Lessen or kill PMS symptoms?

June 24, 2014 7:33 PM

What can we/she do to lessen my wife's PMS symptoms? Specifically cravings, and pretty heavily despondent mood swings.

She takes thyroid, and upping the dose around the pms seems to help, though she doesn't always do this.

Her notable cravings are chocolate, and often ice cream- usually caramel sutra. She often complains about it till I give in and go to the store to fetch it.

Worse, though, is the despondency- Aside from being A-type and a bit of a catastrophizer anyway, she gets these really bad/sad moods where everything seems pointless and shes angsty and it all seems stupid and miserable and such.

...help? Please?

posted by Jacen to Health & Fitness (30 answers total)

Birth control pills helped me *immensely* with mood swings.

Good luck!
posted by pizzazz at 7:35 PM on June 24, 2014 [1 favorite]

Zoloft (sertraline) has been absolutely life-changing for me for this. It's better known as an antidepressant, but it's indicated for PMDD (premenstrual dysphoric disorder). Some people take it all month, and some people just take it during the luteal phase, which is the 2 weeks before the period would start.

Hormonal birth control works for a lot of people. It didn't happen to work for me but it is definitely worth trying.

My experience is that an ob-gyn will take it more seriously then your basic general practitioner. If you have a doctor who appears to not take it seriously, the magic words are "interferes with my ability to function normally."
posted by selfmedicating at 7:46 PM on June 24, 2014 [4 favorites]

All my PMS symptoms disappeared while on the Whole30 diet. ???
I even added grains back in ('cause my body functioned better like that; but I mean whole grains: rice, barley, quinoa, etc. Not Wonderbread.) You could also google recipes for "Buddha Bowl" or "Nourishment Bowl". I'm not on it now (pregnant) but am keen to try again later this year. PMS symptoms that disappeared included extreme cramping, nausea, mood swings/sadness, blah blah blah - I'd get it all. Not dealing with PMS is great. I do not have any allergies, intolerances, or any other health issues. Still craved Everything But The.... and Espresso Chip though... maybe stock up a few days ahead of time ;)
YMMV.

MY PMS symptoms are bad enough that if it doesn't work again, I'd probably look into birth control (or on preview, selfmedicating's suggestion) despite a previous bad experience (depression on a very high dose of a tricyclic pill - the opposite of what you'd want). I also tend to have a short-ish cycle, really heavy periods, and struggle with anemia - so I may ask about the one where you only get your period a few times a year.

It can take some time + experimenting to find the right pill for you, so take the time to find a doctor she really likes and is comfortable with. And since it's for PMS mostly, get a timeframe for expected effects/results and don't hesitate to quit taking it if feeling super sad / "not herself".

Good luck!
(6mo pregnant and I don't miss my period at all.)
posted by jrobin276 at 7:50 PM on June 24, 2014 [2 favorites]

Seconding birth control pills. The difference is astounding.
posted by scratch at 8:03 PM on June 24, 2014

Not to play counter to the thread, but I sound like your wife and hormonal birth control pills made me suicidal. Four different formulations, many "low hormone" kind. All made it worse for me. (Depo provera just gave me a 3-month-long migraine.) Not that birth control might not help, but tread carefully.

For me, turns out I was low on iron - really, really low. And while PMS still knocks me out, having a steady level of iron supplement keeps me from the super lows and some of the more intense food cravings.

A doctor can run a blood test mid-month and pre-cycle and compare hormones, iron levels, vitamin levels, etc.
posted by Gucky at 8:31 PM on June 24, 2014 [3 favorites]

I used to have crippling PMS (mood swings and physical incapacitation) but found that birth control pills were pretty intolerable as well, even the low-hormone ones -- I was suicidal and prone to flying off the handle in inexplicable rage. In case your wife is in the same boat, I'll tentatively suggest the Mirena IUD. I was initially hesitant because the Mirena also dispenses hormones, but I've had one for 8 years now (one replacement) with no problems and even landed in the lucky ~20% of people whose periods stop entirely. It's a sizable up-front cost, so if you're stuck paying out-of-pocket it wouldn't be the first thing I'd try, but if you're lucky enough to have it covered by insurance, I'd say it's worth a shot.

Best of luck and hang in there.
posted by dorque at 8:37 PM on June 24, 2014 [1 favorite]

I have this type of PMS even when I am on hormonal birth control. Some of us aren't so lucky to have a pill or IUD make it go away. But what DOES help me is a good old dose of xanax. Ah, xanax, how I love you. Of course, I can only take it when I don't need to be working or driving around, but even just taking it at night seems to cut the edge down a bit the next day, if only because I sleep better than I would without it.

