When women are anxious, tense, irritable - yelling at the kids and screaming at their husbands - men typically attribute the moodiness "to that time of the month."
Specialists concur that it's much more complicated than that, and, furthermore, something can be done about it. Women intuitively have known that physical changes, affecting their dispositions, occur before their menstrual period begins.But until recently they hadn't persuaded the medical establishment to take them seriously.That's all changed. Utahns have played a major role in the increased awareness, recognition and medical acceptance of premenstrual syndrome, a disease researchers believe is caused by a hormonal disorder that originates in the brain and affects many systems of the body all at once.
Salt Lake City has been tagged the "birthplace of PMS information and scientific data."
Utah's capital was one of the first in the nation to have a free-standing PMS center at the Western Institute of Neuropsychiatry and a nationally recognized support group. Specialists at the University of Utah Medical Center have led the nation in PMS research.
Women from around the world are writing the U. for information on the disease's symptoms and possible treatments. They're getting answers from the foremost PMS researchers.
Dr. William R. Keye is dispelling myths surrounding the syndrome, which for many years has been used as a "scapegoat." The truth, he says, is that few women suffer symptoms severe enough to require medical treatment. And, those who aretreated can lead normal lives.
"PMS is not as common as some would have you believe. Significant PMS doesn't occur in any more than 5 to 10 percent of women; 75 to 90 percent more can tell when their menstrual period is going to start," said Keye, associate professor and chief of the Division of Reproductive Endocrinology at the University of Utah Medical Center. "However, some women do suffer from PMS. It's legitimate and real; it's not a figment of their imagination - one created by the media or society. It's a real medical disorder for which there's effective medical treatment."
The syndrome, Keye said, can no longer be used as a scapegoat by either women or men, who, on occasion, have discriminated against sufferers.
"Men had better be aware of PMS and what it's all about because it affects their personal, as well as professional life," the specialist said. "Dealing with PMS, instead of criticizing it, can increase the profitability of a business and the effectiveness within."
Doctors, equipped with more scientific means for diagnosing PMS, are also taking a healthier approach to the syndrome.
"It used to be that the diagnosis was made by talking with a person over thetelephone," Keye said. "A physician would ask, `What's bothering you most?' and then prescribe medication to alleviate one or two isolated symptoms."
If a woman felt anxious, the physician would prescribe a tranquilizer. If she was depressed, he'd prescribe anti-depressant. If she felt bloated and her breasts hurt, she was given a diuretic.
Today, through a series of sophisticated tests, physicians are able to distinguish women with more chronic emotional problems from those who might suffer from PMS.
One of the methods developed by Keye is a calendar on which women chart their daily temperatures, dietary changes, medication, physical and emotional symptoms and menstrual cycle.
The calendar, combined with blood and psychological tests, assist doctors in more objectively diagnosing and prescribing appropriate treatments for the syndrome.
"We have learned that biological, psychological and social forces combine to create the symptoms," Keye said. "That's exciting because we can break that cycle by treating any one of those three. We can get her out of a difficult social situation, build some psychological skills or provide medical therapy, or a combination of all three."
Keye said medical treatment that can alter the hormones during the menstrual cycle so they don't trigger PMS are available. Progesterone is the drug most commonly prescribed.
Exercise and a proper diet can also be beneficial. Women suffering from PMS are encouraged to avoid concentrated sugar, salt, caffeine, alcohol and fasting.
PMS cannot be cured, but doctors can reduce the symptoms among most women.
"Physicians have a much better feeling for the cause of PMS," Keye said. "There is more and more solid evidence that the normal hormone changes during the menstrual cycle among women susceptible to PMS trigger abnormal symptoms.
"These abnormal reactions range from depression to anxiety, to phobia to physical problems."
A woman's lifestyle, experiences and stresses determine the severity of the symptoms.
"If women are concerned about the way they feel before their menstrual period, they should seek professional help," Keye said. "They don't have to become so depressed that they want to commit suicide before seeing a physician. Being unhappy at that time of the month is reason enough."
***** (CHART #1:)
- Abdominal bloating
- Breast tenderness
- Sharp, one-sided ovarian pain
- Sensitivity to light
- Fainting spells
- Craving for sweets or salty food
- Inability to cope
- Physical violence
***** (CHART #2:)
Significant PMS doesn't occur in any more than 5 percent to 10 percent of women;
75 percent to 90 percent more can tell when their menstrual period is going to start.