What is PMS and how does it affect women. What are the common symptoms of premenstrual syndrome. How is PMS diagnosed and treated. Can PMS symptoms change with age. How does PMS impact other health conditions.

What is Premenstrual Syndrome (PMS)?

Premenstrual syndrome, commonly known as PMS, is a complex combination of physical and emotional symptoms that many women experience in the days leading up to their menstrual period. These symptoms typically begin after ovulation and subside shortly after the onset of menstruation.

PMS affects a significant portion of the female population, with up to 90% of women reporting some form of premenstrual symptoms. While the severity of symptoms varies greatly among individuals, for some women, PMS can be disruptive enough to interfere with daily activities and quality of life.

When Does PMS Occur?

PMS symptoms typically manifest about 5-11 days before the start of menstruation and usually resolve within a few days after the period begins. This cyclical pattern is closely tied to the hormonal fluctuations of the menstrual cycle.

Common Symptoms of PMS

PMS symptoms can be broadly categorized into physical and emotional/behavioral symptoms. It’s important to note that the experience of PMS is highly individual, and women may experience different combinations and severities of symptoms.

Physical Symptoms

• Bloating and water retention
• Breast tenderness and swelling
• Headaches or migraines
• Fatigue and sleep disturbances
• Acne flare-ups
• Joint or muscle pain
• Gastrointestinal issues (constipation or diarrhea)
• Food cravings or changes in appetite

Emotional and Behavioral Symptoms

• Mood swings and irritability
• Depression or feelings of sadness
• Anxiety or tension
• Difficulty concentrating
• Social withdrawal
• Changes in libido
• Crying spells
• Increased emotional sensitivity

How many symptoms must a woman experience to be diagnosed with PMS? There is no specific number of symptoms required for a PMS diagnosis. Instead, healthcare providers look at the pattern, timing, and impact of symptoms on a woman’s daily life.

Causes and Risk Factors of PMS

The exact cause of PMS remains unclear, but researchers believe it’s related to the complex interplay of hormonal fluctuations during the menstrual cycle. Several factors may contribute to the development or exacerbation of PMS symptoms:

1. Hormonal changes: Fluctuations in estrogen and progesterone levels are thought to play a significant role in PMS.
2. Neurotransmitter imbalances: Changes in serotonin levels may contribute to mood-related symptoms.
3. Genetic predisposition: Family history of PMS or mood disorders may increase susceptibility.
4. Lifestyle factors: Diet, exercise habits, and stress levels can influence PMS severity.
5. Underlying health conditions: Certain medical conditions may exacerbate PMS symptoms.

Are some women more likely to experience severe PMS? Yes, research suggests that women with a history of depression, anxiety, or other mood disorders may be more prone to experiencing more severe PMS symptoms. Additionally, women in their late 30s and early 40s often report more intense PMS as they approach perimenopause.

Diagnosing PMS: Challenges and Approaches

Diagnosing PMS can be challenging due to the wide range of symptoms and their similarity to other health conditions. Healthcare providers typically use a combination of methods to diagnose PMS:

• Symptom tracking: Women are often asked to keep a detailed diary of their symptoms for at least two to three menstrual cycles.
• Medical history: A comprehensive review of personal and family medical history helps identify potential risk factors and rule out other conditions.
• Physical examination: This helps exclude other possible causes of symptoms.
• Laboratory tests: While there’s no specific test for PMS, certain tests may be conducted to rule out other health issues.

How long should symptoms be tracked to confirm a PMS diagnosis? Most healthcare providers recommend tracking symptoms for at least two to three consecutive menstrual cycles to establish a clear pattern and confirm a PMS diagnosis.

Treatment Options for PMS

Managing PMS often involves a multi-faceted approach, combining lifestyle changes with medical interventions when necessary. The goal is to alleviate symptoms and improve overall quality of life during the premenstrual phase.

Lifestyle Modifications

• Dietary changes: Reducing salt, caffeine, and alcohol intake; increasing complex carbohydrates and lean proteins.
• Regular exercise: Engaging in moderate physical activity can help reduce symptoms.
• Stress management: Techniques such as mindfulness, yoga, or meditation can be beneficial.
• Adequate sleep: Maintaining a consistent sleep schedule can help regulate mood and energy levels.

Medical Treatments

• Over-the-counter pain relievers: NSAIDs can help with physical symptoms like cramps and headaches.
• Hormonal contraceptives: Birth control pills or patches may help regulate hormonal fluctuations.
• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) may be prescribed for severe mood-related symptoms.
• Diuretics: These can help with bloating and water retention.
• Cognitive-behavioral therapy: This can be effective for managing emotional symptoms.

Can dietary supplements help with PMS symptoms? Some women find relief from PMS symptoms through supplements like calcium, magnesium, vitamin B6, and evening primrose oil. However, it’s important to consult with a healthcare provider before starting any supplement regimen, as the efficacy and safety can vary among individuals.

PMS and Age: How Symptoms Change Over Time

The experience of PMS can evolve throughout a woman’s reproductive years. Many women report changes in the severity and nature of their symptoms as they age.

PMS in Younger Women

Teenage girls and women in their 20s may experience more variable PMS symptoms as their hormonal cycles stabilize. Some may find that symptoms become more predictable or manageable over time.

PMS in the 30s and 40s

Women in their 30s often report the most significant PMS symptoms. As women approach their 40s and enter perimenopause, PMS symptoms may intensify due to more erratic hormonal fluctuations.