As for the cravings, I dunno. This is one of those cases where I think giving in to a craving is an okay thing. Her body is probably asking for it for a reason.

IANAD.
posted by joan_holloway at 8:57 PM on June 24, 2014 [1 favorite]

My friend gave me a motherswort tincture a few months ago when I had really bad PMS, and all my symptoms cleared up in under an hour. I was so impressed. I'm usually not much for natural remedies, but I am slowly being won over as some of them seem to actually work. You can buy it at stores like Whole Foods. It clears up a lot of the physical as well as all of the mental symptoms and has no significant side effects.

FWIW, birth control pretty much made me feel like I was PMSing all month long, and I got craaazy during the actual 'PMS' period. No thank you. I have a copper (non-hormonal) IUD and I love it.
posted by ananci at 8:59 PM on June 24, 2014 [3 favorites]

If she is on other medications, she will of course check with a doctor before starting anything new... here is what I take. You know it's not all in your head when your mom points out that your dog is avoiding you. My doctor okayed this stuff for me, but your own physician's opinion may vary.

-Premsyn PMS (it has acetaminophen, diuretic, and an antihistamine - the antihistamine in this product is what helps my mood swings and irritability according to the doctor)
-Magnesium
-Vitamin B complex

I also do lots of things in terms of Self Care for Introverts. I am already crabby if I do not get enough time to myself to sit and do nothing or walk and admire trees. If I get enough alone time, I am much more cheerful in general, and this helps with the PMS. I read, play solitaire (and Friday - love that game), do lots of yoga, and play with my dogs. And garden. Lots of things I like. I make time for things I like. This makes a huge difference in my overall attitude, which helps a great deal with the PMS.

Regarding birth control pills - I took them for a very short period (6 months) Within a week of starting them, I was crying all the time and depressed (other people noticed this and pointed it out, especially my running buddy at the time). This was very different for me, and a huge change, and the only thing in my life that changed was taking the pills. The doctor insisted it could not be the pills. Lo and behold, research at the library informed me that depression is in fact a possible side effect of birth control pills. I did not have the PMS mood swings until I took the birth control pills.
posted by AllieTessKipp at 9:00 PM on June 24, 2014 [4 favorites]

Calcium supplements lessen PMS symptoms.

Re: bcp. It is possible to take pills continuously for months so you have periods very rarely. She should ask her doctor about this and specifically request a monophasic pill that can be taken in this way.
posted by bq at 9:54 PM on June 24, 2014

My ob-gyn prescribes very low amounts of anti depressants, usually Prozac for PMS. I don't have PMS but she makes a big point of offering it to all her clients in a non judgmental "just let me say this way" so i assume it is a) a problem for a lot of people and b) her solution works.

Body fat % is a huge deal in terms of general hormon-ness for me and most women. Losing fat (not weight) makes periods lighter, PMS less etc for me and a lot of people. Having said that ice cream is also positively indicated for PMS, especially caramel and most especially when it conveyed directly to you on the couch, so keep up the good work on that front. Maybe consider setting up a reminder so you have it on hand.

Also regular hormonal BCP make me stabby but the Mirena didn't at all and it basically eliminates PMS and periods. Anecdotally a lot of my friends have the same result so worth a try.
posted by fshgrl at 10:17 PM on June 24, 2014 [2 favorites]

I am on Zovia for PMDD, but as there is usually 24 hrs between the pill packs that I am supposed to stack, I have to take 0.5mg of Xanax to stave off the Jekkyl/Hyde transformation that happens when my brain loses whatever hormone stabilizer Zovia provides.
posted by Hermione Granger at 10:27 PM on June 24, 2014

I find raspberry leaf tea helpful with moods and amount of bleeding, but it works best if I use it every day.
posted by Comet Bug at 10:29 PM on June 24, 2014

My PMS was at its peak of utter diabolical horror when my iron was very very low. It might pay to have some basic bloodwork done to see if hers is in the lower range of normal or even below.
posted by elizardbits at 11:13 PM on June 24, 2014 [4 favorites]

Taking 50mg of vitamin B6 throughout the menstrual cycle can help with mood swings. I just take a b complex every morning (B6 can keep you up at night if you take it later in the day.)
posted by needs more cowbell at 11:20 PM on June 24, 2014 [2 favorites]

I have very bad pms... I seem to have almost mixed episodes. Extreme anxiety and depression but also very wired. But I'm happy with my birth control (non hormonal coil) and didn't want to take medication long term... My doctor prescribes a few valiums that I can take like this: a few days ago I demolished 2 boxes of cookies,
I got very very weepy the day before yesterday and was up all night way too wired to sleep. So I went to work yesterday exhausted,
cried again, and realized it was my
Pms- took a Valium, ate a nice healthy meal, did some stretching... Watched television and went to sleep and got a full nights. They are like a little reset button... I can relax and look after myself instead of worrying and crying.
posted by misspony at 11:36 PM on June 24, 2014

