How can I make experiencing PMS easier for my partner?

Q. My wife is unapproachable before her monthly cycle starts. How can I get her to be calmer?

A. "Premenstrual syndrome" (PMS), also known as "premenstrual tension" occurs in the days leading up to the menstrual period. Symptoms are usually not very severe, and most women cope well with them.

Many women experience PMS characterised by various physical and psychological symptoms that can start from a few days to two weeks before a period, with intensity ranging from very mild to severe.

Hormonal fluctuations after ovulation, certain sensitivity to the rising progesterone and decrease in oestrogen, chemical messengers in the brain, genes and environmental factors can all affect the chances of getting PMS.

Most experience milder forms of PMS characterised by breast tenderness abdominal discomfort, bloating, headaches, lower back ache, joint and muscle aches, water retention, poor sleep, skin breakouts and certain food cravings are also common. Some have problems with concentration, mood swings, irritability and exhaustion that may lead to frustration.

Severe PMS can affect your quality of life and relationships, leading to a sense of loss of control over your body and emotions, as experienced by about 20% to 40% of all girls and women. These can be so severe they significantly affect mental health as anxiety or depression is known as premenstrual dysphoric disorder (PMDD) affecting 3% to 8%.

Many women who have PMS cannot always take time off work to relax. Where possible, try meditation, relaxation techniques, exercise more, decrease alcohol and coffee. Have a hot bath, go for a walk, or spend a quiet evening curled up on the sofa or in bed with a book or watching TV.

Because of the prejudiced views that women are irrational and unpredictable at certain times of the month, many have a hard time sharing their experiences of PMS and thus lose out on possible support from a partner, family and friends. Flowers, fulfillment of cravings and a lot of tenderness goes a long way.

The severity can vary from month to month and change over time. It is possible to track your symptoms and keep a diary that you can share with your doctor for a thorough consultation. Some medication can be prescribed to ease some of the symptoms.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za.

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