What is Premenstrual Syndrome (PMS). How does PMS affect women’s health. What are the common symptoms of PMS. How is PMS diagnosed and treated. Can lifestyle changes help manage PMS symptoms. What is the difference between PMS and PMDD. How does age impact PMS symptoms.

Decoding PMS: A Comprehensive Overview

Premenstrual Syndrome, commonly known as PMS, is a complex set of physical and emotional symptoms that many women experience in the days leading up to their menstrual period. This condition affects a significant portion of the female population, with over 90% of women reporting at least some premenstrual symptoms. While the severity can vary greatly from person to person, understanding PMS is crucial for women’s health and wellbeing.

What exactly is PMS?

PMS is characterized by a combination of symptoms that occur after ovulation and before the onset of menstruation. These symptoms are believed to be triggered by the dramatic fall in estrogen and progesterone levels that happens if pregnancy does not occur. Typically, PMS symptoms subside within a few days after the period begins, as hormone levels start to rise again.

The Spectrum of PMS Symptoms

PMS manifests differently for each woman, encompassing a wide range of physical and emotional symptoms. Some women may experience mild discomfort, while others might find their daily activities significantly impacted.

Physical Symptoms of PMS

• Breast tenderness or swelling
• Bloating and gastrointestinal issues
• Headaches or backaches
• Fatigue
• Changes in appetite or food cravings

Emotional and Mental Symptoms

• Irritability or mood swings
• Anxiety or tension
• Depression or feelings of sadness
• Difficulty concentrating
• Sleep disturbances

Do these symptoms always indicate PMS? Not necessarily. It’s important to note that while many women experience these symptoms, their presence alone doesn’t automatically mean a PMS diagnosis. The timing and recurrence of symptoms are crucial factors in determining whether someone is dealing with PMS.

Unraveling the Causes of PMS

Despite extensive research, the exact cause of PMS remains somewhat elusive. However, scientists have identified several factors that likely contribute to its development:

1. Hormonal fluctuations: The cyclical changes in estrogen and progesterone levels are believed to play a significant role in PMS.
2. Neurotransmitter imbalances: Changes in serotonin levels may influence mood and emotional symptoms.
3. Genetic predisposition: Family history appears to be a risk factor for PMS.
4. Stress: High levels of stress can exacerbate PMS symptoms.
5. Nutritional factors: Deficiencies in certain vitamins and minerals may contribute to symptom severity.

Is PMS inevitable for all women? While a majority of women experience some degree of premenstrual symptoms, not all will develop PMS. Factors such as overall health, lifestyle, and individual physiology influence whether a woman will experience significant PMS symptoms.

Diagnosing PMS: A Process of Elimination

Diagnosing PMS can be challenging due to the wide range of symptoms and their similarity to other health conditions. However, healthcare providers typically follow a specific set of criteria to determine if a woman is experiencing PMS:

• Symptoms occur consistently in the five days before menstruation for at least three consecutive cycles
• Symptoms end within four days after the period starts
• Symptoms interfere with normal daily activities or relationships

To aid in diagnosis, women are often encouraged to keep a symptom diary for several months, tracking the timing, severity, and impact of their symptoms. This information can be invaluable in distinguishing PMS from other conditions and determining the most appropriate treatment approach.

PMS and Age: How Symptoms Evolve Over Time

The experience of PMS is not static throughout a woman’s life. Many women find that their symptoms change as they age, particularly as they approach menopause.

PMS in Different Life Stages

• Adolescence: Symptoms may begin to appear as menstrual cycles become established
• 20s and 30s: PMS symptoms are often most pronounced during these decades
• Perimenopause: Many women report worsening PMS symptoms as they enter their late 30s and 40s
• Menopause: PMS symptoms cease once menstruation stops

Why do PMS symptoms often worsen during perimenopause? This intensification is likely due to the increased hormonal fluctuations characteristic of the transition to menopause. Women who are particularly sensitive to hormonal changes may find this period especially challenging.

