Is it “that time” of the month? Are you not feeling quite your normal self? Is coping with work and family becoming difficult?

The question to ask yourself is: Am I suffering from Premenstrual Syndrome (PMS)?

About 5 out of 100 ladies experience severe symptoms of PMS, though overall prevalence is 3% - 30%. It is more commonly seen in ladies who are obese and where there is lack of exercise. It is less commonly seen in women who use hormonal contraception.

PMS can be a cause of distressing physical, behavioral and psychological symptoms. There is usually no history of a pre-existing physical or psychiatric disorder. PMS occurs in a cyclical manner, during the second half of each menstrual cycle, and significantly regresses by the end of menstruation.

Symptoms range from mild to severe, and not everyone will experience the same combination of symptoms. The cause for this disorder is not precisely known, but hormonal fluctuations during the menstrual cycle, and cyclical ovarian activity are important contributors.

PMS is diagnosed with the help of a symptom diary maintained over two menstrual cycles. The type and severity of symptoms should be recorded in the diary. Symptoms to watch out for include mood swings, irritability, depression, feeling out of control, breast tenderness, bloating, headaches, and behavioral symptoms like being prone to accidents.

Treatment for PMS is targeted towards life style changes, cognitive behavioral therapy, hormonal treatment, medication to deal with specific symptoms such as tablets for depression, and rarely, in very severe intractable cases, surgery may need to be done.

Complementary therapies such as magnesium, calcium/vitamin D, isoflavones, agnus castus, ginkgo biloba and pollen extract have shown some benefit, but further research is awaited, before their use can be recommended.

In the management of PMS, lifestyle modification with a healthy balanced diet, exercise and stress reduction is of great importance. Cognitive behavioral therapy and referral to a clinical psychologist is likely to help symptoms.

Symptom diaries should be used to monitor and assess results of treatment. Majority of PMS problems can be managed successfully with maintaining a healthy, stress-free lifestyle and cognitive behavioral therapy, and these should be the initial steps in the management of this condition.