R. Wayne Whitted MD, MPH
8740 North Kendall Dr.
Suite 101
Miami, Florida 33176-2212
Phone: 305-596-3744
Fax: 305-596-3676
www.drwhitted.net
Raymond Wayne Whitted MD,
MPH
...dedicated to healthy lifestyles and safe, state-of-the-art
surgery for women of all ages.
Premenstrual Syndrome: The Truth
Many women are only too familiar with the discom-
fort that accompanies their menstrual cycle before
bleeding begins. Indicators of premenstrual syn-
drome (PMS) range from uncomfortable blating,
water retention, breast tenderness,, moodiness, to
severe cramping and debilitating migraine head-
aches.
If you're affected by premenstrual syndrome, ac-
cepting these effects as normal part of your
monthly cycle may help to reduce the anxiety you
feel about PMS. The next step is to go about tak-
ing care of your body in a way that decreases dis-
comfort, if possible.
Long misunderstood, PMS is now formally defined
by the U.S. National Library of Medicine as “a
symptom or collection of symptoms that occurs
regularly in relation to the menstrual cycle, with the
onset of symptoms five to eleven days before the
onset of menses and resolution of symptoms with
menses or shortly thereafter?
Do all Women get Premenstrual Syn-
drome?
Seventy to ninety percent of women of childbear-
ing age are affected by PMS. For about half of
these women, the condition is severe enough to
interfere with daily tasks, and for about ten percent
of women, it’s severe enough to be disabling.
Women at most risk for PMS are between the
ages of 20 and 50, those with at least one child,
and/or a family history or personal history of de-
pression or affective mood disorder.
PMS shouldn't be confused with premenstrual dys-
phoric disorder (PMDD) which is a major premen-
strual mood disorder that can affect 5% of women.
Dr. Whitted is dedicated to safe, state-of-the-art,
innovative surgeries and healthy lifestyles for
women of all ages. In a nurturing environment,
the physicians and staff strive to promote a part-
nership in your healthcare and make every effort
to bridge the sterile science of diseases with your
emotional, physical, and spiritual needs. Every-
one is confronted with difficult healthcare deci-
sions at one time or another. You’ll want your
physician and staff to have the knowledge, experi-
ence, and sensitivity to guide you safely through
the decision-making process.
Dr. Whitted provides comprehensive gynecologic
office and surgical healthcare. He is certified in
laparoscopy and hysteroscopy and is an expert in
advanced gynecologic surgery. He has been a
national speaker, trainer, and researcher in ad-
vanced surgical techniques. In addition, Doctor
Whitted is a Certified Menopause Clinician who
educates, trains, and has done research in the
science of menopause. Finally, he is certified in
advanced colposcopy.
Doctor Whitted offers expert education and care in
the following areas:
If you need surgery, Dr. Whitted usually performs
minimally invasive surgery (Vaginal, laparoscopy
and hysteroscopy) and has many years experi-
ence in these areas.
Abnormal Paps (HPV) Loss of Urine
Abnormal Menstrual Cycles Menopause
Bladder Prolapse Ovarian cysts
Chronic Pelvic Pain Osteoporosis
Endometriosis Rectocele
Ectopic Pregnancy Uterine Prolapse
Family Planning Vaginal Prolapse
Fibroids (Leiomyoma) Well-Woman visit
***Evaluation and Diagnosis of Gynecologic Cancers
Understanding Menstruation and the
Menstrual cycle
A woman’s body usually prepares for pregnancy
about every 28 days. Each woman’s body is unique
but, in general, the menstrual cycle is considered to
begin on the first day of bleeding and continue to the
first day of the next period. For some women, a
menstrual cycle is as short as 23 days or as long as
35 days—and for some women, each month may be
different from the last. What one woman might con-
sider an irregular menstrual cycle another woman
might consider normal.
About mid-cycle, a woman’s body releases an egg
from the ovaries down the fallopian tubes and to-
wards the uterus. The lining of the uterus prepares
for pregnancy by thickening. If the egg remains un-
fertilized (if no sperm reaches it), the extra blood and
tissue that formed in the uterus is shed—this is what
women call their “period.” Then a new menstrual
cycle begins.