Beyond PMS: Understanding PMDD

While PMS is common, a small percentage of women experience a more severe form known as Premenstrual Dysphoric Disorder (PMDD). PMDD affects less than 5% of women of childbearing age but can have a significant impact on quality of life.

Key Differences Between PMS and PMDD

• Severity of symptoms: PMDD symptoms are more intense and debilitating
• Impact on daily life: PMDD often severely disrupts work, relationships, and daily activities
• Emotional symptoms: PMDD is characterized by more severe mood disturbances, including episodes of depression
• Diagnostic criteria: PMDD has specific diagnostic criteria in the DSM-5

How is PMDD diagnosed? A diagnosis of PMDD requires the presence of at least five specific symptoms, including at least one mood-related symptom, occurring in the week before menstruation and improving shortly after the period begins. These symptoms must be present for most menstrual cycles over the past year and significantly impair daily functioning.

Managing PMS: A Multifaceted Approach

While there is no cure for PMS, various strategies can help manage and alleviate symptoms. The most effective approach often involves a combination of lifestyle changes, natural remedies, and, in some cases, medical interventions.

Lifestyle Modifications

• Regular exercise: Physical activity can help reduce bloating, improve mood, and alleviate cramps
• Stress management: Techniques such as meditation, yoga, or deep breathing exercises can help manage stress-related symptoms
• Dietary changes: Reducing salt, caffeine, and alcohol intake may help minimize bloating and mood swings
• Sleep hygiene: Maintaining a consistent sleep schedule can help manage fatigue and mood disturbances

Natural Remedies

• Calcium and vitamin D supplements: May help reduce mood swings and physical symptoms
• Magnesium: Can potentially alleviate bloating and breast tenderness
• Chasteberry: Some studies suggest this herb may help balance hormone levels
• Evening primrose oil: May help reduce breast pain and mood symptoms

Medical Treatments

• Hormonal birth control: Can help regulate hormonal fluctuations and reduce symptoms
• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) may be prescribed for severe mood symptoms
• Diuretics: Can help relieve bloating and water retention
• Pain relievers: Over-the-counter medications can help manage cramps and headaches

Are there any risks associated with PMS treatments? While many treatments for PMS are safe and effective, it’s important to consult with a healthcare provider before starting any new medication or supplement regimen. Some treatments may have side effects or interact with other medications.

The Impact of PMS on Overall Health

PMS doesn’t exist in isolation; it can interact with and exacerbate other health conditions. Understanding these interactions is crucial for comprehensive healthcare management.

PMS and Mental Health

Women with pre-existing mental health conditions such as depression or anxiety may experience worsening symptoms during the premenstrual phase. Conversely, severe PMS or PMDD can increase the risk of developing mood disorders.

PMS and Chronic Conditions

Several chronic health conditions may be influenced by the hormonal changes associated with PMS:

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Symptoms may worsen premenstrually
• Irritable Bowel Syndrome (IBS): Gastrointestinal symptoms can be exacerbated during the premenstrual phase
• Migraine: Some women experience increased frequency or severity of migraines before their period

How can women manage the interplay between PMS and other health conditions? A holistic approach that addresses both PMS symptoms and the underlying health condition is often most effective. This may involve coordinating care between different healthcare providers and developing a comprehensive treatment plan.

Breaking the Stigma: PMS in Society

Despite its prevalence, PMS has often been stigmatized or dismissed in society. This attitude can lead to underdiagnosis and inadequate treatment, impacting women’s quality of life and professional opportunities.

Challenging Misconceptions

• PMS is not “all in your head”: It’s a real physiological condition with measurable symptoms
• PMS doesn’t affect all women the same way: Symptoms and severity vary greatly among individuals
• PMS is not an excuse for mood swings: While mood changes can occur, they don’t define the condition

Promoting Understanding and Support

Educating both women and men about PMS can help create a more supportive environment. This includes:

• Encouraging open dialogue about menstrual health
• Providing workplace accommodations when necessary
• Ensuring access to appropriate healthcare and treatment options

How can society better support women with PMS? By fostering a culture of understanding and empathy, providing comprehensive health education, and ensuring access to quality healthcare, we can help women manage PMS more effectively and reduce its impact on their lives.