PMS and Perimenopause

During perimenopause, the years leading up to menopause, many women experience an exacerbation of PMS symptoms. This can include more severe mood swings, irregular periods, and intensified physical discomfort.

Does PMS continue after menopause? No, PMS typically ceases after menopause when menstrual cycles stop. However, some women may experience symptoms similar to PMS during hormone replacement therapy.

The Impact of PMS on Other Health Conditions

PMS can interact with and exacerbate various existing health conditions. Understanding these interactions is crucial for comprehensive management of both PMS and concurrent health issues.

PMS and Mental Health Disorders

Women with pre-existing mental health conditions such as depression or anxiety may experience a worsening of symptoms during the premenstrual phase. This phenomenon, known as premenstrual exacerbation, can make managing these conditions more challenging.

PMS and Chronic Pain Conditions

Conditions characterized by chronic pain, such as fibromyalgia or migraines, may be more severe during the premenstrual period. The hormonal fluctuations associated with PMS can lower pain thresholds and increase sensitivity.

PMS and Autoimmune Disorders

Some autoimmune conditions, like rheumatoid arthritis or lupus, may show cyclical patterns of symptom flare-ups that coincide with the menstrual cycle. PMS can potentially exacerbate these flare-ups.

How can women with chronic health conditions manage PMS more effectively? A holistic approach is often most beneficial. This may include working closely with healthcare providers to adjust medications during the premenstrual phase, implementing stress-reduction techniques, and making targeted lifestyle modifications to address both PMS and the underlying condition.

Premenstrual Dysphoric Disorder (PMDD): When PMS Becomes Severe

While PMS is common and often manageable, some women experience a more severe form known as Premenstrual Dysphoric Disorder (PMDD). PMDD is characterized by intense emotional and physical symptoms that significantly disrupt daily life.

Key Differences Between PMS and PMDD

• Severity: PMDD symptoms are markedly more severe than typical PMS.
• Impact: PMDD significantly interferes with work, school, social activities, and relationships.
• Prevalence: PMDD affects approximately 3-8% of women of reproductive age.
• Diagnostic criteria: PMDD is recognized as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

PMDD Symptoms

PMDD symptoms are similar to those of PMS but are more intense. They typically include:

• Severe mood swings, often including suicidal thoughts
• Intense feelings of anxiety or tension
• Marked irritability or anger
• Persistent and severe depression
• Loss of interest in usual activities
• Difficulty concentrating
• Fatigue or low energy
• Changes in appetite or sleep patterns
• Feeling overwhelmed or out of control

How is PMDD diagnosed and treated? PMDD diagnosis typically involves tracking symptoms over at least two menstrual cycles. Treatment often includes a combination of antidepressants (particularly SSRIs), hormonal treatments, and lifestyle modifications. In severe cases, cognitive-behavioral therapy or other forms of psychotherapy may be recommended.

Navigating PMS in the Workplace and Social Settings

Managing PMS symptoms can be particularly challenging in professional and social environments. Women often face the dilemma of balancing their personal comfort with professional obligations and social expectations.

Strategies for Managing PMS at Work

• Planning ahead: Scheduling important meetings or presentations around your cycle when possible.
• Creating a comfortable work environment: Using heat pads, ergonomic seating, or taking short breaks as needed.
• Communicating with supervisors: If severe symptoms interfere with work, discussing potential accommodations or flexible arrangements.
• Prioritizing self-care: Ensuring adequate rest, hydration, and healthy eating habits during work hours.

Coping with PMS in Social Situations

• Setting boundaries: It’s okay to decline social invitations if you’re not feeling up to it.
• Being prepared: Carrying pain relievers, comfort items, or change of clothes if needed.
• Practicing self-compassion: Recognizing that it’s normal to have off days and not being too hard on yourself.
• Educating friends and family: Helping loved ones understand PMS can foster a more supportive environment.

Should women disclose their PMS symptoms to employers or colleagues? This is a personal decision that depends on individual circumstances, workplace culture, and the severity of symptoms. In some cases, discussing PMS with a trusted supervisor or HR representative can lead to helpful accommodations. However, it’s important to consider potential stigma and privacy concerns.

The Role of Partners and Support Systems in Managing PMS

The support of partners, family members, and friends can play a crucial role in helping women manage PMS symptoms effectively. Understanding and empathy from loved ones can significantly reduce the emotional burden associated with PMS.

How Partners Can Provide Support

• Education: Learning about PMS and its effects can foster understanding and patience.
• Emotional support: Offering a listening ear and validation of feelings without judgment.
• Practical help: Assisting with household tasks or childcare during difficult days.
• Encouraging self-care: Supporting healthy lifestyle choices and stress-reduction activities.

Building a Supportive Network

Beyond partners, having a broader support system can be beneficial. This might include:

• Friends who understand and can offer empathy or distraction
• Support groups for women with PMS or PMDD
• Professional counselors or therapists for additional emotional support
• Healthcare providers who take PMS concerns seriously

How can partners initiate conversations about PMS without seeming insensitive? Open, honest communication is key. Partners can express their desire to understand and support, ask how they can help, and be receptive to feedback. It’s important to approach the topic with empathy and avoid making assumptions or dismissive comments.