Have you ruled out endometriosis?
posted by Mr. Yuck at 1:43 AM on June 25, 2014 [1 favorite]

I am a very lazy person, but even I can attest to the huge difference it makes to exercise especially in the fortnight before your period - it really helps to even out mood swings, as well as lessen cramps. My cramps and PMS mood swings are generally bad and as a rule I know when my period is coming because I feel so bad; but if I make a point of getting some exercise in then these symptoms improve so much that my period, when it comes, takes me by surprise.

Re: the cravings, I don't think it's a disaster to give into them. Does she feel sick or bad afterwards? I always find the best way to make a craving worse is to tell myself "No Ziggy, you must not have this". If you accept that you can totally have some caramel sutra (yum, by the way) if you want, if you give yourself permission in other words, then that often helps with the anxiety that stems from constant battling with cravings.

I like these self-soothing techniques and often go to them. You will notice that eating mindfully and pleasurably does count as a self-soothing technique!
posted by Ziggy500 at 2:21 AM on June 25, 2014 [1 favorite]

I get in a similar funk when I'm on my period. Like Ziggy500 I've benefited a lot from self-soothing techniques - a little walk in my favorite part of town, or watching my favorite episode of my favorite TV show, or reading from a book I'm loving all help alleviate my grumpiness.

I don't think giving into cravings during that time of the month is especially bad. So many women crave chocolate when they're on their period that it's now accepted as standard, and has become a bit of a TV trope. Unless she feels ill after eating it or it is making her unhealthy, why not indulge?

But you are not a servant, so if I were you I'd encourage her to stock up on Caramel Sutra a day or two before her period. "She often complains about it till I give in and go to the store to fetch it" does not seem like a healthy, respectful dynamic. And what's more, being waited on hand-and-foot often makes me feel incredibly helpless, and that can really exacerbate the period mood funk. Just a thought.
posted by schroedingersgirl at 3:57 AM on June 25, 2014 [1 favorite]

I appreciate that you say you want to give her ideas for her symptoms but does she agree that they are bad enough that she wants to get rid of them? In this day and age we're all meant to be evenly tempered, feel well and energetic at all times. But I guess we weren't necessarily designed for that. So before you give her any or all the suggestions you're getting here what exactly do you want to achieve?

If you don't want to be sent to the store make sure the craved for foods are in the store cupboard/freezer.

If you are at the receiving end due to the mood swings make her aware that that's a problem as a starting point.

If you don't want to see her suffering the mood swings how does she feel within herself at these times? Does she suffer?

Can't speak to mood swings as such but I do get unreasonably tired a few days before my period. And you know what, I drag myself to work because that's non negotiable. And then I allow myself to collapse on my sofa the minute I come home and allow myself to be very tired and take it easy for a few days.

I'm not suggesting that tired = mood swings. But you may want to be clear on your objectives and work out what your wife wants before you print off this thread and hand it to her as useful suggestions.
posted by koahiatamadl at 4:22 AM on June 25, 2014 [4 favorites]

If it were me, I'd definitely get checked out for vitamin and iron levels and such, but I also have noticed that my PMS is almost non-existent when I'm generally happy with my life and relationships, and especially when my romantic relationship feels balanced and respectful. Something about the sudden premenstrual drop of estrogen puts me into a "RIGHT ALL WRONGS!" mode, which can lead (if I don't actually act on it and fix things) to feeling very resentful and put-upon.

The fact that she's begging you to go to the store until you give in is a bit weird -- is there some reason you don't just go when she asks the first time? If you are in some sort of power struggle with this kind of stuff, maybe work on that.
posted by jaguar at 6:26 AM on June 25, 2014

Exercise -- especially working the abdominal muscles -- really cuts down both the physical and mental symptoms of pms for me. Even just a few minutes per day prevents the craziness ... ymmv.
posted by phoenix_rising at 6:52 AM on June 25, 2014

I have done micro doses of Prozac for severe PMDD, which were very helpful. I do not take them regularly because even the micro doses impact my sex life. That said, I'd just take them for two weeks after ovulation and it only made it difficult to have an orgasm, not impossible, and it was still fun to have sex--so even though I'm currently giving that one a rest, it worked. The dosage I was taking was ridiculously small. I think 2.5. I had to cut the pill and then cut it again.