Future Directions in PMS Research

As our understanding of PMS continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and prevention. Some promising areas of investigation include:

• Genetic markers: Identifying genetic factors that may predispose women to severe PMS or PMDD
• Hormonal therapies: Developing more targeted treatments to address hormonal imbalances
• Neurotransmitter research: Exploring the role of brain chemistry in PMS symptoms
• Nutritional interventions: Investigating the potential of specific dietary approaches to manage symptoms
• Mind-body techniques: Assessing the effectiveness of practices like mindfulness and cognitive-behavioral therapy in managing PMS

What potential breakthroughs could change the landscape of PMS treatment? Advances in personalized medicine could lead to more tailored treatment approaches based on individual genetic profiles and symptom patterns. Additionally, a deeper understanding of the complex interplay between hormones, neurotransmitters, and the immune system may pave the way for novel therapeutic strategies.

The Role of Technology in PMS Management

Emerging technologies are also playing an increasingly important role in PMS management:

• Symptom tracking apps: Help women monitor their cycles and identify patterns in symptoms
• Wearable devices: Can track physiological changes associated with the menstrual cycle
• Telemedicine platforms: Provide easier access to healthcare providers for consultation and treatment

How might these technologies shape the future of PMS care? By providing more accurate and comprehensive data, these tools could enable more precise diagnosis and personalized treatment plans. They may also empower women to take a more active role in managing their menstrual health.

Empowering Women Through Education and Support

While medical interventions play a crucial role in managing PMS, empowering women with knowledge and support is equally important. This includes:

• Comprehensive menstrual health education starting at a young age
• Promoting body literacy and awareness of cyclical changes
• Encouraging open communication about menstrual health with healthcare providers
• Fostering supportive communities where women can share experiences and coping strategies

How can women become more proactive in managing their PMS? By understanding their unique symptom patterns, exploring various management strategies, and advocating for their health needs, women can take control of their PMS experience. This proactive approach, combined with support from healthcare providers and loved ones, can significantly improve quality of life for those affected by PMS.

In conclusion, while Premenstrual Syndrome remains a challenging aspect of many women’s lives, our growing understanding of its mechanisms and management strategies offers hope for improved outcomes. By combining medical advancements, lifestyle interventions, and societal support, we can work towards a future where PMS is no longer a significant barrier to women’s health and wellbeing. As research continues and awareness grows, women with PMS can look forward to more effective, personalized approaches to managing their symptoms and maintaining optimal health throughout their menstrual cycles.