Future Directions in PMS Research and Treatment

As our understanding of PMS continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and management of this complex condition. Several promising areas of research are emerging:

Genetic Factors in PMS

Scientists are investigating genetic markers that may predispose women to more severe PMS symptoms. This research could lead to more personalized treatment approaches based on individual genetic profiles.

Hormonal Biomarkers

Researchers are working on developing more precise methods to measure hormonal fluctuations and their impact on PMS symptoms. This could lead to more accurate diagnosis and targeted treatments.

Novel Treatment Approaches

• Selective progesterone receptor modulators: These drugs may help regulate the effects of progesterone on PMS symptoms.
• Nutraceuticals: Advanced formulations of vitamins, minerals, and herbal supplements are being studied for their potential in managing PMS.
• Chronotherapy: Timing medication administration to align with the body’s natural rhythms may enhance effectiveness.

Technological Interventions

The development of sophisticated tracking apps and wearable devices may provide more accurate symptom monitoring and prediction, allowing for proactive management strategies.

What potential breakthroughs in PMS treatment are on the horizon? While it’s difficult to predict specific breakthroughs, the integration of personalized medicine, advanced hormone therapies, and technology-assisted management tools hold promise for more effective and individualized PMS treatments in the future.

As research continues to unravel the complexities of PMS, the hope is that women will have access to more effective, targeted, and personalized approaches to managing this common yet challenging condition. The ongoing efforts to destigmatize PMS and increase public awareness are also crucial steps towards improving the overall quality of life for women affected by premenstrual symptoms.

Premenstrual syndrome (PMS) | Office on Women’s Health

Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. Most women, over 90%, say they get some premenstrual symptoms, such as bloating, headaches, and moodiness.³ For some women, these symptoms may be so severe that they miss work or school, but other women are not bothered by milder symptoms. On average, women in their 30s are most likely to have PMS.⁴ Your doctor can help you find ways to relieve your symptoms.    

What is PMS?

PMS is a combination of physical and emotional symptoms that many women get after ovulation and before the start of their menstrual period. Researchers think that PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant. PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin rising again.

Some women get their periods without any signs of PMS or only very mild symptoms. For others, PMS symptoms may be so severe that it makes it hard to do everyday activities like go to work or school. Severe PMS symptoms may be a sign of premenstrual dysphoric disorder (PMDD). PMS goes away when you no longer get a period, such as after menopause. After pregnancy, PMS might come back, but you might have different PMS symptoms.

Who gets PMS?

As many as three in four women say they get PMS symptoms at some point in their lifetime.⁵ For most women, PMS symptoms are mild.

Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD).⁶

PMS may happen more often in women who:

• Have high levels of stress⁷
• Have a family history of depression⁸
• Have a personal history of either postpartum depression or depression^9,10

Does PMS change with age?

Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause.¹¹

This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse.

PMS stops after menopause when you no longer get a period.

What are the symptoms of PMS?

PMS symptoms are different for every woman. You may get physical symptoms, such as bloating or gassiness, or emotional symptoms, such as sadness, or both. Your symptoms may also change throughout your life.

Physical symptoms of PMS can include:¹²

• Swollen or tender breasts
• Constipation or diarrhea
• Bloating or a gassy feeling
• Cramping
• Headache or backache
• Clumsiness
• Lower tolerance for noise or light

Emotional or mental symptoms of PMS include:¹²

• Irritability or hostile behavior
• Feeling tired
• Sleep problems (sleeping too much or too little)
• Appetite changes or food cravings
• Trouble with concentration or memory
• Tension or anxiety
• Depression, feelings of sadness, or crying spells
• Mood swings
• Less interest in sex

Talk to your doctor or nurse if your symptoms bother you or affect your daily life.

What causes PMS?

Researchers do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role.¹³ These changing hormone levels may affect some women more than others.

How is PMS diagnosed?

There is no single test for PMS. Your doctor will talk with you about your symptoms, including when they happen and how much they affect your life.

You probably have PMS if you have symptoms that:¹²

• Happen in the five days before your period for at least three menstrual cycles in a row
• End within four days after your period starts
• Keep you from enjoying or doing some of your normal activities

Keep track of which PMS symptoms you have and how severe they are for a few months. Write down your symptoms each day on a calendar or with an app on your phone. Take this information with you when you see your doctor.

How does PMS affect other health problems?

About half of women who need relief from PMS also have another health problem, which may get worse in the time before their menstrual period. ¹² These health problems share many symptoms with PMS and include:

• Depression and anxiety disorders.These are the most common conditions that overlap with PMS. Depression and anxiety symptoms are similar to PMS and may get worse before or during your period.
• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Some women report that their symptoms often get worse right before their period. Research shows that women with ME/CFS may also be more likely to have heavy menstrual bleeding and early or premature menopause.¹⁴
• Irritable bowel syndrome (IBS). IBS causes cramping, bloating, and gas. Your IBS symptoms may get worse right before your period.
• Bladder pain syndrome. Women with bladder pain syndrome are more likely to have painful cramps during PMS.

PMS may also worsen some health problems, such as asthma, allergies, and migraines.

What can I do at home to relieve PMS symptoms?

These tips will help you be healthier in general, and may relieve some of your PMS symptoms.