Keeping a Menstrual Calendar
Maintaining a menstrual cycle journal or menstrua-
tion calendar will help. Knowing when to expect your
period can help you prepare: eat right, exercise
regularly and keep sanitary supplies handy. This is
also an excellent way to monitor the onset of symp-
toms. Remember PMS occurs always after ovulation
and tends to improve significantly at the onset of the
menses or shortly thereafter. Symptoms that occur
beyond this are not part of PMS.
Preventing PMS through Diet and Exer-
cise
Everything a woman takes into her body—from
sugar and salt to alcohol and drugs—potentially
affects how intensely she suffers from PMS symp-
toms. A preventative lifestyle begins with small,
important lifestyle changes. At the top of the list
are stopping smoking and reducing alcohol intake.
Eat right—despite your cravings! Eating more
fresh fruits and increasing your intake of certain
minerals and vitamins can sometimes mitigate un-
healthy cravings for sugar or salt.
Exercise! Regular exercise can help reduce the
bloating and fluid retention of PMS by improving
blood circulation. It also reduces stress and ten-
sion and increases natural production of beta-
endorphins, which can help prevent or combat mild
depression. Aerobics, walking, jogging, bicycling,
swimming and yoga are a few good ways to exer-
cise.
Here are some helpful hints for preventing or re-
ducing PMS:
Eat a low fat diet
Reduce your intake of sugar and salt
Reduce or eliminate caffeine and alcohol
Exercise regularly: at least three 20-minute
sessions a week
Drink 8-10 glasses of water daily
Increase your intake of calcium and vitamin E.
PMS and the Migraine Diet
The PMS diet, which is a good one for all Ameri-
cans to follow, is also the recommended migraine
diet because it helps balance blood sugar and
avoid energy highs and lows. Women who suffer
from premenstrual migraine headaches and want
to follow a migraine diet may find that they feel bet-
ter by eating five or six small meals at regular three
-hour intervals.
Adequate Sleep: A woman’s body may have
different sleep requirements at different times dur-
ing her menstrual cycle, so obtain adequate rest.
...
dedicated to healthy lifestyles and safe, state-of-the-art, innovative surgery for women of all ages
Avoid Alcohol: Studies have shown that
alcohol can imbalance hormone production and
create irregularities in the menstrual cycle.
Since alcohol is a depressant, it exacerbates
PMS symptoms. It also lower blood sugar level,
which can increase irritability. A 1996 report in
the British Journal of Obstetrics and Gynecology
said that regular alcohol consumption increased
the duration and severity of cramps in women
who suffered from cramping.
Water and fluid Retention: Nutritionists
and many medical doctors recommend that
women who have PMS drink at least six glasses
of water a day and reduce their intake of fat,
sugar and salt. In a healthy adult, drinking more
water does not increase fluid retention—it actu-
ally helps flush fluids from the body as water is a
natural diuretic.
PMS Treatment: Vitamins to Hor-
mone Therapy Diets and vitamins rich in B-
complex are thought to improve symptoms.
One controlled study reported relief from symp-
toms in women who took 1000mg of calcium
daily. At least six different studies have shown
some PMS relief in women who used a daily
vitamin that was high in magnesium (at least
300 mg daily) and minerals. Two controlled
studies validated the benefits of taking at least
300 IU of Vitamin E daily.
Hormone Treatments: Although most
have not been studied, Birth Control Pills may
treat ovarian hormonal “imbalances”. Danazol,
a male-type hormone, has shown ability to re-
duce PMS symptoms. It is taken during the
symptom period (dose = 200mg/day). Proges-
terone cream is used by many to improve pro-
gesterone levels and some see improvement in
symptoms.
Antidepressants: Prozac and Zoloft have
shown, in studies, improvement in symptoms.
Complementary Therapies: Soy, black
cohosh, red clover, evening of primrose oil have
shown promise in reducing PMS symptoms.
Acupuncture may have clinical benefit.