Hello XXXXXXX

Thanks for your query.

Premenstrual symptoms can be seen in some females in second half of the menstrual cycle and usually settle with in 4-7 days after menses.

These symptoms tend to get worse or increased in some women in late 30s and 40s as she approaches the transition to menopause.

Depression, mood swings, sleep disturbances are seen as side effects of the pills.

So if you have these symptoms through out the cycle then you should stop the pills and consult your treating doctor.

At your age you should use contraceptive pills with caution and get regularly examined by the doctor to rule out any possible health risk.

I hope this answer is helpful to you.

Please revert back in case of any query.

Please do accept this answer if you have no further questions.

Take care.
Regards

---

Hello XXXXXXX

Thanks for writing back.

Let’s start with the management part and regarding contraception I will write later.

1. If the PMS are not very severe and you can control yourself then life style changes will help you to reduce them like:-
-Do regular exercise like brisk walking, aerobics.
-Restrict salt intake around 10-12 days before the menstrual period;
-Reduce caffeine intake, wine or alcohol
-Family and friends can provide emotional support during the time of cycle,
-Reduce intake of refined sugars,
-Try sleeping early.

2. In case you have severe symptoms then you may need help of medicines like:-
-Diuretics like Spironolactone(Aldactone) are helpful in women with symptoms like severe fluid retention,bloating, breast tenderness,and weight gain.
-Drugs like bromocriptine, and tamoxifen are used for relieving breast pain and even medicines like danazol to control excess bleeding.
-Certain vitamins and minerals like:-Folic acid, Vitamin B6 and D, E, Calcium, Magnesium
-Evening primrose oil.

3. In very severe cases of anxiety and mood changes anti-anxiety drugs like Fluoxetine a Seletive Serotonin Reuptake Inhibitors (SSRI) group of drug may be needed.

Please discuss with your doctor regarding the role of these medicines in your case. He/she can prescribe it to you if necessary after assessing your condition.

Women after 35 years on regular hormonal pills need to review with a doctor regularly. The reason being -Deep vein thrombosis (DVT), depression, increase in blood pressure, weight gain and changes in vaginal bleeding is seen in increased number in women using it after this age. Since you are closing towards menopause there will already be some hormonal imbalance in your body and hormonal pill may cause more disturbance.

Now the second issue is about contraception, so here you should use non-hormonal methods like:-
-condom for your partner,
-Diaphragm or caps that cover upper part of vagina and cervix,
-Intrauterine device like Copper-T
You may also consider tube ligation too if no method is suitable to you.

Discuss with your doctor which will the most suitable for you.

I hope I have answered all your concerns. If I have missed out on any please write back to me.
And if all your queries are answered, please close this discussion.

Wish you good health.

Regards

---