Moody, Cranky and Tired? 9 Ways to Fight Off PMS

Birth ControlBy Arricca Elin SanSone

About 85 percent of women get at least one PMS symptom a month. There's no magic cure, but these tips can help.

1. Stop Getting Your Period
Taking the birth control pill on a continuous basis may stabilize hormonal swings and knock out physical symptoms for some women. "If you're on the pill, you aren't ovulating so you may get symptom relief," says David Plourd, M.D., an OB/GYN practicing in San Diego. You can use a pill that delivers the same dose of hormones all month long and skip the placebo pills, or use an extended-cycle pill such as Seasonale. Take the pill at the same time every day so you're getting a steady dosage. The main complaint with continuous dosing is breakthrough spotting, though it may decrease over time.

2. Eat Good Carbs
Complex carbohydrates can reduce mood swings so eat more whole grain breads, pastas, brown rice and beans. Try steel cut oatmeal for breakfast instead of sweetened cereal, a handful of soy nuts instead of chips and ditch that boring turkey sandwich for hummus on warm whole-wheat pita bread. Just go easy on the salt, which can make bloating worse. Try eating several smaller meals throughout the day instead of three big ones and avoid skipping meals. "If you're already on edge and you don't eat, you'll just feel worse as blood sugar levels drop," says Steven J. Sondheimer, M.D., professor of obstetrics and gynecology at Penn Medicine, Hospital of the University of Pennsylvania, in Philadelphia. If PMS tends to make you anxious, stay away from caffeine -- it will make you feel worse.

3. Try to Relax
"Find what relaxes you in any stressful situation and use it," says Ginsburg. "PMS is individualized, but that means you can be your own 'science experiment' to find coping techniques that work for you personally." Try yoga, meditation, massage or acupuncture. Learn deep-breathing exercises or progressive muscle relaxation. You won't know what works for you until you try it.

4. Get Enough Sleep
Not getting enough shuteye hasn't been studied in direct relation to PMS, but it makes sense: If you're tired and cranky, everything seems worse, says Sonderheimer. Do what you can to get a better night's sleep:
- Establish a relaxing bedtime routine
- Use your bed only for sleep or sex
- Keep your bedroom cool and dark because even lights from your cell phone or clock can disrupt sleep
- Maintain regular wakeup and bedtimes, even on weekends

5. Take a Walk
There's little research on whether or not exercise prevents PMS, but most experts agree that exercise may help you cope with it better. "It's good for stress reduction as well as the release of feel-good endorphins," says Frances Ginsburg, M.D., director of reproductive endocrinology and infertility at Stamford Hospital in Stamford, Conn. "Most women do feel better overall when they're exercising regularly." Choose whatever activity you like so you'll stick with it. Brisk walking, tennis, cycling and yoga are all good options.

6. Get More Calcium
Some studies indicate calcium and vitamin D (which aids calcium absorption) may improve PMS symptoms. Eat calcium-rich foods such as skim milk and low-fat yogurt, leafy greens and calcium-fortified orange juice, but consider adding a supplement to get adequate levels. "Aim for 1200mg of calcium and 600 units of vitamin D per day," says David Plourd, M.D., an OB/GYN practicing in San Diego. "Even if you see no relief of symptoms, you need calcium for strong bones. Many women simply don't get enough."

7. Take a Pain Reliever
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen block chemicals called prostaglandins, which cause cramps, nausea and diarrhea for some women. NSAIDs may also relieve the breast tenderness, headaches and backaches that are common with PMS. Take NSAIDs a day or two before (or at the onset) of your period. Check with your doctor if you need to take NSAIDs every month, as long-term use can cause stomach bleeding or ulcers.

8. Consider Prescription Meds
If bloating and breast tenderness are your biggest complaints, your doctor may prescribe diuretics (water pills). For severe PMS, antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), may reduce symptoms like fatigue and mood symptoms. They may be taken daily or just for the two weeks before your period. But they don't work for everyone: A recent study suggests women with symptoms such as anxiety and irritability were more likely to respond to the drugs than women with more physical symptoms.

9. Talk to Your Doctor
If PMS is affecting your ability to function, see your doctor. He or she can take a full history and rule out other conditions that may mimic PMS such as perimenopause. "That's why a diary is helpful," says David Plourd, M.D., an OB/GYN practicing in San Diego. Chart your cycle for few months, focusing on the three symptoms that most affect the quality of your life -- say, bloating, irritability and breast tenderness. Score each symptom daily on how much they're affecting you (0 means you're not bothered at all and 5 means you couldn't fee worse). "If we see from your log that you're struggling all month long and not just the week before your period, we may be dealing with an underlying issue such as depression. An accurate diagnosis is important to tailor a treatment plan."

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