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

1. Freeman, E., Halberstadt, M., Sammel, M. (2011). Core Symptoms That Discriminate Premenstrual Syndrome. Journal of Women’s Health; 20(1): 29–35.
2. Dennerstein, L., Lehert, P., Bäckström, T.C., Heinemann, K. (2009). Premenstrual symptoms—severity, duration and typology: an international cross-sectional study. Menopause International; 15: 120–126.
3. Winer, S. A., Rapkin, A. J. (2006). Premenstrual disorders: prevalence, etiology and impact. Journal of Reproductive Medicine; 51(4 Suppl):339-347.
4. Dennerstein, L., Lehert, P., Heinemann, K. (2011). Global study of women’s experiences of premenstrual symptoms and their effects on daily life. Menopause International; 17: 88–95.
5. Steiner, M. (2000). Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. Journal of Psychiatry and Neuroscience; 25(5): 459–468.
6. Potter, J., Bouyer, J., Trussell, J., Moreau, C. (2009). Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population Survey. Journal of Women’s Health; 18(1): 31–39.
7. Gollenberg, A.L., Hediger, M.L., Mumford, S.L., Whitcomb, B.W., Hovey, K.M., Wactawski-Wende, J., et al. (2010). Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study. Journal of Women’s Health; 19(5): 959-967.
8. Endicott, J., Amsterdam, J., Eriksson, E., Frank, E., Freeman, E., Hirschfeld, R. et al. (1999). Is premenstrual dysphoric disorder a distinct clinical entity? Journal of Women’s Health & Gender-Based Medicine; 8(5): 663-79.
9. Richards, M., Rubinow, D.R., Daly, R.C., Schmidt, P.J. (2006). Premenstrual symptoms and perimenopausal depression. American Journal of Psychiatry; 163(1): 133-7.
10. Bloch, M., Schmidt, P.J., Danaceau, M., Murphy, J., Nieman, L., Rubinow, D.R. (2000). Effects of gonadal steroids in women with a history of postpartum depression. American Journal of Psychiatry; 157(6): 924-30.
11. Pinkerton, J.V., Guico-Pabia, C.J., Taylor, H.S. (2010). Menstrual cycle-related exacerbation of disease. American Journal of Obstetrics and Gynecology; 202(3): 221-231.
12. American College of Obstetricians and Gynecologists. (2015). Premenstrual Syndrome (PMS).
13. Dickerson, L., Mazyck, P., Hunter, M. (2002). Premenstrual Syndrome. American Family Physician; 67(8): 1743–1752.
14. Boneva, R. S., Lin, J. M., & Unger, E. R. (2015). Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women. Menopause, 22, 826–834.
15. El-Lithy, A., El-Mazny, A., Sabbour, A., El-Deeb, A. (2014). Effect of aerobic exercise on premenstrual symptoms, haemotological and hormonal parameters in young women. Journal of Obstetrics and Gynaecology; 3: 1–4.
16. Aganoff, J. A., Boyle, G. J. (1994). Aerobic exercise, mood states and menstrual cycle symptoms. Journal of Psychosomatic Research; 38: 183–92.
17. Kaur, G., Gonsalves, L., Thacker, H. L. (2004). Premenstrual dysphoric disorder: a review for the treating practitioner. Cleveland Clinic Journal of Medicine; 71: 303–5, 312–3, 317–8.
18. Tsai, S.Y. (2016). Effect of Yoga Exercise on Premenstrual Symptoms among Female Employees in Taiwan. Int J Environ Res Public Health; 13(7).
19. Hernandez-Reif, M., Martinez, A., Field, T., Quintero, O., Hart, S. , Burman, I. (2000). Premenstrual symptoms are relieved by massage therapy. J Psychosom Obstet Gynaecol; 21(1):9-15.
20. Arias, A. J., Steinberg, K., Banga, A., Trestman, R. L. (2006). Systematic review of the efficacy of meditation techniques as treatments for medical illness. Journal of Alternative and Complementary Medicine; 12(8):817-32.
21. Dennerstein, L., Lehert, P., Heinemann, K. (2011). Global epidemiological study of variation of premenstrual symptoms with age and sociodemographic factors. Menopause International; 17(3): 96–101.
22. Rapkin A. (2003). A review of treatment of premenstrual syndrome and premenstrual dysphoric disorder. Psychoneuroendocrinology; Suppl 3:39-53.
23. The Medical Letter. (2003). Which SSRI?. Med Lett Drugs Ther; 45(1170):93-5. 
24. National Institute for Health Research, U.K. (2008). Dietary supplements and herbal remedies for premenstrual syndrome (PMS): a systematic research review of the evidence for their efficacy.  
25. Ghanbari, Z., Haghollahi, F., Shariat, M., Foroshani, A.R., Ashrafi, M. (2009). Effects of calcium supplement therapy in women with premenstrual syndrome. Taiwanese Journal of Obstetrics and Gynecology; 48(2): 124–129.
26. Office of Dietary Supplements. (2016). Magnesium. 
27. Rocha Filho, F., Lima, J.C., Pinho Neto, J.S., Montarroyos, U. (2011). Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. Reproductive Health; 8: 2. doi: 10.1186/1742-4755-8-2.
28. Johnson, T. L., Fahey, J. W. (2012). Black cohosh: coming full circle? Journal of Ethnopharmacolgy, 141(3): 775-9. doi: 10.1016/j.jep.2012.03.050.
29. Dietz, B. M., Hajirahimkhan, A., Dunlap, T. L., Bolton, J. L. (2016). Botanicals and their bioactive phytochemicals for women’s health. Pharmacological Reviews, 68(4): 1026-1073. doi: https://doi.org/10.1124/pr. 115.010843.
30. Girman, A., Lee, R., Kligler, B. (2003). An integrative medicine approach to premenstrual syndrome. American Journal of Obstetrics and Gynecology, 188 (5), S56–S65.

