Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms that occur during the week or two before a menstrual period. Falling levels of the hormones estrogen and progesterone after ovulation are the most likely cause of these symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762986d37398-1857-49f1-a32b-1c907cc4446c The majority of women will experience PMS symptoms at some point in their reproductive years. Symptoms range from mild and annoying to severe enough to interfere with daily life.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e15434c7-275c-4bfd-8b08-ec5984178815 PMS is tied to menstrual periods, so symptoms of PMS should end completely when periods stop after menopause or during pregnancy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762986d37398-1857-49f1-a32b-1c907cc4446c
Signs and Symptoms of Premenstrual Syndrome (PMS) Symptoms PMS causes both physical and emotional symptoms. Every person has a unique experience with PMS, and symptoms can change during different stages of life.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b928dcb6-39c3-4001-b90e-e8fbec843cbb
Emotional symptoms of PMS include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e074e418-093c-4330-8d32-b557355b9686 Depression Irritability and anger Crying Anxiety Trouble concentrating Loss of interest in sex Sleeping too much or too littlee60dc2a1-f33c-4a05-9b50-8e3e8e597629e4bb0f96-9985-453f-bce8-186dc3e2134c Food cravings or appetite changese60dc2a1-f33c-4a05-9b50-8e3e8e597629e4bb0f96-9985-453f-bce8-186dc3e2134c Physical symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e074e418-093c-4330-8d32-b557355b9686 Bloating Tender or swollen breasts Weight gain Headache Tiredness Body aches Diarrhea or constipatione60dc2a1-f33c-4a05-9b50-8e3e8e597629e4bb0f96-9985-453f-bce8-186dc3e2134c Cramps e60dc2a1-f33c-4a05-9b50-8e3e8e597629e4bb0f96-9985-453f-bce8-186dc3e2134c Increased sensitivity to light and sounde60dc2a1-f33c-4a05-9b50-8e3e8e597629e4bb0f96-9985-453f-bce8-186dc3e2134c
Causes and Risk Factors of Premenstrual Syndrome (PMS) Causes The exact cause of PMS is unknown. It’s likely that hormone changes during the menstrual cycle are behind these symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292a7580be-0343-425d-b245-6e1813d8df57 Normally, levels of estrogen and progesterone rise in the early part of the menstrual cycle to prepare a woman’s body for pregnancy. If a pregnancy doesn’t occur, hormone levels drop and the uterine lining sheds in a period.e60dc2a1-f33c-4a05-9b50-8e3e8e597629392f2997-e562-451a-846d-cab80414bae1 Declining estrogen levels cause lower levels of the brain chemical serotonin, which plays a role in mood, sleep, sexual desire, and other body functions. Having less serotonin may contribute to PMS symptoms. Certain lifestyle factors, including eating junk food, drinking coffee, not exercising, and not sleeping well, are associated with PMS. It is difficult to know whether these are causes of PMS symptoms or a result of PMS itself.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299b2fb8a3-7da2-4ec5-8e3c-ea1f8e1deb7e A history of postpartum depression , a history of anxiety or depression (in yourself or your family), and high levels of stress can also increase your risk for PMS.e60dc2a1-f33c-4a05-9b50-8e3e8e59762924e3a745-3754-468a-bdff-5f3cfd215f6a
How Is Premenstrual Syndrome (PMS) Diagnosed? Diagnosis There are no specific tests for PMS, but other tests can rule out conditions with similar symptoms, such as thyroid disease or a mood disorder like depression or anxiety.e60dc2a1-f33c-4a05-9b50-8e3e8e597629afaf8024-6134-416a-9774-8e6e1dbcdec0 Doctors usually diagnose PMS based on symptoms alone. Tracking your PMS symptoms in a calendar or app for two months can help your doctor more accurately diagnose you. Write down when your symptoms start and how long they last each menstrual cycle.e60dc2a1-f33c-4a05-9b50-8e3e8e597629afaf8024-6134-416a-9774-8e6e1dbcdec0 To meet the diagnostic criteria for PMS, symptoms have to:e60dc2a1-f33c-4a05-9b50-8e3e8e59762966c39e6e-d91f-4c61-8d79-90cd2be46c90 Start within five days before a period and happen at least three months in a row Stop within four days after the period starts Affect at least some daily activities
Treatment and Medication Options for Premenstrual Syndrome (PMS) Treatment Many women can manage PMS with lifestyle changes alone. Medications help with more severe or bothersome symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d8c1f93f-028b-4832-8ebb-3aa52633cc6f Medication Options PMS treatments include a combination of over-the-counter and prescription medicines that relieve both physical and emotional symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve) help with symptoms like headaches, cramps, and breast soreness. You can take an NSAID at the start of or right before your period to reduce these symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629827cf210-35fd-490f-8082-9fa60d7cc82f Avoid using these medicines long-term, because they can cause side effects like stomach bleeding and ulcers (sores).e60dc2a1-f33c-4a05-9b50-8e3e8e5976297739df59-326f-4dce-ba6b-e1d2d5cfb0c3 Hormonal birth control methods like the pill stop ovulation, which may lessen PMS symptoms. You may need to try a few types of birth control to find one that helps.