Premenstrual Syndrome (PMS)

What is premenstrual syndrome (PMS)?

Premenstrual syndrome or PMS is a group of physical and emotional symptoms many people may have in the days before their period starts. Symptoms usually stop when the period starts or shortly after. It’s thought to be related to the changing hormone levels of the menstrual cycle.

Lifestyle changes and sometimes medicine are used to treat PMS.

What causes PMS?

The cause of PMS is unclear. It seems to be related to hormone fluctuations in the body. Changes in brain chemicals may also play a role.

What are the symptoms of PMS?

Symptoms may be slightly different for each person. The following are the most common symptoms of PMS:

• Irritability and mood swings

• Trouble sleeping

• Anxiety

• Bloating and fluid buildup

• Constipation or diarrhea

• Backache or headache

• Tender breasts

• Forgetfulness and trouble concentrating

• Acne

• Food cravings

The symptoms of PMS may look like other conditions or medical problems. Talk with a healthcare provider for diagnosis.

How is PMS diagnosed?

There are very few additional tests aside from a complete health history and physical and pelvic exam. Your healthcare provider may ask that you keep a journal of your symptoms for several months. This is to better assess the timing, severity, onset, and duration of symptoms.

How is PMS treated?

Your healthcare provider will consider your age, overall health, symptoms and other factors when finding the best treatment for you.

Lifestyle changes and sometimes medicines or an herbal remedy can help manage PMS symptoms. Medicines include:

• Water pills (diuretics) before symptoms start to reduce fluid buildup

• Nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, to reduce pain

• Birth control pills  

• Medicines used to temporarily stop ovaries from making estrogen and progesterone

• Antidepressants

Herbal remedy:

• Chasteberry (Vitex agnus castus) may be a treatment choice for people with mild premenstrual symptoms.

Lifestyle changes:

• Changing your diet to eat more protein and less sugar and caffeine

• Taking vitamin supplements, such as vitamin B-6, calcium, and magnesium

• Getting regular exercise

• Managing your stress

Can PMS be prevented?

For some people, making lifestyle changes helps to reduce the occurrence of PMS symptoms. These changes may include:

• Exercise most days of the week.

• Eat a well-balanced diet. Eat more whole grains, vegetables, and fruits, while eating less salt, sugar, caffeine, and alcohol.

• Get enough sleep and rest.

• Don’t smoke.

When to call your healthcare provider

Call your healthcare provider if you have symptoms of PMS that interfere with your ability to carry out your normal daily activities.

Key points about premenstrual syndrome

• Premenstrual syndrome (PMS) is a group of physical and emotional symptoms many people may have in the days before their period starts. Symptoms usually stop when the period starts or shortly after.

• It's thought to be related to the hormone changes of a person’s menstrual cycle.

• Lifestyle changes and sometimes medicines are used to treat PMS.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends or holidays.