Problem
Linda Knoll, 35 years old, presents to you at the GYN clinic for her annual physical and pelvic examination. You obtain the following menstrual history: LMP 8 days ago. Periods occur every 29 days and last 5 days. She tells you that she uses superabsorbent tampons during the first 2 days of her period and then changes to regular absorbency tampons for the duration, and that she currently has an IUD in place for contraception. She tells you that her husband has been complaining for the past few months that she seems irritable, tense, and moody near "that time of the month." Linda admits that she doesn't feel well before her period and describes having low pelvic discomfort, breast tenderness, "bloating," and some constipation. She seems to cry easily 2 to 3 days before her period. She has noticed this pattern over the last 4 or 5 months. You recognize these symptoms as related to premenstrual syndrome (PMS).
Linda asks you if these changes are due to female hormones. How would you answer Linda's question concerning female hormones?
After reviewing Linda's diet with her, what would you recommend to help? Linda has an IUD in place. What other type of contraceptive might help reduce the symptoms of PMS? What other activities can you suggest to help Linda reduce PMS symptoms? What should you tell Linda about using tampons during heavy menstrual flow?