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297739df59-326f-4dce-ba6b-e1d2d5cfb0c3 Antidepressants improve depression and other mood changes related to PMS, but they don’t work for everyone. Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft) are the antidepressants most often used for PMS. To prevent PMS-related mood changes, many women only use them in the two weeks before a period, whereas others take them daily.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d8c1f93f-028b-4832-8ebb-3aa52633cc6f Diuretics, also called water pills, remove extra fluid from the body. They can help with symptoms like bloating and breast soreness. Diuretics should not be combined with NSAIDs, as they may cause kidney problems when taken together.e60dc2a1-f33c-4a05-9b50-8e3e8e597629827cf210-35fd-490f-8082-9fa60d7cc82f
Complementary and Integrative Therapies Some people take herbal supplements like evening primrose oil, black cohosh, chasteberry, or St. John’s wort to relieve their PMS symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629343c902f-8e8b-49ea-8859-aba12e0f78ff While some supplements do seem to help, others either haven’t been studied in clinical trials or don’t have enough evidence to confirm that they work. Because the Food and Drug Administration (FDA) doesn’t regulate supplements like it does medications, talk to your doctor before trying any natural products. These vitamins and minerals have more evidence to support their use for PMS: Calcium may help with symptoms like tiredness, food cravings, and depression.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd820a30-3a15-4d14-aec6-0488f6dfb2c7The recommended dose is 1,200 milligrams (mg) a day, which can come from foods like dairy (milk, cheese, yogurt) and fortified products (juice, cereals), or from a supplement.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef9bb46-abaa-43fc-926b-33c8226d198a Vitamin B6 might be helpful for mood changes, anxiety, irritability, and bloating. This vitamin is found in foods like fish, chicken, potatoes, and fortified cereals, or you can get it from a supplement.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd820a30-3a15-4d14-aec6-0488f6dfb2c7 The recommended dose for PMS is 50 to 100 mg daily.e60dc2a1-f33c-4a05-9b50-8e3e8e597629343c902f-8e8b-49ea-8859-aba12e0f78ff Magnesium is thought to reduce bloating, breast soreness, mood symptoms, and menstrual migraines .e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef9bb46-abaa-43fc-926b-33c8226d198a e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd820a30-3a15-4d14-aec6-0488f6dfb2c7 This mineral is found in foods like leafy green vegetables (spinach), whole grains, nuts, and fortified cereals.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd820a30-3a15-4d14-aec6-0488f6dfb2c7 Omega-3 fatty acids from fish, flaxseeds, and leafy green vegetables may be helpful for reducing cramps.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd820a30-3a15-4d14-aec6-0488f6dfb2c7 Some people find these complementary practices helpful for relieving PMS symptoms: Yoga Not only does this series of poses strengthen the body, it also improves PMS symptoms like bloating, sore breasts, and cramps.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296f73b20a-b4cb-4799-93e8-c50416737d3c Meditation Focusing and calming the mind with meditation reduces stress, which may be helpful for PMS symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629322d444b-fe87-417f-9d03-03f988e0b238 Massage Therapy This treatment is used to reduce stress, release muscle tightness, and help you relax.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef9bb46-abaa-43fc-926b-33c8226d198a Biofeedback In this treatment, you’re connected to a device that helps you learn how to control body functions such as heart rate, breathing, and muscle activity. Biofeedback helps to promote a state of relaxation.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef9bb46-abaa-43fc-926b-33c8226d198a Self-hypnosis With this technique, you put your mind into a deep state of relaxation and then use the power of suggestion to change behaviors and improve symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef9bb46-abaa-43fc-926b-33c8226d198ae60dc2a1-f33c-4a05-9b50-8e3e8e59762992186fa9-78fd-43f8-a47e-02aff56a66a6