All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.

Page last updated:
February 22, 2021

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What is premenstrual syndrome (PMS)?

Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The symptoms may range from mild to severe.

What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a severe type of PMS. With PMDD, the symptoms are severe enough to interfere with your life. PMDD much less common than PMS.

What causes premenstrual syndrome (PMS)?

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

What are the symptoms of premenstrual syndrome (PMS)?

PMS symptoms are different for everyone. You may get physical symptoms, emotional symptoms, or both. Your symptoms may also change throughout your life.

Physical symptoms may include:

• Breast swelling and tenderness
• Acne
• Bloating and weight gain
• Headache
• Joint pain
• Backache
• Constipation or diarrhea
• Food cravings

Emotional symptoms may include:

• Irritability
• Mood swings
• Crying spells
• Depression
• Anxiety
• Sleeping too much or too little
• Trouble with concentration and memory
• Less interest in sex

How is premenstrual syndrome (PMS) diagnosed?

You may wish to see your health care provider if your symptoms bother you or affect your daily life.

There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed with PMS, your symptoms must:

• 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

Your provider may wish to do tests to rule out other conditions which may cause similar symptoms.

What are the treatments for premenstrual syndrome (PMS)?

No single PMS treatment works for everyone. If your symptoms are not severe, you may be able to manage them with:

• Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen, to help ease cramps, headaches, backaches, and breast tenderness
• Getting regular exercise
• Getting enough sleep
• Eating healthy foods
• Avoiding salt, caffeine, sugar, and alcohol in the two weeks before your period

Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.

Some women take certain herbal supplements for PMS symptoms. But there is not enough evidence to prove that supplements are effective for PMS. Check with your provider before taking any vitamins or supplements.

If you are not able to manage your PMS symptoms, your provider may suggest prescription medicines. These medicines may also be used to treat PMDD. They include:

• Hormonal birth control, which may help with the physical symptoms of PMS. But sometimes they may make the emotional symptoms worse. You may need to try several different types of birth control before you find the right one.
• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which may help with emotional symptoms.
• Diuretics (“water pills”) to reduce symptoms of bloating and breast tenderness.
• Anti-anxiety medicine to ease symptoms of anxiety.

Dept. of Health and Human Services Office on Women’s Health

• Premenstrual Syndrome (PMS)

  (Mayo Foundation for Medical Education and Research)

• Premenstrual Syndrome (PMS)

  (Department of Health and Human Services, Office on Women’s Health)

  Also in Spanish

• Premenstrual Syndrome (PMS) FAQ

  (American College of Obstetricians and Gynecologists)

• Black Cohosh

  (National Center for Complementary and Integrative Health)

• Chasteberry

  (National Center for Complementary and Integrative Health)

• Evening Primrose Oil

  (National Center for Complementary and Integrative Health)

• Mittelschmerz

  (Mayo Foundation for Medical Education and Research)

  Also in Spanish

• Premenstrual Dysphoric Disorder (PMDD)

  (American Academy of Family Physicians)

• Premenstrual Dysphoric Disorder (PMDD): Different from PMS?

  (Mayo Foundation for Medical Education and Research)

  Also in Spanish

• Water Retention: Relieve This Premenstrual Symptom

  (Mayo Foundation for Medical Education and Research)

  Also in Spanish

• ClinicalTrials. gov: Premenstrual Syndrome

  (National Institutes of Health)

• Article: The effect of progressive muscle relaxation technique and myofascial release technique. ..

• Article: Effect of curcumin on inflammatory biomarkers and iron profile in patients…

• Article: The role of purity and frequency in the classification of perimenstrual. ..

