Q: I am a 45-year-old female. A week before my menstrual period, I get depressed and miserable. It is not fair for the people I live with. Is there some medication I should be taking during this time to calm me down? I am not allergic to any medications.
A:We are not entirely sure what causes premenstrual tension, but it affects about half of all women of childbearing age. It may have something to do with the fluctuating female hormone levels, or other hormones such as those found in the pituitary gland in the brain. The neurotransmitter substance known as serotonin might also have something to do with it.
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Women suffering from this condition can be irritable for a week or more before the onset of their periods. There can be unexplained sadness and moodiness, often accompanied by retention of fluid, leading to weight gain. A craving for carbohydrates and sweets causes even more weight gain. My weight used to go up about five pounds during this time, but then fall a couple of days after menstruation started. Fluid retention leads to bloating, breast tenderness and swollen feet and ankles. Some women get insomnia and muscle aches and pains.
To control the craving for carbohydrates, salt and sweets for the week before menstruation, try eating small, frequent meals of a balanced diet, so your blood sugar does not get too low. Avoid caffeine, alcohol and cigarettes and try to get as much sleep as possible. Sometimes calcium supplements up to 1,000 milligrams per day, or 400 international units of magnesium can help if taken in the second half of the cycle.
Vitamins E, B6 and evening primrose oil are also rumoured to be effective, but this has not been completely proven. Doctors can prescribe a drug called Bromocryptin that lowers certain chemicals in the blood, or a diuretic such as Spironolactone. The oral contraceptive pill helps some
people, but makes others worse. You can take these at your age, provided you are not a smoker and have not had problems with blood clots.
There is a more severe form of PMS known as Premenstrual Dysphoric Disorder. Dysphoria means an abnormal mood, which can be either severe depression, possibly leading to suicidal thoughts, or a bad temper that could lead to acts of violence. These women should seek professional help and might need to take antidepressant medications such as Effexor, Paxil, Zoloft or Luvox.
Fortunately, you are 45 and nearing the age of menopause. The average age of menopause is just over 50. The problem will then start to disappear.
