Pre-menstrual Syndrome is a condition where a series of symptoms occur on a regular and routine basis during the pre-menstrual phase of the menstrual cycle. For some women it can be very debilitating.

The symptoms
These begin, for the most part, seven to ten days prior to menstruation, but they can also be present around the time of ovulation. Mild symptoms that occur one or two days prior to menstruation are not considered to be part of PMS.

•  Bloating
•  Irritability
•  Tearfulness
•  Carbohydrate craving
•  Headaches
•  Anxiety
•  Dizziness
•  Suicidal tendencies

Vitamin B6
This vitamin is essential for maintaining the health of the nervous system and controlling the production of certain hormones in the body. A daily supplement of 50 to 100mg can be safely taken. However, some consideration should be given to keeping a balance of the B vitamins, and therefore a B-complex or B-complete supplement may be preferable.

Fatty acids
These are essential for the production of Prostaglandins which regulate the menstrual cycle. Regular consumption of oily fish, fresh unroasted nuts (stored in a cool place), natural unheated cold-pressed oil (eg virgin olive oil, kept cool or in the fridge, on salads) can help levels. A daily supplement of 500mg Evening Primrose Oil capsules is recommended.

Magnesium and Calcium
Magnesium combined with calcium has a natural calming and pain relieving effect on the body. Deficiency caused by stress and poor diet can lead to an inability to relax, insomnia, cramps and sensitivity to noise and pain.

The best sources are nuts, soya beans and green leafy vegetables (eg spinach, chard, broccoli). Foods such as fish, apples, bananas, apricots, wholegrain cereals and brown rice are also a source.

Calcium is added to many refined foods. A daily supplement of dolomite (a natural mineral) or multi-mineral can be taken. Magnesium supplements of 250mg can be taken daily. Vitamin D intake should also be adequate.

Blood sugar regulation can be difficult to manage premenstrually. If the blood sugar level drops too low production of the hormone adrenaline is stimulated.

This hormone prepares the body for a 'fight' (increased heart rate, feelings of aggression, rage and irritability), 'fright' (panic, anxiety, apprehension), or 'flight' (withdrawn, depressed, poor concentration). Very low levels can also cause dizziness and nausea.

Avoiding low blood sugar

Eat regularly: To avoid low blood sugar and to keep insulin levels constant it may be necessary to eat small meals every two hours. This does not mean eating foods with high sugar content such as cakes, buscuits, chocolate and sweets - on the contrary these should be avoided. Wholefoods such as brown bread, nuts and fresh fuit are much more long lasting in their effect.

Develop body awareness: It is important to take notice of your body's signals warning of low blood sugar and not to go without food. Crash diets and diets which severly limit the amount and variety of foods eaten should not be followed. Good health is the reward for taking care of your body and eating well.

Avoid Alcohol: It is best to avoid all acoholic drinks, as these dramatically lower the blood sugar levels - as anyone with a hangover must realise!

Don't give in to sugar craving: The body's response to low blood sugar is to create a craving for high sugar foods, eg chocolates, sweets, cakes and biscuits. Foods with a high sugar content give a quick fix which doesn't last and causes levels to plummet even more as these foods are too rapidly digested.

Foods that take longer to digest and release their nutrients more slowly into the blood should be eaten instead.

A small meal of wholemeal toast and a little protein such as cheese or eggs will eliminate the feelings brought on by low blood sugar and replace them with feelings of well-being. Ideal foods are those with no added sugar such as wholegrain cereals, wholemeal bread, brown rice and pasta. Complex carbohydrates found in potatoes, carrots and peas, combined with small amounts of high protein foods (e.g. cheese, meat or meat substitutes, fish, eggs) all help to keep the balance.

Avoid feast and famine: Notice what you eat and when, so that you are not stuffing yourself one minute and starving yourself the next - try to eat regular meals that include fresh fruit and vegetables.

Stress levels

There is a healthy amount of stress we usually think of as excitement! There is also an unhealthy amount of stress, excessive stress over a prolonged period which can lead to ill health.

Stress levels go up and down as we cope with our day to day lives - work, shopping, looking after our families, going to new places, new social activites. However some events are excessively stressful and can effect our health and sense of well-being. These are major events such as a change of job, bereavement and moving house.

Women in particular can experience an exaggeration of the symptoms of Pre-menstrual Syndrome (PMS) when stress levels are high.

Stress management

Identify what situations you find most stressful and try to avoid these or, if this is not possible, take time to relax and de-stress at every opportunity.

Changing your mood can be as easy as changing the scene - walk away rather than confront. Simply pausing to make a hot drink, or taking a few deep slow breaths can make a difference to your stress levels.

Diet affects your mood and ability to cope. If you are hungry and your blood sugar is low, you are less able to deal with stressful situations. It is essential to eat regularly and ensure a balanced diet. Foods you prepare yourself are usually healthier than 'fast food' or ready prepared foods you can buy in a supermarket.

Stress management should include making an effort to eat a healthy diet. Try to limit fried foods, pastry, dairy produce and red meat. Also try limiting your caffeine and salt intake. Avoid dehydration - drink water and fruit juice in preference to tea and coffee which are diuretics as well as stimulants. Avoid those artificially high sugary foods which are not necessary and can be detrimental to health if eaten instead of fresh fruit and vegetables.

Sleep reduces anxiety and boosts energy levels. If you have lost sleep, try make it up. Although we can funtion with only 4 hours sleep a night, most people function better with an average of 8 hours. We cope better with stressful situations after a good night's sleep.

Good health and a lifestyle free from excessive stress promotes feelings of optimism and a sense of well-being.

Conventional treatment
This is often centred on nutritional support, stress management and hormonal support in the post-ovulation phase of the menstrual cycle, but the success of these treatments remains controversial.

CPRT is different
This is a method of progesterone support that works. The ovary releases the hormone Progesterone after ovulation has occurred. A deficiency in progesterone is considered to be a cause of PMT.

In the past Progesterone support was started on a given day in an average cycle, and was often inappropriate as it did not coincide accurately with the ovulation event.

Using CPRT, the precise time of ovulation is identified and progesterone support is started to correspond with this. Therefore treatment may start on a different day to correspond exactly with an individual woman's cycle. If progesterone support is not given at the right time in the menstrual cycle, it simply doesn't work.

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