Pre-menstrual syndrome

Premenstrual Syndrome, most commonly known as PMS, encompasses a vast array of physical and psychological symptoms that impact around 75% of those menstruating in the week before the onset of their period. While the condition can often be made light of, it is known to impact, sometimes severely, the quality of life of those who experience it.

While the cause of the syndrome remains unknown, there are an array of factors contributing to complex condition’s presentation. These factors include:

• Change in hormone levels impacting neurotransmitters like serotonin
• Hypersensitivity to progesterone in those with deficient serotonin levels
• Hyperactive prostaglandins (lipids formed near tissue damage and infection sites)
• Genetic link – the condition is found to be two times more prominent in identical twins than fraternal twins

PMS symptoms range from behavioural to psychologic to physical with the onset beginning in the luteal phase of the cycle and subsiding once menstruation begins.

More than 200 symptoms have been linked to PMS; however, the following symptoms are most common:

• Fatigue
• Headaches
• Sensitive or swollen breasts
• Abdominal discomfort (cramping or dull ache)
• Abdominal bloating
• Water retention
• Muscle and joint pain
• Nausea
• Food cravings
• Mood swings
• Irritability
• Depression
• Low self-esteem

While there are no diagnostic screenings for the condition, your doctor will likely review your symptoms and medical history to achieve a diagnosis of PMS. Typically, throughout this process it’s recommended that a daily diary should be kept detailing your menstrual cycle for at least two cycles.

While the research is continuing to grow in this area, studies suggest that PMS symptoms may diminish performance in the late luteal phase of your menstrual cycle.

Please note each athlete may perceive their performance and training to be different in each phase and may not necessarily experience all these impacts at same level. Therefore, tracking your menstrual cycle and documenting how you think, feel, and perform during the different stages of your cycle is so important.

Common methods of managing these symptoms include taking tranexamic acid or contraceptive options such as the oral contraceptive pill or Mirena.

lthough there is no single cure for PMS, there are things that you can implement into your treatment plan to combat the symptoms. All tools suggested should be implemented at the discretion of your medical professionals i.e., doctor, dietitian, physio, psychologist etc. These management tools may include:

• Lifestyle changes
  • Ensure you are getting sufficient sleep
  • Engaging in a consistent exercise routine
  • Avoid smoking
  • Reduce caffeine and alcohol intake during your luteal phase

• Dietary changes
  • Eating smaller portions of food more often
  • Decreasing your salt intake
  • Increase your diary intake
  • Increasing your fruit and vegetable intake

Swimming Australia does not endorse the use of supplements due to the known risk of contamination with doping products. Information on supplements can be found via Sport Integrity Australia

If you have concerns about PMS impacting your life and athletic performance, we encourage you to get in touch with Ignite Athlete. We have a network of specialised General Practitioners, fertility specialists and gynaecologists across Australia who will be more than happy to speak with you and discuss your individual circumstances.

With over 50 dedicated specialists across 70 consulting locations throughout the country, our friendly staff can help you choose the right medical professional to guide you and help you achieve your sporting goals.

Premenstrual syndrome (PMS)

The menstrual cycle and athletic performance

Female Performance & Health Initiative – Understanding your menstrual cycle