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)
Triage Questions
Do symptoms of PMS, such as anxiety, depression or anger cause you to want to harm yourself or someone else?