Book Review

Once a Month: The Original Premenstrual Syndrome Handbook

Katrina Dalton
Hunter House, Inc.

Dalton tries to dispel certain myths about the menstrual cycle, stressing the importance of trying to understand the way the female body works and trying to cope with problems. A point made early is that, while daily bodily functions such as digestion, respiration or growth do not involve pain (unless there is an underlying disease), menstruation and childbirth rarely take place without pain. The author describes the menstrual cycle and its slight variations among women, going on to discuss what happens when this cycle goes awry, and how we can take steps to correct problems.

Dalton defines premenstrual syndrome (PMS) and describes how it is diagnosed, stating that symptoms must be present for three consecutive months, cannot start before ovulation, and must subside after menstruation and be absent for at least seven days. She gives examples of various tools to help patient and doctor monitor symptoms, stating that, while progesterone blood levels may not indicate PMS, a blood test to estimate the binding capacity of sex hormone-binding globulin may be of value. (She acknowledges the limitations associated with this test.) Symptoms particularly helpful in diagnosing PMS are mood swings, premenstrual tension, water retention, and monthly headaches. Dalton indicates that, because of PMS, chronic diseases and their symptoms worsen before menstruation. Painful periods may be one of the first indications that a woman is suffering from PMS; it is important to differentiate between spasmodic dysmenorrhea; congestive PMS dysmenorrhea; and, possibly, endometriosis.

Dalton focuses on helping men understand what women are dealing with and, in instances of cohabitation, what they, too, will be dealing with. The author’s advice to husbands is to be active in their wife’s disease. If the wife is keeping a symptom chart, the husband should participate and help his wife be aware of symptoms. He should accompany his wife to doctor’s appointments and offer information, if needed. Involving the husband can provide someone to help support dietary requirements, as well as to encourage continued progesterone therapy.

The author next looks at three types of women and their daily difficulties in living with PMS: the mother, the working woman, and women at leisure.

The remainder of the book focuses on progesterone for treatment of PMS and in fertility and pregnancy, as well as in surgical and natural menopause. Progesterone receptors are located all over the body: they are concentrated in the lining of the uterus but are also located in the limbic area, nasopharyngeal passages, lungs, eyes, breast and liver. These sites are all subject to PMS symptoms, such as rhinitis, asthma, or mastitis. If a woman suffers from low progesterone, she is likely to notice these and other symptoms. However, Dalton gives some credence to the opinion that, perhaps, PMS is not due to lack of progesterone but to a lack of receptors capable of carrying progesterone into the nucleus of the cell. She offers six rules to be followed when using the hormone and suggests other drug therapies for PMS, emphasizing the three-hourly starch diet as part of PMS treatment.


Reviewed By:  Gina Ford, RPh
In:  Jan/Feb 1998