• Get regular aerobic physical activity throughout the month.¹⁵ Exercise can help with symptoms such as depression, difficulty concentrating, and fatigue.¹⁶
• Choose healthy foods most of the time.¹⁷ Avoiding foods and drinks with caffeine, salt, and sugar in the two weeks before your period may lessen many PMS symptoms. Learn more about healthy eating for women.
• Get enough sleep. Try to get about eight hours of sleep each night. Lack of sleep is linked to depression and anxiety and can make PMS symptoms such as moodiness worse.¹²
• Find healthy ways to cope with stress. Talk to your friends or write in a journal. Some women also find yoga,¹⁸ massage,¹⁹ or meditation²⁰ helpful.
• Don’t smoke. In one large study, women who smoked reported more PMS symptoms and worse PMS symptoms than women who did not smoke.²¹

What medicines can treat PMS symptoms?

Over-the-counter and prescription medicines can help treat some PMS symptoms.

Over-the-counter pain relievers you can buy in most stores may help lessen physical symptoms, such as cramps, headaches, backaches, and breast tenderness. These include:

• Ibuprofen
• Naproxen
• Aspirin

Some women find that taking an over-the-counter pain reliever right before their period starts lessens the amount of pain and bleeding they have during their period.

Prescription medicines may help if over-the-counter pain medicines don’t work:²²

• Hormonal birth control may help with the physical symptoms of PMS,¹² but it may make other symptoms worse. You may need to try several different types of birth control before you find one that helps your symptoms.
• Antidepressants can help relieve emotional symptoms of PMS for some women when other medicines don’t help. Selective serotonin reuptake inhibitors, or SSRIs, are the most common type of antidepressant used to treat PMS.²³
• Diuretics (“water pills”) may reduce symptoms of bloating and breast tenderness.
• Anti-anxiety medicine may help reduce feelings of anxiousness.

All medicines have risks. Talk to your doctor or nurse about the benefits and risks.

Should I take vitamins or minerals to treat PMS symptoms?

Maybe. Studies show that certain vitamins and minerals may help relieve some PMS symptoms. The Food and Drug Administration (FDA) does not regulate vitamins or mineral and herbal supplements in the same way they regulate medicines. Talk to your doctor before taking any supplement.

Studies have found benefits for:

• Calcium. Studies show that calcium can help reduce some PMS symptoms, such as fatigue, cravings, and depression.^24,25 Calcium is found in foods such as milk, cheese, and yogurt. Some foods, such as orange juice, cereal, and bread, have calcium added (fortified). You can also take a calcium supplement.
• Vitamin B6. Vitamin B6 may help with PMS symptoms, including moodiness, irritability, forgetfulness, bloating, and anxiety. Vitamin B6 can be found in foods such as fish, poultry, potatoes, fruit (except for citrus fruits), and fortified cereals. You can also take it as a dietary supplement.

Studies have found mixed results for:

• Magnesium.²⁴ Magnesium may help relieve some PMS symptoms, including migraines. If you get menstrual migraines, talk to your doctor about whether you need more magnesium. ²⁶ Magnesium is found in green, leafy vegetables such as spinach, as well as in nuts, whole grains, and fortified cereals. You can also take a supplement.
• Polyunsaturated fatty acids (omega-3 and omega-6). Studies show that taking a supplement with 1 to 2 grams of polyunsaturated fatty acids may help reduce cramps and other PMS symptoms.²⁷ Good sources of polyunsaturated fatty acids include flaxseed, nuts, fish, and green leafy vegetables.

What complementary or alternative medicines may help relieve PMS symptoms?

Some women report relief from their PMS symptoms with yoga or meditation. Others say herbal supplements help relieve symptoms. Talk with your doctor or nurse before taking any of these supplements. They may interact with other medicines you take, making your other medicine not work or cause dangerous side effects. The Food and Drug Administration (FDA) does not regulate herbal supplements at the same level that it regulates medicines.

Some research studies show relief from PMS symptoms with these herbal supplements, but other studies do not. Many herbal supplements should not be used with other medicines. Some herbal supplements women use to ease PMS symptoms include:

• Black cohosh.²⁸ The underground stems and root of black cohosh are used fresh or dried to make tea, capsules, pills, or liquid extracts. Black cohosh is most often used to help treat menopausal symptoms,²⁹ and some women use it to help relieve PMS symptoms.
• Chasteberry .³⁰ Dried ripe chasteberry is used to prepare liquid extracts or pills that some women take to relieve PMS symptoms. Women taking hormonal birth control or hormone therapy for menopause symptoms should not take chasteberry.
• Evening primrose oil. The oil is taken from the plant’s seeds and put into capsules. Some women report that the pill helps relieve PMS symptoms, but the research results are mixed. ²⁹

Researchers continue to search for new ways to treat PMS. Learn more about current PMS treatment studies at clinicaltrials.gov.

Did we answer your question about PMS?

For more information about PMS, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

• Premenstrual Syndrome (PMS) — Information from the American Congress of Obstetricians and Gynecologists
• Premenstrual Syndrome — Information from the National Library of Medicine

Sources

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Page last updated:
February 22, 2021

What it is, symptoms, and treatments

Premenstrual syndrome (PMS) refers to the physical and psychological symptoms that a person may experience before their menstrual period. These can include bloating, headaches, mood changes, and more.

Headaches, bloating, cramps, and mood swings are among the most common PMS symptoms. For some, these symptoms are a minor inconvenience. For others, the symptoms can be so severe that they miss work or school.

Most females experience some degree of PMS. In fact, over 90% report experiencing PMS symptoms in the week or two before their period.