• Premenstrual Syndrome — see more articles

• Normal Female Reproductive Anatomy

  (National Cancer Institute)

• Department of Health and Human Services, Office on Women’s Health

  Also in Spanish

• Find an Ob-Gyn

  (American College of Obstetricians and Gynecologists)

• Menstrual Period: Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

  (Boston Children’s Hospital)

  Also in Spanish

• PMS, Cramps, and Irregular Periods

  (Nemours Foundation)

  Also in Spanish

• Premenstrual Syndrome (PMS)

  (Department of Health and Human Services, Office on Women’s Health)

pms hotel management system: which one to choose

The purpose of this article is to show hoteliers and business owners the points to pay attention to at the initial stages of work, when choosing or replacing an existing PMS.

Personal experiences and decisions

I have been in the hotel business for 15 years now. During this time, a certain experience in managing various types of hotels has been accumulated. And today I want to share with you my experience in choosing a hotel management system.

It so happened that during my work in hotels I managed to approach the issue of using PMS from different angles. In some hotels, I was just a user of an already existing product. In others, I had the opportunity to initially choose the system. Still others had to deal with the transition from one system to another.

It was the experience gained that made it possible to objectively evaluate the process of choosing and owning a PMS, not only as a user at the monitor, but also as the owner of this system with all the operational and content characteristics. Agree, these are different approaches, each of which has its own nuances. For example, someone wants speed and stability, but for someone saving in program and server maintenance is important. Also, when was the last time you asked your employees about the convenience of working on an existing PMS?

Network, franchise and free float

I note right away that in the article I focus on the Russian market and on colleagues who have the opportunity to influence the choice. However, this information will also be useful to other representatives of the hotel business.

You know that many chain or franchise hotels do not have the right to choose systems on their own and are completely dependent on the decision of the head office. This is primarily due to the rules of networks and the presence of already approved standards for the quality of work, as well as maintenance procedures.

Independent hotels themselves decide this issue and often more than once during the entire cycle of the hotel. Personally, I know several cases of transition from one PMS to another. The reasons that led to such decisions and the results obtained will be explained below.

Are you familiar with PMS?

So what is PMS, what is it for, and how to choose it?

If we talk about a short and closer definition for me that explains this concept, then PMS (Property Management System, from the English “Property Management System”) is a system that allows the owner or manager to automate all cycles of guest service: from booking and check-in to the final payment of the guest. And also PMS is an opportunity to organize all business processes in the hotel: from the work of the maid service to full financial reporting.

I would like to note that a number of PMS are not recommended to be implemented in the work of chain hotels. The reason for this is the inconvenience and lack of functionality required for the full operation of the network. As an example, the reasons may be the following:

× Lack of a common database with the possibility of loading guests in any of the hotels.

× Lack of access to deposits of the company or individuals.

× And most importantly – the lack of the possibility of generating general reporting for the network.

Principles for choosing a PMS or 3 steps to choosing an assistant

At the moment, due to the exchange rate of the ruble and a number of other points, Russian products get a big advantage. Undoubtedly, some of them are competitive and worthy of choice. At the same time, our task is not just to fit into the budget and save money, but to acquire the best assistant in business, both for employees and owners. Therefore, I urge you to be objective and focus on functionality, not cost.

How to choose one and only PMS from such a huge range on the market? I would highlight the following steps:

STEP 1. Write down the points that you may not like in the system, including cost indicators.

STEP 2. Compare all these points and compare offers on the market.

Typically, at this stage, your list will narrow down to 3-5 solutions.

STEP 3. This is where things get interesting. Below are my recommendations for this stage:

× It is obligatory to personally meet both the company’s management and the technical management implementing the product. And here it is necessary to solve two nuances:

1. Development and integration.

Often sellers and future users understand the main functions in the program a little differently. It’s good if you manage to see in the eyes of sellers not only the desire to sell the product, but also the desire to make it better, update and adjust it to the modern market. After all, every year more and more applications are released into the world to improve the operation of the hotel, and, as a result, increase the profit of the enterprise. This is where you need to think ahead of time about integrating them with your PMS. It is worth immediately understanding whether the developers are ready to move in this direction or not.

