Sunday 11 September 2022 12:25 AM DR ELLIE CANNON: My granddaughter's life is being wrecked by PMS trends now
I suffered from severe PMS when I was younger. I’m 75 now, and thankfully that’s all behind me, but my granddaughter, who’s 19, now seems to be suffering the same problems, but worse. I’m really concerned about her. Are there any new developments with regard to this problem?
PMS, or premenstrual syndrome, is the name for a collection of symptoms that women can experience in the weeks before their period.
Thankfully, these days it’s recognised that if it interferes with work, relationships and everyday life, it’s a medical problem that should be treated.
Recognised symptoms include depression, anxiety, mood swings, bloating, breast pain and brain fog that occur specifically in the second half of the menstrual cycle.
PMS, or premenstrual syndrome, is the name for a collection of symptoms that women can experience in the weeks before their period
There is also a condition called PMDD – premenstrual dysphoric disorder – where the symptoms are more severe and can even involve suicidal thoughts.
In either case, a GP should be able to help.
It is helpful to take along a diary of the symptoms, so the monthly patterns can be seen. This is one way we can tell it’s not standard depression or another mental health problem.
Regular sleep, meals and exercise are known to improve things, while contraceptive pills taken continuously can help tackle PMS.
Cognitive behavioural therapy – CBT – is another highly effective treatment. In some cases, sessions can be taken online.
A few years back I was diagnosed with spondylolisthesis in my lower back. I have been prescribed various pain relievers to little effect. My GP has now prescribed gabapentin, which does not dull the pain but does make me very sleepy. I also have a heart problem called atrial fibrillation, and this means my consultant refuses to operate on me. I’m in agony to the point I find it difficult to walk. Is there anything that may help?
Spondylolisthesis is when one of the bones of the spine, known as the vertebra, slips forward. This causes back pain that’s particularly bad when walking or standing but is relieved when sitting or bending forward. It can also cause pain, numbness or tingling in the legs due to compression of the nerves that run through the back into the lower limbs.
Treatment such as steroid injections and physiotherapy as well as painkillers would be the usual treatment for the more mild cases. Surgery would be carried out under general anaesthetic, so would certainly carry risks for somebody with heart problems.
Gabapentin is a very specific type of painkiller which targets nerve related pain and should work in this instance. If it doesn’t then it may be worth considering combining this with more mainstream painkillers like anti-inflammatories or paracetamol. Otherwise the medication needs to be stopped.
It is never worth continuing taking a drug if it is not doing anything. There are other specific nerve painkillers, including pregabalin and amitriptyline, which may be worth trying.
If the risks of the surgery outweigh the potential benefits, it may be worth a referral to a local pain clinic in order to access both drug and non-drug options such as osteopathy or acupuncture.
If the pain has dramatically worsened or changed compared with the past few years, then it may be worth having a reassessment with the doctor or physio as another condition may have occurred.
I am covered in moles and freckles. Recently