In this article we look at PMS, including its symptoms, causes, treatments, and tips for coping. We also discuss when a person should see a doctor about their symptoms.

PMS refers to the diverse range of physical and psychological symptoms that people experience before their menstrual period.

The exact cause of PMS remains unknown. However, natural fluctuations in hormone levels, especially those of estrogen and progesterone, in the week or two before menstruation are likely responsible for the symptoms.

Estrogen and progesterone levels decrease dramatically after ovulation. This could play a major role in the development of PMS symptoms.

The drop in estrogen levels may affect a person’s serotonin levels. Serotonin is a brain chemical that helps regulate mood, sleep, and appetite, all of which PMS affects.

Severe or debilitating PMS symptoms are not common, and they may indicate the presence of an underlying health condition. Speak to a doctor about any severe PMS symptoms.

Image credit: Stephen Kelly, 2019.

PMS symptoms range from mild to severe. Some people get their periods without experiencing any PMS symptoms at all.

For other people, however, PMS symptoms can significantly affect their ability to perform regular activities and may even reduce their quality of life.

Physical symptoms of PMS can include:

• changes in appetite, such as food cravings
• tender or swollen breasts
• weight gain
• abdominal bloating
• pain in the lower abdomen or menstrual cramps
• constipation or diarrhea
• headaches
• fatigue
• oily skin
• acne, pimple breakouts, and other skin symptoms

Psychological symptoms of PMS can include:

• low mood
• feeling tearful or crying
• irritability or anger
• depression
• increased anxiety
• mood swings
• social withdrawal
• problems sleeping, such as insomnia
• difficulty concentrating
• decreased libido

In PMS, people may also notice that the symptoms of conditions such as diabetes, depression, and inflammatory bowel syndrome worsen.

Also, age can affect the severity of PMS. During perimenopause, which is the transitional period leading up to menopause, people may experience worsening PMS symptoms.

Share on PinterestA person who experiences severe PMS symptoms should speak to a doctor.

People may not realize straight away that their symptoms are related to menstruation, especially if they have an irregular cycle.

Keeping a diary of when symptoms occur can help a person notice patterns. If symptoms occur at roughly the same time each month, or at the same stage in a person’s menstrual cycle, they may be due to PMS. If not, the symptoms may have another cause.

Severe or debilitating PMS symptoms are not common. Speak to a doctor if PMS symptoms get in the way of daily life. In some cases, severe symptoms may indicate premenstrual dysphoric disorder (PMDD) or another medical condition.

Some conditions affecting the reproductive system, such as endometriosis and polycystic ovary syndrome, can cause severe PMS. A doctor can help treat these conditions and reduce a person’s symptom frequency and severity.

People may want to consider seeing a doctor if their PMS symptoms do not improve after trying over-the-counter (OTC) medications, home remedies, or lifestyle changes.

Sometimes, taking hormonal contraception can give rise to PMS-like symptoms. This is because these drugs change the levels of hormones in the body.

These symptoms may be less predictable depending on the type of contraception a person is using. People may notice their symptoms get better after they change birth control.

Estimates for how common PMS is vary.

The Office of Women’s Health explain that over 90% of females report experiencing some PMS symptoms.

A 2017 study into premenopausal females reported that although 75% experience at least one PMS symptom, only 8–20% meet the clinical criteria for a diagnosis of PMS.

According to the American College of Obstetricians and Gynecologists, a healthcare provider will make a clinical diagnosis of PMS when:

• symptoms interfere with daily activities
• symptoms appear 5 days before the period starts and end 4 days within it starting
• symptoms occur for at least 2–3 months

A smaller number of people experience a severe form of PMS called PMDD.

Treatment options for PMS vary depending on a person’s specific symptoms.

People can manage PMS symptoms by taking medications, making dietary changes, exercising, trying self-care methods, and making other lifestyle changes.

Medication

Taking OTC and prescription medication can help relieve painful symptoms, such as abdominal cramps and headaches.

Examples of medication that people take to treat PMS include:

• pain relievers such as acetaminophen, which can help relieve muscle pain, cramps, and headaches
• nonsteroidal anti-inflammatory drugs, which can reduce cramp pain, headaches, and muscle aches
• diuretics, which can help relieve bloating and breast soreness

For severe PMS symptoms, a doctor may recommend that a person starts taking hormonal birth control pills to reduce PMS symptoms. These drugs work by affecting the levels of estrogen and progesterone in the body.

Speak to a doctor about severe PMS. They may prescribe medications to relieve depression, anxiety, or other mood-related symptoms.

Use relaxation techniques

Share on PinterestGentle exercise, such as walking and stretching, can help ease PMS symptoms.

Managing stress and using relaxation techniques, such as deep breathing or meditation, can help regulate emotional imbalances due to PMS.

Other examples of stress management and relaxation techniques include:

• yoga
• tai chi
• stretching
• taking a bath
• going for a walk
• journaling
• speaking with a close friend or loved one
• meeting with a mental health counselor or therapist

Try gentle exercise

Exercising gently can increase estrogen and progesterone levels, which may help reduce PMS symptoms.

A 2018 study involving college-age females found that 1.5 hours of aerobic exercise each week led to improvements in the following physical PMS symptoms:

• nausea
• constipation or diarrhea
• swelling of breasts
• bloating
• flushing
• increased appetite

It is worth noting that uncontrolled external factors, such as sleep patterns, nutrition, and the participants’ living environments, could have affected these results.

