remenstrual syndrome, or PMS, is now widely acknowledged to be a medical condition - not a psychosomatic one - affecting many women. Common symptoms include cramps, bloating, breast tenderness, skin problems, depression, irritability, clumsiness, food cravings, tearfulness and fatigue. In some women, these symptoms are debilitating: a 1996 survey of 500 sufferers found that 52 per cent had contemplated suicide and 94 per cent felt their work suffered. But as every woman knows, it's simply not on to call in sick every time you have a bad period.
One of the worst things about PMS is the way it seems to take control of you. You know it's coming, but you can't do anything about it, and dreading it compounds the problem. The first thing to do is to break this cycle. Take control of your PMS: you may not be able to cure it, but you can manage it. The next prerequisite for successful therapy is correct diagnosis. PMS gets a bad name because it is often used as an excuse to conceal other conditions with different causes: resentment, dissatisfaction, depression or physical illness.
To check whether your problem is menstrual, keep a record of your symptoms to see if they recur regularly on a monthly basis. You can print off a menstrual chart (and useful advice) from the website of the National Association for Premenstrual Syndrome (NAPS, see below), or you could use your diary. NAPS recommends using abbreviations (H for headache, B for bloating, P for your period), and keeping the diary for at last three months. You can then use it when you consult your GP, practice nurse or a self-help group.
Selecting a remedy that might be helpful depends on your symptoms. NAPS stresses good nutrition, and recommends eating three balanced meals a day, with lots of starch, fibre and fruit. Avoid caffeine, sugar and salt. Drinking lots of water helps reduce bloating.
Another group, the Women's Nutritional Advisory Service (WNAS), argues that many of the symptoms of PMS are caused by deficiencies of minerals and micronutrients, in particular magnesium, iron and the B vitamins.
A more surprising treatment, called photic stimulation, was developed to treat migraine. It involves shining flickering lights into the eyes for about 15 minutes each day, using a special mask. It sounds wacky, but a study found the masks reduced PMS symptoms substantially.
It is no longer necessary to suffer in silence. By logging your symptoms, you will know what to expect when, and the self-help groups can advise about remedies to treat various symptoms. Just contacting a support group will reassure you that you are not going mad - another common symptom.
There are two PMS support organisations: the National Association for Premenstrual Syndrome (01732 760012, www.pms.org.uk), and the Premenstrual Society (01932 872 560). The Women's Nutritional Advisory Service is on 01273 487 366 or visit www.wnas.org.ukpms.htm For details about photic stimulation masks, costing pound;34.95, contact Lightmask Ltd on 0870 516 8143 or visit www. light-therapy.com