Q I am a 22-year-old woman. Whenever I have my menstruation, I will have symptoms such as giddiness, fainting, cold sweat, cramps, aches in the thighs and knees, and weak knees.
On top of that, I also have diarrhoea.
Vomiting is a rare occurrence, although it happened recently.
I have always had pain during my menstruation, especially on the first day.
Generally, I would be so weak on the first day that I would skip school.
Recently, I feel that the pain has become worse.
Usually, my period would be accompanied by diarrhoea too. I would have really loose stools on the first day and I would have to go to the toilet often.
My legs and knees would hurt even when I am lying down to rest.
I would often sweat, but at the same time, I would feel cold when the wind blows.
These symptoms have affected my life.
Is it normal to have such symptoms? How do I resolve them?
A The symptoms which you describe are some of the physical symptoms of premenstrual syndrome.
There may also be emotional symptoms such as irritability, depression or anxiety.
The symptoms may occur up to two weeks before the onset of menstruation and usually will resolve after the menstruation.
The cause of this syndrome is not known, but it may be related to hormonal changes associated with ovulation. This is the process during which a mature egg is released from a woman's ovaries.
Many women experience some of these symptoms before and during menstruation, but they are usually mild.
Some women experience more severe symptoms and these may be aggravated by factors such as stress, and vitamin or mineral deficiency.
If the symptoms have affected your life, you would require medical attention.
Check For Other Causes
CHECK FOR OTHER CAUSES
If your symptoms are severe or if they are worsening, it is important to exclude other underlying conditions such as endometriosis.
Endometriosis is a condition where the cells of the lining of the uterine cavity are deposited outside the uterus.
The cells can be deposited on any of the pelvic organs and can cause severe menstrual cramps.
If the cells are deposited on the bowel, it may irritate the bowel and cause diarrhoea during menstruation.
Endometriosis may also lead to the development of ovarian cysts and may result in infertility.
If you experience tiredness, giddiness and fainting, it may be due to a low blood count.
You should consult a doctor to exclude other medical conditions and work out an appropriate treatment plan.
It may be necessary to do a pelvic ultrasound scan and some blood tests.
Eat Right and Exercise
EAT RIGHT AND EXERCISE
If you are having premenstrual syndrome, treatment may include lifestyle modification as well as medical therapy.
Lifestyle changes include having a healthy balanced diet to avoid nutritional deficiency and drinking lots of water to avoid dehydration.
They also include doing regular exercise (at least 30 minutes of moderate to vigorous intensity exercise daily), having adequate sleep and stress management.
You may also consider taking some vitamin and mineral supplements, such as calcium, magnesium, folate, vitamin B and vitamin D supplements.
To alleviate the menstrual cramps and leg pain, you may consider the use of a heat pad.
If the non-medical treatment fails, you may consider taking some pain killers.
Oral contraceptive pills may also be used in the treatment of premenstrual syndrome.
Dr watt Wing Fong, consultant obstetrician and gynaecologist at Raffles Women's Centre at Raffles Hospital.
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