In contrast, the results of a 2017 cross-sectional study did not find a significant association between physical activity and improvements in PMS symptoms.

Relieve bloating

Bloating can make a person feel heavy and lethargic. People can reduce PMS-related bloating by:

• not eating salty foods, which make bloating worse
• eating potassium-rich foods, such as bananas
• staying hydrated
• doing gentle exercise

Learn more about how to relieve menstrual bloating here.

Relieve menstrual cramps

Menstrual cramps usually arise a few days before the period starts and can last for several days. Trying home remedies such as applying heat to the abdomen, doing gentle exercise, trying massage, and using essential oils can help.

Learn more about how to relieve menstrual cramps here.

Eat certain nutrients

Making some dietary changes may reduce mild to moderate PMS symptoms. The following are some examples of nutrients that may help a person manage their PMS symptoms:

• Magnesium may help relieve migraine episodes related to PMS. Leafy green vegetables, such as kale and spinach, contain magnesium.
• Fatty acids may help reduce abdominal cramps related to PMS. Good sources include fish, nuts, and green vegetables.
• Calcium supports bone strength and density. Having adequate calcium levels also helps regulate mood, sleep, and food cravings. A 2017 double-blind trial study reported that college-age females who consumed 500 milligrams of calcium daily for 2 months had significant reductions in depression, anxiety, and water retention related to PMS.

Most females experience at least one symptom of PMS. Fluctuations in hormone levels might play a significant role in PMS, but the exact cause remains unknown.

A small percentage of people can develop a severe form of PMS called PMDD.

Taking OTC pain relievers, making appropriate dietary changes, and managing stress may all help reduce PMS symptoms.

People may wish to see their doctor if symptoms do not improve, if they worsen despite treatment, or if they interfere with their ability to perform daily tasks.

Premenstrual syndrome (PMS) – causes, what diseases it occurs in, diagnosis and treatment

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Premenstrual syndrome: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Tearfulness, irritability, unreasonable anger (according to others), pain in the abdomen and lower back, feeling of melancholy and anxiety, headache, swelling – these and many other symptoms are associated with the development of premenstrual syndrome, or PMS. Is PMS a condition that needs to be treated?

Premenstrual syndrome is a complex of pathological symptoms that includes a variety of psycho-emotional, somatovegetative and metabolic-endocrine manifestations that begin during the luteal phase of the cycle, which lasts approximately 14 days before the onset of menstruation, and disappears in its first days.

Thus, all the symptoms of PMS can appear both immediately after ovulation, and one or two days before the start of the next menstruation.

Varieties of PMS

Depending on what symptoms prevail in the manifestation of premenstrual syndrome, the following forms are distinguished:

• edematous;
• cephalgic;
• crisis;
• neuropsychiatric;
• atypical.

The edematous form of PMS is characterized by swelling of the face, legs, fingers, and associated weight gain. Possible manifestations such as engorgement of the mammary glands, sweating, pruritus and functional bowel disorders (constipation, diarrhea, increased flatulence). All of these symptoms disappear at the onset of menstruation and rarely require medical attention.

The cephalgic form of PMS is characterized by severe headaches, often unilateral, throbbing, aggravated by movement. Such pains are accompanied by irritability, hypersensitivity to smells, aggression, nausea, pain in the heart area. The cephalgic form of PMS occurs in women who have suffered a traumatic brain injury or neuroinfection, as well as those suffering from arterial hypertension and other cardiovascular diseases. The pain disappears at the end of the luteal phase of the menstrual cycle.

The crisis form of PMS is characterized by a predominance of sympathoadrenal crises (something similar to panic attacks), accompanied by an increase in blood pressure, increased heart rate, pain in the heart area without changes in the ECG. Such attacks may result in increased urination.

The neuropsychic form of PMS includes a number of symptoms that a woman usually does not pay attention to. They regularly appear before the onset of menstruation and are a reason for consulting a doctor: irritability, tearfulness, insomnia, aggression, depression, fatigue, sexual disturbances, suicidal thoughts and various hallucinations.

The neuropsychic form often co-occurs with other forms, especially in severe cases of PMS.

The atypical form of PMS is rare, passes under the guise of other diseases – bronchial asthma, ulcerative gingivitis or stomatitis, iridocyclitis, myocardiopathy.

According to the severity of the course, a mild form of PMS is distinguished – 2–10 days before menstruation, up to four symptoms appear, while up to two symptoms are expressed to a significant extent.

In severe PMS, more than five symptoms appear 3 to 14 days before the onset of menstruation, and many of them are severe.

Possible causes of premenstrual syndrome

The incidence of PMS depends on the age of the woman. If at the age of 30 years, symptoms of PMS occur only in 20% of women, then after 30 years, PMS occurs in almost every second woman.

Emotionally labile women, asthenic physique, often with a lack of body weight are predisposed to the development of premenstrual syndrome.

Other risk factors for developing PMS include:

• frequent stressful situations at home and at work;
• complicated childbirth;
• history of abortion;
• surgical interventions;
• neuroinfections;
• frequent change of climatic zones;
• the presence of chronic gynecological diseases.

According to modern data, a change in sensitivity to the hormone progesterone is of decisive importance in the development of negative symptoms. The role of the trigger mechanism in the onset of PMS is played by the normal change in the level of sex hormones during the menstrual cycle. In the second half of the cycle (luteal phase), progesterone has the main effect on the woman’s body.

