PMS Guide |

A woman may suffer premenstrual syndrome in combination with menstrual cramps, or she may experience either condition alone. However, she should try not to confuse the two because, first of all, they spring from different sources.

Scientists recently discovered that cramp-causing, hormone-like substances called prostaglandins, which are produced in many tissues of the body, are significantly present in the lining of the uterus. Women who have excruciating menstrual cramps have been found to have more prostaglandins than women who were less bothered. PMS, on the other hand, is never mentioned in connection with prostaglandins. Premenstrual syndrome had been linked to hormonal imbalances and changes in interactions between brain hormones and the body’s neuroendocrine system.

Women who endure monthly attacks of cramps may sometimes have nausea, vomiting, diarrhea, headache, fatigue, and nervousness in addition. Headache, fatigue, and nervousness are occasionally observed as symptoms of premenstrual syndrome, but they are not accompanied by cramps. Also, while PMS sufferers notice symptoms anywhere from two to fourteen days before menstruation, women with menstrual cramps do not experience symptoms until their periods are about to begin.

During most of the monthly cycle, cramp-causing prostaglandins are held in check by the hormone progesterone. But just before menstruation, progesterone drops and prostaglandins rise. The cervix, the mouth of the womb from which the blood usually flows, tightens. The prostaglandins in the menstrual blood trapped within the womb are absorbed by the uterine muscles, released, reabsorbed, and released again in a circular fashion. It’s a vicious cycle. As the prostaglandins follow their circuit, the uterus contracts and cramps with ever more intensity, and until the menstrual blood flows from the vagina, taking with it the prostaglandins, women feel terrible. They are suffering very real pain, which is clinically called primary dysmenorrhea. (Secondary dysmenorrhea involves pain brought on by a pelvic disorder such as infection, endometriosis, fibroid tumors pressing on nerves, or a poorly placed IUD.

Scientists have discovered that aspirinlike medication prevents the body from releasing prostaglandins. In fact, a woman who has not tried aspirin might take two aspirins four times a day for two days before her period starts, and during the first days of her flow. Prostaglandins will not be blocked unless the aspirin, or any other antiprostaglandin drug, is taken before menstruation. Timing is essential for treatment.

Women have also been helped by Midol, the time-honored, over-the-counter, aspirinlike menstrual-pain reliever. Doctors did not know that Midol was actually lowering the prostaglandin level for women all these years, but indeed it does. Two Midol tablets four times a day, two days before and during the first few days of menstruation, have been known to provide positive changes. The antispasmodic in Midol also enhances its effects. Once again, it is essential for a woman to monitor her body for the arrival of her period, because she will have a much better chance for relief if she takes antiprostaglandin medicine prior to menstruation.

Three prescription drugs are approved by the FDA for dysmenorrhea—Motrin (ibuprofen), Anaprox (naproxen sodium), and Ponstel (mefenamic acid)—are often more effective than aspirin in blocking prostaglandins. One to two tablets of either drug, taken four times a day before menstruation and continued during the first few days of bleeding, should work their magic. Besides curbing cramps, these drugs also reduce menstrual flow. Since the drugs can irritate the stomach, they should be taken with some food, a cracker, or a glass of milk.

Each woman must listen to her body and decide how many tablets she needs for her own menstrual problem. She might even change her dosage from month to month. With the intense research that is currently being conducted, a variety of prescription and nonprescription antiprostaglandin medications will probably be available in the near future. For now, however, it is important to remember that Motrin, Anaprox, Ponstel, and Midol, taken properly, can act like wonder drugs. They can exorcise the menstrual pain that grips perfectly healthy women.