Health Notes, March 14th 2010, by Sarah Stacey

Helping PMT

After 15 years on the contraceptive pill, Linda, a 34 year old reader who emailed me recently, came off it last year. When  her periods hadn’t returned after several months, her GP did blood tests.  She was diagnosed with hyperprolactinaemia, ie raised levels of the hormone prolactin; this is normally responsible for stimulating breast development in pregnancy and lactation - high levels are abnormal otherwise. 

Consultant gynaecologist Mr Michael Dooley of the Poundbury Clinic (www.mdooley.co.uk) says it’s a common cause of women menstruating irregularly (oligomenorrhea) or not at all (amenorrhea).   Although fertility is suspended, sufferers often produce milk from their breasts (‘galactorrhoea’).  Hyperprolactinaemia can occur at any age, and even occasionally in men and children, but the symptoms are most often picked up in women who should be menstruating.  Other symptoms include reduced libido, erectile dysfunction in men, headaches and visual disturbance (which should be taken very seriously).  It lowers levels of oestrogen so can lead to osteoporosis and bone density should be monitored. 

A common cause of hyperprolactinaemia is a brain tumour, usually benign, in the hormone-controlling pituitary gland.  The tumour can block the production of dopamine, the hormone that regulates prolactin. If initial blood tests are positive, doctors may refer patients for an MRI scan to detect any tumour.  Dopamine blocking drugs (including some anti-depressants and anti-psychotics) may also trigger raised prolactin levels; they may also result from hypothyroidism or polycystic ovarian syndrome, and, commonly, from physical and/or psychological stress.  

Most patients are treated with ‘dopamine agonists’, drugs which reduce prolactin levels.  Linda took cabergoline, which restored regular periods but after six months she ‘started having terrible symptoms of depression and aggression about a week before my period: I could pick a fight with a paper bag! It lasts two or three days, then - as if a switch is turned off - I return to being calm, reasonable and happy.’ 

‘This is classic PMT,’ says Michael Dooley.  ‘She’s suddenly started ovulating – and then whack! into premenstrual symptoms.  Depression is a rare side effect of cabergoline but that would be continuous.’  Linda asks if anything will help ‘these terrible mood swings – I prefer holistic methods if possible.’  Mr Dooley says the symptoms may go with time but meanwhile he recommends the following, which may help anyone with PMT (aka PMS)– remember they’re not magic bullet drugs so allow a couple of months to take effect. 

Eat wholesome low GI food every two to three hours to keep blood sugar levels steady.  (Avoid sugary foods, fruit juices and more than two pieces of fruit daily – fruit sugar is still sugar!) 

Sip eight glasses of still water daily, mainly between meals.  Reduce caffeine and alcohol. 

Exercise 30 to 60 minutes most days (walking, swimming, yoga etc). 

Identify and address stressful areas eg don’t schedule a dinner party just before your period.  Consider homeopathy (www.a-r-h.org) or hypnotherapy. Get plenty of sleep.  If stress is overwhelming, talk to your GP about cognitive behavioural therapy (CBT). 

Try supplements of vitamin B6 (by Lamberts £4 for 100 tablets), D3 (Life Extension, £16.95 for 250 capsules), magnesium (Dynomins, £14.15 for 90 tablets), evening primrose oil (Lamberts 1000mg, £7.97 for 90 capsules)  and the herb chasteberry aka agnus castus (Chasteberry Extract by Nature’s Plus, £17.58 for 60 capsules).   From www.victoriahealth.com (and don’t forget your 5% discount, and free postage for online orders). 

Try acupuncture (www.acupuncture.org.uk), and/or reflexology (www.aor.org.uk) .   

If none of these help, discuss hormonal drug treatment (one of the newer mini-pills or a combine pill) to suppress ovulation with your doctor. 

Enter for the YOU/Beauty Bible Perfume Panel

Scent is one of the great pleasures of life, and as experts now agree that enjoying yourself is a big factor in wellbeing, I’m delighted to invite perfume-loving readers to enter for the YOU/Beauty Bible Perfume Panel.  Just write 250 words on ‘My favourite scent and why’ and email it to to my Beauty Bible co-author Jo Fairley and me at perfumepanel at beautybible dot com, by Monday 26th March.  The only stipulation is that you must be free, if chosen to be one of the ten judges of new summer scents, to come to Associated Newspapers in Kensington, London, on Tuesday 20th April, 2010, between 11.30 and 2.30.  I’m afraid we can’t pay travel expenses but last year’s team all agreed they had a great time.  (You do get refreshments, plus a goodie bag.)  We look forward to hearing from you - don’t forget that deadline of 26th March. 
 

Website of the week: www.kateloganbeauty.com

Rave reviews for facialist Kate Logan’s pure skincare from my allergy-prone colleague Victoria: ‘Kate’s Borage and Calendula Skin Balm (£12.99 for 60 ml) is a skin-healing wonder product, acting as cleanser, eye make-up remover, moisturiser, lip balm and facial massage oil.  I also love Chamomile Flower Water, £8.99 for 50ml, a soothing flower water as a toner at night.’  PS I love the bath oils!