2. Development of an additional interface.

As a rule, system vendors do not refuse to develop new interfaces, but request funds for this that are comparable to the cost of the PMS itself. All this leads to a stalemate, when the user becomes a hostage between the desire to automate the business, on the one hand, and the inability to implement it for financial reasons, on the other.

All this can be avoided thanks to a single meeting with the company’s management. Moreover, they love to do it and will be happy to chat with you!

Important: according to the result of the meeting, there must be a protocol, which should cover all the agreed points and the conditions for their implementation, even if in the form of a regular letter between both parties. At the same meeting, it would be right to ask about previous projects. Be sure to specify which of them were unsuccessful, what is the reason for what happened .

× It is desirable to meet with the current users of this system and those who have changed the system.

Discuss the experience of use, the pros and cons of working. If you are not from a million-plus city, then it makes sense to send your employee on a business trip for personal communication.

Checklist of questions for a personal meeting:

• · Are there any cases where the program freezes/crashes and how often?
• Is information lost after crashes?
• · Support response time, especially at night, on weekends and holidays?
• · Estimated time to resolve the issue?
• · Average time spent on training a new employee?
• · A list of stages and moments where the staff most often makes mistakes?
• · Required Internet speed for stable operation?
• · Regularity of changes in the cost of system maintenance?
• How often are updates released?
• · What is the nature of these updates: a new version or an improvement of the current work?
• · Do I need a separate server?
• · Is there a backup of the entire database and how often does it happen?

etc.

These and other important points must be reflected later in the contract, protecting yourself from unnecessary waste of time in the future.

Basic criteria for system selection or re-evaluation.

For all the time I have worked in the hotel business, I would single out the following:

1. Spectrum of functionality.
2. Operating speed.
3. Easy to use.
4. Reliability.
5. Possibility of development and renewal
6. Use of modern software products in the system.
7. Plasticity of settings.
8. Intuitive and clear interface.
9. The ability to customize the system in accordance with the standards of the hotel.
10. Multiuser.
11. Differentiation of access rights.
12. Orientation to the peculiarities of work on the territory of the Russian Federation (taxes, etc.).
13. Availability of user manual.
14. Timing of complete implantation of the system.
15. Scope of interfaces with other systems.
16. Availability and scope of internal interfaces.
17. Implementation cost.
18. Usage/support cost.
19. Failure statistics and root causes.
20. Product geography.
21. Opportunities and conditions for developers to modify the system for a specific market or the wishes of the customer.

What about data retention law?

A separate point that I would like to draw attention to concerns not only those who are faced with choosing a system, but also those who have been using PMS for a long time and are satisfied with everything.

Surely, each of you, one way or another, heard about the law on the storage of data of citizens of the Russian Federation on servers in Russia. This is the so-called “Lugovoy’s law”, initiated by the Deputy Chairman of the State Duma Committee on Security and Anti-Corruption, a member of the LDPR faction Andrey Konstantinovich Lugovoi. In other words, any PMS falls under the monitoring of this legislation.

At the same time, I would like to draw your attention to the fact that PMS belonging to a Russian product does not mean that it will not be 100% subject to the law that comes into force on September 1, 2015. After all, most services in the Russian Federation use foreign servers for storing and processing data. You will ask why? Good price, stability, technical support and other reasons. We have it much more expensive and less stable. If today the issue of price has been resolved by itself due to the exchange rate, and the foreign server has become comparable to the domestic one, then other parameters have remained unchanged.

Of course, the law can be further pushed back in terms of implementation, but I try to reason on the fact and within the framework of the legislative situation that exists today in the country. Therefore, today it is necessary to pay close attention to this point and ask the creators of PMS to provide their vision of resolving this issue.

PMS demos

As a rule, a potential buyer is given the opportunity to get acquainted with the demo version. I want to draw everyone’s attention to the fact that these versions are completely “raw”, and they lack certain functionality or they have it in a stripped down form.

Of course, the brand of the company and its fame play a role. However, most people in charge of choosing a system make a number of mistakes.

– The first of them, and perhaps the most common: the initial choice of the system according to its own criteria – and only then adapting it to the necessary requirements in the hotel. But it should be the other way around: from the features and requirements of the object to the capabilities of the system itself.

