Premenstrual Syndrome (PMS)

Premenstrual syndrome is a group of physical, emotional, and behavioral symptoms that affect women of childbearing age. PMS starts 1–2 weeks before the start of a woman’s period and goes away a few days after the period starts. It often recurs in a predictable pattern.

PMS can range from mild to severe. When it is severe, it is called premenstrual dysphoric disorder (PMDD). PMS can interfere in many ways with normal daily activities.

What are the causes?

The cause of this condition is not known, but it seems to be related to hormone changes that happen before menstruation.

What are the signs or symptoms?

Symptoms of this condition often happen every month. They go away completely after your period starts. Physical symptoms include:

• Bloating.
• Breast pain.
• Headaches.
• Extreme fatigue.
• Backaches.
• Swelling of the hands and feet.
• Weight gain.
• Hot flashes.

Emotional and behavioral symptoms include:

• Mood swings.
• Depression.
• Angry outbursts.
• Irritability.
• Anxiety.
• Crying spells.
• Food cravings or appetite changes.
• Changes in sexual desire.
• Confusion.
• Aggression.
• Social withdrawal.
• Poor concentration.

How is this diagnosed?

This condition is diagnosed if symptoms of PMS:

• Are present in the 5 days before your period starts.
• End within 4 days after your period starts.
• Happen at least 3 months in a row.
• Interfere with some of your normal activities.

Other conditions that can cause some of these symptoms must be ruled out before PMS can be diagnosed.

How is this treated?

This condition may be treated by:

• Maintaining a healthy lifestyle. This includes eating a balanced diet and exercising regularly.
• Taking medicines. Medicines can help relieve symptoms such as cramps, aches, pains, headaches, and breast tenderness. Depending on the severity of the condition, your health care provider may recommend:
  • Over-the-counter pain medicines.
  • Prescription medicines for PMDD.

Follow these instructions at home:

Eating and drinking

• Eat a well-balanced diet.
• Avoid caffeine and alcohol.
• Limit the amount of salt and salty foods you eat. This will help lessen bloating.
• Drink enough fluid to keep your urine clear or pale yellow.
• Take a multivitamin if told to by your health care provider.

Lifestyle

• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Exercise regularly as suggested by your health care provider.
• Get enough sleep.
• Practice relaxation techniques.
• Limit stress.

Other Instructions

• For 2–3 months, write down your symptoms, their severity, and how long they last. This will help your health care provider choose the best treatment for you.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you are using oral contraceptive pills, use them as told by your health care provider.