If you suffer from PMS, perhaps a spa day will do the trick

Some researchers – and surely many women – have suspected that stress can exacerbate symptoms of PMS. Some of the most common symptoms of premenstrual syndrome are anger, anxiety, depression, mood swings and decreased concentration – all things that clearly could be made worse by stress.

At least 10 studies have found an association between stress and PMS symptoms, but none was able to tell whether stress made symptoms worse – or if severe PMS caused women to feel stressed out. To answer that question, researchers from the National Institute of Child Health and Human Development and colleagues tracked 259 women over two-and-a-half menstrual cycles to see how stress before a cycle affected PMS.

It turned out that women who had high scores on the Perceived Stress Scale in one month were much more likely to have moderate or severe psychological PMS symptoms in the next month, compared to low-stress women. For instance, high-stress women were twice as likely to experience anger, short temper, anxiety and irritability, and three times more likely to report sadness, depression or crying spells.

The most convincing evidence that stress is a cause, not an effect, of PMS came from the subset of women who were high-stress before one cycle and low-stress before the other.

In the 16% of cases where women went from high-stress in one month to low-stress in the next, the proportion of women who had at least eight moderate or severe PMS symptoms fell from 29% to 5%. Conversely, in the 9% of cases where women went from low-stress to high-stress, the proportion of women with at least eight moderate or severe symptoms rose from 18% to 22%, according to the study. (The researchers used eight symptoms as a cutoff because that’s what classifies someone as having a severe case of premenstrual dysphoric disorder, or PMDD.)

It’s not clear exactly how stress worsens the symptoms of PMS. The researchers mentioned several theories. Stress may cause hormonal changes that make women more vulnerable to PMS. Alternatively, it could make them more sensitive to cortisol, which might make them more prone to PMS. Perhaps feeling stressed-out simply makes women more attuned to their PMS symptoms.

No matter what the mechanism, the findings suggest that reducing stress in your life is a good way to reduce your PMS symptoms. Spa day, anyone?

The results were published online in the Journal of Women’s Health.

-- Karen Kaplan/Los Angeles Times