Progesterone indirectly affects the dynamic change in the level of serotonin secretion. It is this system that provides the regulation of mood at the level of neurons.

It is believed that in the luteal phase of the menstrual cycle, there is an increase in the processing time of negative emotions in the structures of the brain and a decrease in control over the level of expression of emotions.

Another mechanism that affects the change in the level of serotonin in the brain is constant stress, prolonged experiences of unresolved conflict situations, fear, expectation of real or imaginary events. Anxiety in most cases increases appetite, and “jamming in a bad mood” leads to the development of flatulence and other dyspeptic disorders (constipation and diarrhea), which contributes to the course of premenstrual syndrome.

Hereditary predisposition plays a huge role in the development of PMS.

Which doctors to contact for PMS

If the manifestations of PMS prevent you from leading a full social and personal life, to solve this problem, you should turn to
gynecologist.

It is important to exclude the presence of other somatic pathology that may worsen the course of the second phase of the menstrual cycle. For this you need to contact
therapist. If necessary, the doctor will refer you to the necessary laboratory and instrumental examinations and consultations of narrow specialists.

If the organic cause of the disease is not found, it is necessary to consult a psychiatrist to determine tactics to overcome anxiety and other stressful conditions.

Diagnostics and examinations for PMS

During the diagnosis of premenstrual syndrome, an important role is played by the patient’s diary for several cycles.

It notes all the symptoms of PMS, their severity in points from 0 to 10.
In the course of exclusion of somatic and neuroendocrine pathology, a complex of laboratory and instrumental diagnostics is performed depending on the symptomatic picture.

• Hormonal blood test: follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, estradiol, adrenocorticotropic hormone (ACTH), thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH).

Follicle Stimulating Hormone (FSH)

Synonyms: Blood test for FSH; Follitropin. Follicle-Stimulating Hormone; follitropin; FSH.

Brief description of the analyte Follicle-stimulating hormone

…

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Luteinizing Hormone (LH)

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Prolactin (+ additional macroprolactin test if prolactin result is above 700 mU/l)

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Estradiol (E2, Estradiol)

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Brief description of the analyte Estradiol
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ACTH (Adrenocorticotropic hormone, corticotropin, Adrenocorticotropic Hormone, ACTH)

Adrenocorticotropic hormone is a pituitary hormone that regulates the production of glucocorticoids in the adrenal cortex.

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Free thyroxine (Free T4, Free Thyroxine, FT4)

Free thyroxine not bound to blood plasma transport proteins.
Synonyms: Blood test for free thyroxine. Free T4; Free Form of Thyroxin.
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Free triiodothyronine (Free T3, Free Triiodthyronine, FT3)

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Free T3.
Brief description of the test substance Triiodothyronine free
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Thyroid Stimulating Hormone (TSH)

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Glucose (in the blood) (Glucose)

Research material

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Cholesterol total (cholesterol, Cholesterol total)

Synonyms: Cholesterol, cholesterol. Blood cholesterol, Cholesterol, Chol, Cholesterol total.
Brief characteristics of the analyte Total cholesterol
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Cholesterol – VLDL (VLDL Cholesterol, VLDL Cholesterol)

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Very Low Density Lipoprotein; VLDL; Very low density lipoproteins.
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LDL Cholesterol (Low Density Lipoprotein Cholesterol, LDL, Cholesterol LDL)

Synonyms: LDL; Low density lipoproteins; LDL; LDL cholesterol; Low density lipoprotein cholesterol; Cholesterol beta-lipoproteins; Beta lipoproteins; Beta LP.
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HDL Cholesterol (HDL Cholesterol)

Synonyms: High density lipoproteins; HDL; HDL; HDL cholesterol; alpha cholesterol; α-cholesterol. High density lipoprotein cholesterol; high density lipoprotein; Alpha-Lipoprotein Cholesterol; α-lipoprotein cholesterol; α-Lp c…

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Glycated hemoglobin (HbA1С, Glycated Hemoglobin)

Synonyms: Blood test for glycated hemoglobin. Glycohemoglobin; HbA1c; Hemoglobin A1c; A1c; HgbA1c; Hb1c.

Brief characteristics of the analyte Glycated hemo…

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Ultrasound of the mammary glands and regional lymph nodes

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Magnetic resonance imaging of the brain and adrenal glands.

Brain MRI

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MRI of the lumbosacral spine

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What to do with PMS

Prevention and reduction of the severity of premenstrual syndrome is based on a change in habitual lifestyle and vitamin therapy.

If possible, it is necessary to exclude stressful situations, sudden changes in climate, the use of combined oral contraceptives.

In addition, caffeine and alcohol should not be abused, it is also advisable to eat small meals throughout the day. To prevent irritability and fatigue, it is recommended to take vitamins B6 and E, magnesium, calcium.

PMS treatment

To reduce the level of anxiety that causes an increase in appetite (“stress eating”), leading, in turn, to dyspepsia, it is recommended to follow a diet aimed at increasing the content of serotonin.

Products with a large amount of tryptophan help in solving this issue: yogurt, cheese, cottage cheese, bananas, mushrooms, dates.

It is also important to observe the rest regime, because a tired person is more sensitive to external stimuli and is capable of inadequate reactions in response to exposure.

