More than personal change: effective elements of symptom management

Symptoms are the most common reason people seek health care. Although the menstrual cycle, a normative process, is not a chronic illness, about 10% to 15% of women experience severe recurring symptoms associated with the menstrual cycle that can be considered a chronic illness. Severe perimenstrual symptoms, although distressing for some women, provide a model for understanding complex gender-specific conditions that include biological, psychosocial, and cultural factors, and have application to other women's health problems such as stress-related conditions (heart disease, arthritis, immune system disorders), psychiatric disorders, or normative menstrual cycle transitions (menarche, postpartum, menopause). The Perimenstrual Symptom Management Program, developed by the author, was evaluated to determine the short-term and long-term effectiveness of a multimodal, nonpharmacological treatment package aimed at relieving the symptom and stress experience as well as increasing health behaviors. Selected results from this longitudinal clinical trial will be presented along with examples of effective elements of personal and environmental strategies for symptom management and health promotion. Recommendations for clinical application of these research findings will be presented with a focus on both patient outcomes and intervention processes for personal and environmental therapeutic change.