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Definition

Premenstrual syndrome (PMS) is a set of bothersome physical and emotional symptoms. They occur 1 to 2 weeks before the start of a period.

The Menstrual Flow

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Causes

The exact cause of PMS is not known. Hormone changes occur in all women around their period. Overall health, daily habits, and other factors may make some more sensitive to these changes.

Risk Factors

PMS most often occurs in women aged 25 to 40 years. Other factors that may increase your chance of PMS include:

  • Stopping birth control pills
  • Major life stress
  • Depression

Symptoms

PMS may cause:

  • Irritability
  • Mood swings
  • Anxiety
  • Depression
  • Low self-esteem
  • Having a hard time concentrating
  • Sleep problems
  • Appetite changes, such as sugar and/or salt cravings or overeating
  • Weight gain
  • Fatigue
  • Bloating
  • Headache
  • Breast swelling and tenderness
  • Palpitations
  • Lightheadedness
  • Belly upset
  • Muscle pain

Diagnosis

The doctor will ask about symptoms and past health. A physical exam may be done.

You may be asked to keep a log of your symptoms. It will include when your symptoms start and stop and the date of your period. The doctor will assume PMS based on these details.

Treatment

There is no one treatment that will cure PMS. Steps may help to ease symptoms. Options include:

Stress Management

Stress can trigger PMS and make symptoms worse. Certain habits and tools can help to ease the effect of stress. Relaxation techniques such as music or deep breathing may help. Massage and hot baths may also help reduce tension in the body.

Diet and Exercise

Diets high in salt, sugar, and caffeine may make PMS worse. Large meals may also increase discomfort. Diet should focus on healthy foods. This includes plenty of fruits and vegetables and healthy proteins. Plan for small, frequent meals throughout the day.

Exercise may also help to decrease symptoms. It should occur on a regular basis not just during period.

Vitamins and Minerals

Vitamins and minerals that may reduce PMS symptoms include:

  • Vitamin E may reduce breast tenderness
  • Calcium may decrease bloating, depression, and aches
  • Magnesium may decrease pain and fluid retention and improve mood
  • Manganese may help control symptoms of menstrual pain

Medicine

The doctor may recommend medicine for some symptoms. Options include:

  • Diuretics—to reduce bloating and fluid build up
  • Pain relievers
  • Birth control pills—to reduce physical symptoms
  • Antidepressants—to reduce emotional symptoms

Therapy

Some symptoms may not be eased with medicine. Therapy can help you better cope with them. Cognitive behavioral therapy is one common option. It may help to reduce frustrations and discomfort.

Prevention

To help reduce your chance of getting PMS, take the following steps:

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Women's Health—Office on Women's Health
http://www.womenshealth.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca/en/health-canada.html

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

REFERENCES:

Premenstrual syndrome. American Congress of Obstetricians and Gynecologists website. Available at: https://www.acog.org/~/media/For%20Patients/faq057.pdf?dmc=1&ts=20120824T1006488269. Accessed September 9, 2020.

Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T113966/Premenstrual-syndrome. Accessed September 9, 2020.

Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.html. Accessed September 9, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG  Last Updated: 09/04/2020