Exercise Is a Winner in Battle With PMS : Health: The symptoms of premenstrual syndrome appear less severe if a woman adds exercise to her daily regimen.

Premenstrual syndrome has numerous treatments even though doctors still don’t know its exact cause. But the good news for women who suffer from PMS is that experts say a regular program of exercise can relieve many of its physical and emotional symptoms.

Normal premenstrual symptoms, called “molimina,” can include moodiness, increased appetite, bloating and breast tenderness. While PMS has similar symptoms, what sets it apart is the severity of those symptoms.

Although there are more than 70 different treatments for PMS, many of which are contradictory, untested, expensive or have unknown long-term effects, exercise is often recommended.

“Regular exercise has very real benefits for women with PMS,” says Dr. Joan Ullyot, a San Francisco sports medicine physician and psychologist who is also a world-ranked masters distance runner.

“Regular exercisers may have some sort of bloating and sluggishness in premenstrual days, but the mood problems are often eliminated.” Ullyot believes that it’s the profound effect that exercise has on the hormones of the brain, uterus and ovaries that brings about these psychological changes.

Dr. Jerilynn C. Prior, an associate professor of endocrinology at the University of British Columbia, also recommends a conditioning exercise program not only because of its effect on hormones, but also because exercise reduces fat levels, a key in relieving PMS symptoms.

In a controlled six-month study of three groups of women, Prior found that breast and fluid-related symptoms were reduced in formerly sedentary women who started to run a mile a day. The reason? Most likely, she theorizes, because the hypothalamus, the site in the brain where premenstrual symptoms originate, may have been suppressed by exercise and resulting weight loss.

A case in point is that of Justine Malinski, a 41-year-old Oak Park, Ill., biochemist. Two years ago, the demands of graduate school, coupled with a sore knee, forced her to stop running. She usually ran 50 miles a week. When she stopped exercising, Malinski developed the symptoms of PMS. “My body seemed out of control, and I only had one week of good health a month,” Malinski recalls now.

“Fourteen days before my menstruation, my PMS symptoms would range from paranoia, fatigue, water retention and bloating. It was difficult bending down to tie my shoes because of the fullness in my middle, and I was easily irritated,” she remembers.

“I also had an extreme craving for good food but could never satisfy it. The worst symptom, though, was breast tenderness. They would change size, and I would often wake in the middle of the night in pain.”

As the months passed, Malinski desperately sought solutions. She took doses of vitamin B6 for a while, ate several small meals during the day and eliminated fats, refined sugars and caffeine from her diet. Nothing worked.

“The emotional component was terrible,” she says. “I was often angry and, when little things started to bother me, I had to constantly force myself to breathe in and breathe out to keep my anger in.”

This spring, her knee rehabilitated, Malinski joined a group of women who go for one long run a week and average 11-16 miles each workout. The effect on her PMS symptoms was miraculous, she says.

“My weekly run was enough to completely eliminate all of my breast tenderness as well as reduce much of the water retention and bloating,” Malinski says. She is convinced that exercise was the only reliable treatment for her PMS symptoms.

“For most women with PMS, exercise is one of the first interventions I would recommend,” says Dr. Sally K. Severino, an associate professor of psychiatry at New York Hospital-Cornell Medical Center in White Plains, and author of “Premenstrual Syndrome: A Clinician’s Guide.”

“Exercise isn’t harmful for someone with PMS, and it can help relieve water-retention problems and improve self-esteem,” she says.

Women with PMS who don’t exercise will, for the most part, experience a beneficial response from exercise, says Dr. Michelle Warren, the head of reproductive endocrinology at St. Luke’s-Roosevelt Hospital Center in Manhattan.

Warren’s approach to PMS is to look for possible hormonal imbalances. If appropriate, she offers hormonal treatment and recommends exercise. “I tell my patients to perspire for 20 minutes, three to four times a week. Their resulting improvement is probably linked to endorphins and an improved sense of self-esteem,” Warren says.

Consistency Is Key

The medical experts conclude that the type of aerobic exercise performed seems to have no bearing on the amount of relief from PMS symptoms. If you like to run, bicycle, swim or take aerobics classes, then do so. What’s extremely important, they say, is that the exercise be consistent, every week, with allowances for how you feel.

“Don’t think you have to push yourself through a tough workout if you don’t feel that good,” cautions Ullyot. “Don’t be so tough on yourself. There are times when it’s just better to go easy or else take a rest.”

“Most women can tolerate PMS symptoms such as bloating, breast tenderness and constipation, but what really causes them to seek medical help is when they develop emotional symptoms,” Severino says. “They don’t like being irritable, angry, depressed or anxious, and they want help.”

“It’s important for women to know that PMS is a recognized symptom, that it’s cyclic, and that it improves with certain forms of therapy,” Warren says.

Although there is no specific treatment for PMS (placebos work in many cases, Warren notes), and the scientific explanation for PMS is still vague, Warren believes an expert should still be consulted for help.

“PMS falls on the edge of science,” she says, “and we’re in an area where people are doing a lot of research. If you think that you have PMS, it’s best to consult a PMS specialist, someone who’s usually a reproductive endocrinologist. Most major hospitals will be able to make recommendations.”

The Melpomene Institute, a center for research and public education on the health concerns of physically active women, has a PMS information packet available for $7.50. For requests or further information, write the Melpomene Institute, 2125 E. Hennepin Ave., Minneapolis, Minn. 55413.