual tension.

Dr Carol Burniston

Consultant Clinical Child Psychologist

These types of problems can be related to physical problems or to changes in lifestyle such as increased stress. Have you experienced significant changes in your life recently?

I would suggest in the first instance that you consult your GP; they will be able to help to identify any physical issues, such as fibroids and recommend the best treatment.

If you are given the all clear, then I suggest that you consider your general stress levels and ensure that you are getting adequate exercise and relaxation. Attention to diet and reducing alcohol intake can all help.

Beyond the above, there are natural or homeopathic remedies that some people find beneficial. You can find specialist information on: www.bbc.co.uk/health/womens_health/ reproductive_pms.