Other non-pharmacological methods of treatment include various types of massage, physiotherapy, reflexology and spa treatment.

To relieve stress, aerobic exercise for 20-30 minutes 3 times a week is recommended in the absence of contraindications.

In some difficult cases, and after conducting the necessary studies, the doctor may prescribe hormone therapy with progesterone or estrogen-gestagen preparations. Also, with some forms of PMS, the use of antidepressants and psychotherapy methods is recommended.

Sources:

1. Yakovleva E.B., Babenko O.M., Pilipenko O.N. Premenstrual syndrome. Emergency Medicine, journal. No. 3 (58), 2014, pp. 159-163.
2. Gulieva L.P., Yureneva S.V. Premenstrual syndrome: clinic, diagnosis and therapeutic approaches. Medical Council, journal. No. 2, 2017. P. 106-111.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories can use different research methods and units of measurement to perform the same analyzes.

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What is PMS, how to treat or relieve it – June 14, 2013

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Do you sometimes feel overwhelmed, nervous and lonely? And used to write off their sorrows on PMS? Canadian scientists in a recent study explained that the existence of this syndrome is nothing more than a myth – it’s all about psychology, not physiology. Do Novosibirsk doctors agree with this statement, what can PMS be confused with and what needs to be done to recover from it – in the material below.

Premenstrual tension syndrome (PMS) is a complex symptom complex that occurs 7-14 days before menstruation and is manifested by neuropsychic, vegetative-vascular and metabolic-endocrine disorders.

Scientists from Toronto, who recently published a study that PMS does not exist and that in fact this syndrome is a female excuse for a bad mood, domestic gynecologists immediately disagreed. According to statistics presented by Tatiana Ovsyannikova, head of the reproductive department of the TsNMT clinic, PMS is noted in up to 95% of women of reproductive age, and up to 30 years the frequency of PMS is about 20%, after 30 years it occurs in every second. Every third sufferer resorts to the help of drugs these days, and about 5% of the ladies cannot even go to work.

“7 out of 10 women who come to an appointment with this or that problem also note PMS symptoms,” Rauza Loginova, a gynecologist at the Katharsis clinic, cites many years of personal experience as an example. She adds that while PMS is not recognized as a disease and scientists have been wrestling with its relevance for years, any medical practitioner will tell you that PMS is real in its manifestations. A set of 3-4 symptoms that worsen a week (and for someone even two) before menstruation suggests that premenstrual tension is by no means a fantasy.

PMS is divided into several forms, united by similar symptoms.

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The neuropsychic form of is characterized by sudden mood swings, irritability, anger, tearfulness, depression, up to attacks of aggression. Quite often – all in turn.

The edematous form is associated with fluid retention in the body, which leads to the formation of edema of the hands, legs, increased volume, soreness and engorgement of the mammary glands, possibly increased sweating.

The cephalgic form is characterized by headaches that are often accompanied by nausea and vomiting.

In the crisis form blood pressure rises, pains in the heart appear, heartbeat quickens, a feeling of fear of death appears.

As Nadezhda Krinitskaya, an obstetrician-gynecologist at the Reafan Medical Clinical and Diagnostic Center, explains, the first two forms are most common. Relatively speaking: a woman wants to cry and quarrel at the same time, experiences uncontrollable hunger, eats a whole chocolate bar, eating it with pickles or chips.

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There are so many symptoms of PMS that it is easy to confuse them with a real disease. So, the crisis form can be considered hypertension and coronary disease, the cephalgic form can be confused with migraines or cerebrovascular accident. The edematous form can mask problems with the kidneys and urinary tract. “It is important to distinguish what exactly a woman complains about, because PMS accounts for the peak of female visits to doctors in general,” Nadezhda Krinitskaya recalls.

According to the doctor, the most important thing to do on your own is to analyze the symptoms and find out if they are repetitive and dependent on the day of the cycle.

If headaches and swelling occur in a specific period – from 2 days to 2 weeks before menstruation, then it most likely makes sense to first be examined by a gynecologist, rather than trying to make a diagnosis with a neurologist or urologist.

Doctors painted the portrait of a woman suffering from PMS in different ways. She can be both a full girl and a thin one (due to hormonal fluctuations in one direction or another). But everyone found a common criterion – excessive mental stress. First, PMS hits a young student who stays up at night to study for an exam; then they remember him after 30 years, when career development is underway.

Here it is time to recall the study of scientists from Canada, who decided that PMS is just a mental stress. If we talk about generally healthy women who do not have a hormonal disorder that justifies their mental instability, then the psychological factor really plays a decisive role. And sometimes in general it is the only reason for the occurrence of headaches and irritation.

Among all measures to combat PMS, doctors put psychotherapy and the normalization of work and rest, including diet, physiotherapy, sports and swimming in the pool, in the first place. “This is a common side effect when, during therapy, a woman notes that the painful manifestations of PMS have subsided,” says psychotherapist Igor Lyakh.

PMS is often synonymous with psychological irritation that a woman throws out on others during this period. “Often this is used for manipulation: a woman seems to feel a certain right to express dissatisfaction,” continues Igor Lyakh.

According to the psychotherapist, the most important thing is that a woman has something to save: dissatisfaction with her relationship with her husband, aggression and irritation. The PMS period serves as a subconscious psychological excuse for others to know about it.

A typical example: PMS often manifests itself in women in couples where the spouse wants a child, but for some reason does not become pregnant.