Right now I am:
-Eating vegan for two weeks after ovulation
-Taking regular Xanax for two weeks after ovulation
-Taking Adderol for two weeks after ovulation

The vegan thing proved enormously helpful early on and remains so. It's not as hard as it sounds, there are lots of fun things vegans can eat. I'm currently having cold sesame noodles for lunch. It's not sad person food or anything. I get less weird bloating and fewer food cravings. It's like a fun little project. I keep a lot of nuts around for moments when I get stuck, and if I'm at a business dinner where it's too difficult or whatever I just eat what I want and go back to being vegan the next day. It's a little adventure, it's empowering, and it's nice to not have my boobs killing me. It probably has as much to do with what I don't eat while eating vegan as what I do eat, but whatever, it's a construct that works.

The Adderol is new and helpful to my cognitive functioning which goes completely to shit during that phase. I wander around the house half finishing tasks and forgetting what I was doing and leaving coffee cups on the washing machine. I swap words out in emails. So that's a new thing my doctor and I are trying this month, and I have so far found it enormously helpful. I tried a lower dose last month, liked it, and am trying a different dose this month. I love my doctor. He's willing to try lots of things.

The Xanax keeps me from killing anyone, though the edginess and anxiety is also tempered by the ability to think and get things done, and get some clarity, which I also get from the Adderol.

Lastly, I'm pretty religious about exercising seriously five days a week. I don't know how much that helps. I don't honestly think it does much, but I guess it takes a little edge of the rage off, probably.
posted by A Terrible Llama at 9:43 AM on June 25, 2014

Just wanted to clarify that birth control pills taken continuously (so no period) is what worked for me.
posted by pizzazz at 11:25 AM on June 25, 2014

She might want to talk to her doctor about magnesium (and possibly also calcium).
posted by moira at 12:11 PM on June 25, 2014 [1 favorite]

There is a book "The 28 Days Lighter Diet" that has diet recommendations, exercise recommendations, and lots of information on periods/pms and how to reduce pms symptoms using diet, exercise, yoga, and supplements, it just came out this year and is a good first step before getting on board with prescriptions and more hormones.
posted by lafemma at 1:00 PM on June 25, 2014

I have really severe PMDD including screaming ragefest mood swings and the antidepresant Celexa (citalopram) has been a magic pill for me.

When I went off Celexa for a year, the severe mood swings and screaming ragefests came back. Went back on Celexa and they disappeared again. Missing just 3 pills during the wrong part of my cycle is enough for me to turn psycho again -- it's such a noticeable personality difference that my husband asks, "Did you forget to take your pills?" and I'm like, "Oh yeah, I misplaced my Celexa when I moved furniture a couple days ago" and then he's all "Let me help you find that right now."

Although I still suffer from other symptoms (insomnia, fatigue, cravings), my 40mg/night Celexa pill completely eliminates my PMDD-related mood swings and has saved my marriage and probably my life.
posted by Jacqueline at 4:36 PM on June 25, 2014

Every day women politely tuck it all in. We don't complain about everything going wrong in life, we trudge through, feeling small and angry sometimes but trying not to show it. And then the hormones hit and it all comes tumbling out. Ask her to write a list every day of her 10 5 most frustrating things. If they are big things then you can give her chocolate and foot rubs.

Mineral water helps with the cramps and some of the ice cream cravings.

Sex helps with every thing, every time, if you are doing it right. If it doesn't seem to help her, there are books that you can read which will explain things.

Also, feed her cinnamon. It helps make the flow lighter.

And take her for walks at least twice a day. It will change your life.
posted by myselfasme at 8:35 PM on June 25, 2014 [2 favorites]

I had a period of somewhere between 6 months and a year that I was experiencing this. It was hard for me to recognize at the time, and when I realized it was happening I saw several doctors. I tried zoloft and had a terrible experience with it. I tried two different birth control pills which was unpleasant and didn't work for me. I realized then that the symptoms had started when I had gone off my low-carb diet and stopped regularly exercising. I went back on my low-carb diet and started running 3-4 days a week (later I switched to crossfit) and the symptoms disappeared completely. When I start feeling low or depressed now it usually correlates to having missed a few workouts.

I wish your wife the best, and I hope shes okay that you posted about this!
posted by palegirl at 10:18 AM on July 4, 2014

I ran across this article today. It talks about food cravings and serotonin and how they relate to PMS. The suggestion is to try a little dose of starchy or sweet non-fruit carbs without fats or proteins (so an empty stomach is key) to boost serotonin. There are specific food suggestions listed. Since the effect is supposed to be pretty immediate, it seems worth a try.

The article doesn't mention dark chocolate, but dark chocolate is also known to boost serotonin.

(I stand by my earlier suggestion to also look into magnesium and calcium.)
posted by moira at 1:25 PM on July 15, 2014