Premenstrual syndrome (PMS)

Most menstruating women have premenstrual syndrome (PMS). A syndrome is a group of signs and symptoms that indicate a disorder.

PMS can be confused with depression. See your doctor for a proper diagnosis.

Signs & Symptoms

As many as 150 physical and emotional symptoms are linked to PMS. The most common ones are:

• Abdominal bloating, weight gain.
• Anxiety and depression.
• Breast tenderness.
• Fatigue.
• Feelings of hostility and anger.
• Feeling irritable.
• Food cravings, especially for chocolate or sweet and/or salty foods.
• Headache.
• Lower backache.
• Mood swings.
• Tension.

For some women, symptoms are slight and may last only a few days before menstruation. For others, they can be severe and last the entire 2 weeks before every period. Also, other problems women have, such as depression, may be worse with PMS. This is known as “menstrual magnification.”

Causes & Diagnosis

The exact cause or causes for PMS are not known. A female’s response to normal monthly changes in estrogen, progesterone and testosterone appear to be involved. So do changes in the level of seratonin, a brain chemical. There is no single test for PMS. Symptoms typically occur during the 5 days before the menstrual period and go away within 4 days after the period begins. Symptoms are not present between days 4 and 12 of the menstrual cycle. Symptoms occur for at least 3 menstrual cycles. PMS usually stops with menopause.

Treatment

• Self-care measures.
• Regular exercise. This includes 20 minutes of aerobic exercise, such as walking or aerobic dance, at least 3 times a week.
• Over-the-counter pain relievers, such as Ibuprofen or naproxen.
• Prescribed medications, such as:
  • A water pill called spironolactone.
  • An anti-anxiety medicine.
  • An antidepressant medicine, such as an SSRI (e.g., fluoxentine or sertraline). This is taken a week or 2 before the menstrual period.
  • Birth control pills.

Self-Care

• Get emotional support.
• Do aerobic exercises. Swim, walk, bicycle, etc.
• Rest. Take naps if you need to.
• Try to avoid stress when you have PMS. Do deep breathing, meditation, and/or yoga. Take a warm bath. Get a massage. Manage stress in ways that work for you.
• Limit or avoid caffeine and alcohol. Avoid tobacco.
• Eat healthy carbohydrate foods. Examples are whole-grain breads and cereals, fruits and vegetables, beans and lentils.
• Have good sources of calcium, such as nonfat milk, nonfat yogurt, collard greens and kale. Choose cereals, juices and plant-based milk that have added calcium. Get good sources of magnesium, too. These include spinach, other green, leafy vegetables, and whole grain cereals.
• Limit salty foods to reduce bloating and fluid retention.
• Satisfy food cravings with a small serving. For example, if you crave chocolate, have a small chocolate bar or add chocolate syrup to skim milk. If you crave salt, eat a small bag of pretzels.
• Record triggers and timing of your symptoms.
• Some vitamin and mineral supplements may help relieve PMS. Ask your doctor if you should take any of them and in what amounts. That goes for herbal supplements, too.
  • Calcium.
  • Magnesium.
  • Vitamin B6.
  • Vitamin E.

For More Information:

Office on Women’s Health

womenshealth.gov

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Premenstrual syndrome (PMS)