– The second mistake is an attempt to immediately evaluate the return on investment spent on the product.

Here, rather, you need to be patient and wait for an objective understanding of the need for this product for business.

Escort: to be or not to be?

After choosing a system, the most voluminous issue becomes the maintenance of the system in the process of work. As a rule, the following components of service exist in the market:

· Telephone support.

· Helpdesk via e-mail.

· Free swimming and resolving issues through the system administrator, who is in the state.

Technical support can be round the clock or hourly. The manufacturer gives the choice to the consumer which option is preferable. There is usually a monthly fee for this.

Here I would like to draw attention to the fact that a good program does not require constant intervention from outside and provides the necessary and proven functionality in no more than 2-4 months. From experience, the real process of implementation and “grinding in” with the staff and the facility takes place just during this time. Further, a reliable system is simply obliged to work without any significant failures.

Important: these points must also be reflected in the agreements. For example, maintenance payments start only from the third or fourth month of use, and not immediately after installation or pre-installation settings.

At some point, it may seem that you are completely managing on your own and can easily refuse to be accompanied. I would recommend not to do this, since maintenance is not only solving problems, but also various cleaning of databases, clarification and implementation of changes related to legislation or other innovations, support in difficult situations, and so on.

There are programs that require licensed maintenance or updates. In such a case, you should seek free maintenance and updates, that is, at no additional cost, and as new versions are released by the developer. Especially if you pay monthly for maintenance.

Total per PMS?

Let’s talk about the total cost of ownership PMS . I would love to help you see the maximum product pricing listing.

So, what do you pay when implementing PMS? What makes up the price?

Try to fill in the empty lines by putting your price in front of each item. This way you will get the final PMS ownership figure.

Instead of terminals

Always try to take a modular system, and not a system that completely automates all hotel services due to its original functionality. There are two reasons:

1. You always have the opportunity to replace obsolete modules without touching others.

2. You do not create the basis for increasing the cost of maintenance in the event of a 100% need to replace something in the system, for example, due to changes in legislation.

09/05/2015

Hydraulic press for 100 30 tons Werther PR30 PMS 656S hand and foot drive 315900 rub in Moscow and St. Petersburg

Description

Characteristics

Video reviews

OMA 656S PR30/PMS Werther hydraulic press 30 t is a power unit with manual and foot hydraulic drive with the function of adjusting the piston feed rate. An effort of thirty tons is enough to work with cars, SUVs, small commercial vehicles and special equipment.

Werther PR30/PMS (OMA 656S)

• Press height 1920 mm;
• Total press width 1240 mm;
• Total press depth 650 mm;
• Stem tip adjustment up to 160 mm;
• Working table width 790 mm;
• Horizontal cylinder offset;
• Hydraulic two-stroke pump has foot and hand drive;
• Pressure gauge built into the frame;
• Automatic piston return after depressurization;
• Overload valve restricts the system to thirty tons of force for system safety;
• Winch for raising and lowering the working table;
• Automatic handle return;
• Chrome-plated hydraulic cylinder surface;
• V-blocks.

Werther-OMA PR30/PMS 656S Floor press complete with welded frame:

• Hydraulic press
• Pressure gauge
• 2 V block
• Reinforced hose
• Hand winch
• Foot pedal
• Pump
• Manual
• Packaging. plywood box

Replaceable hydraulic fluid according to GOST 17479.3-85 is used in the power device.

We recommend using:

At temperatures from +10 – viscosity 46 (41.4-50.6), Russian-made, it makes no sense to buy expensive ones.
In cold rooms – with a viscosity of 32 (29-35) – LUKOIL, TNK or others

Facts about our work:

• Best price, guaranteed.
• Delivery of goods to the transport company “Business Lines” is free of charge.
• Cash and non-cash payment (including VAT)
• Best Range: All leading brands and popular models are represented
• Qualitatively complete description with three-dimensional photographs and video reviews
• Characteristics of goods indicated on the site may be changed by the manufacturer without prior notice
• Service availability
• Managers on call 7 days a week
• We work honestly and openly, complete information.