Lifestyle Changes for Premenstrual Syndrome (PMS) Lifestyle Changes Lifestyle changes like exercising, eating a nutritious diet, sleeping well, and not smoking may reduce PMS symptoms or make them more manageable.e60dc2a1-f33c-4a05-9b50-8e3e8e597629105f16cf-3b39-4a18-8ecc-febf391f932f Sometimes these changes alone are enough to relieve symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629021e899b-3a5d-4c47-8972-9379b1c82966 Eat a Well-Balanced Diet Focus on foods that are rich in nutrition, such as vegetables, fruits, whole grains and legumes (brown rice, beans, whole wheat bread), and dairy products (milk, yogurt). Cut back on fat, sugar, and salt. Eating more complex carbs like leafy green vegetables and whole grains keeps blood sugar levels steady, and may help with moodiness.e60dc2a1-f33c-4a05-9b50-8e3e8e597629516d0b2c-d701-45a1-9269-ff8eb59b511b Drink more fluids, especially water. Avoid sugary sodas, alcohol, and caffeinated beverages.e60dc2a1-f33c-4a05-9b50-8e3e8e597629021e899b-3a5d-4c47-8972-9379b1c82966 Some women find that they feel better when they eat smaller meals or snacks throughout the day instead of three large meals. Eating this way keeps blood sugar levels steady, which can help with food cravings and mood.e60dc2a1-f33c-4a05-9b50-8e3e8e597629516d0b2c-d701-45a1-9269-ff8eb59b511b Stay Active Aerobic exercises like walking, jogging, bike riding, and swimming are good for the heart, lungs, and the rest of your body. Being active also improves energy levels and mood.e60dc2a1-f33c-4a05-9b50-8e3e8e597629516d0b2c-d701-45a1-9269-ff8eb59b511b Yoga is a mind-body form of exercise that can help with anxiety and stress.e60dc2a1-f33c-4a05-9b50-8e3e8e597629021e899b-3a5d-4c47-8972-9379b1c82966 Ideally, try to get at least 30 minutes of exercise on most days of the week.e60dc2a1-f33c-4a05-9b50-8e3e8e597629516d0b2c-d701-45a1-9269-ff8eb59b511b The general recommendation by the American Heart Association for adults is 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290bb628be-b7a2-4055-b932-04da600f0680 Practice Good Sleep Hygiene A lack of sleep can worsen PMS mood symptoms. The goal is to get eight hours of sleep a night, but that can be hard to do.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299eb72384-8eed-4994-b7bd-b562c17fc255 Hormone changes in the weeks leading up to a period can lead to sleepless nights. “Period insomnia” is the name for sleep issues related to the menstrual cycle.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293e7418a0-4e1b-4d9d-a0b3-ea117377cbf7 To sleep longer and more soundly, try these tips:e60dc2a1-f33c-4a05-9b50-8e3e8e5976293e7418a0-4e1b-4d9d-a0b3-ea117377cbf7 Keep your bedroom dark, quiet, comfortable, and cool. Try to go to bed and wake up at the same time each day. Exercise for 30 minutes early in the day, preferably outside where you’re exposed to sunlight. Avoid known sleep disrupters like alcohol and caffeine before bedtime. Do something calming before bed, like taking a warm bath, reading a book, or meditating. Stop Smoking Along with its other harmful health effects, smoking increases the risk of PMS and makes its symptoms worse.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291a6dddff-ceaa-4570-a184-abc1c88e2d91 Quitting is easier said than done because tobacco is very addictive. A doctor can offer advice on methods to help you stop smoking .
Premenstrual Syndrome (PMS) Prognosis Prognosis and Outlook PMS symptoms can range from mild to severe enough to disrupt your daily life. With treatment, most people get relief from symptoms. PMS should improve on its own once your period starts.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977b8156a-5162-4494-a7fc-7e3bcc6c4e18 After menopause, when periods stop, you should no longer have to deal with PMS symptoms. Women who have their ovaries removed before menopause , called oophorectomy, will no longer have PMS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a6f697e-7642-4f01-81ff-7f129dd1fef8
How Many People Have Premenstrual Syndrome (PMS)? Research and Statistics Up to 75 percent of women have at least some PMS symptoms during their reproductive years. Between 3 percent and 8 percent of women have severe PMS symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e5145c9c-7780-4bc5-9ee2-f65160a42d37 Premenstrual dysphoric disorder (PMDD) is a more severe and less common form of PMS. It affects between 5 percent and 10 percent of women during their reproductive years.e60dc2a1-f33c-4a05-9b50-8e3e8e59762909daab1f-05fd-449b-bb75-f50f2306d3f7
Related Conditions to Premenstrual Syndrome (PMS) Related Conditions Other conditions may worsen during the same time period as PMS, due to the hormonal changes occurring in the body. You might experience worse migraine attacks, asthma, allergies, and seizure disorder at the same time as PMS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f690128a-ea0b-4de5-b646-beea8a2f2e92 These mental health conditions often occur together with PMS: Major depressive disorder is persistent sadness and loss of interest in daily activities.e60dc2a1-f33c-4a05-9b50-8e3e8e59762972e1135e-b2d9-45fd-8a57-d71a2246a854 Dysthymic disorder is a milder, long-term form of depression.e60dc2a1-f33c-4a05-9b50-8e3e8e59762958a9e615-bda2-4e6f-ab60-c35fc7bf8b6c
The Takeaway Premenstrual syndrome (PMS) is a group of physical and emotional symptoms that occur a week or two before a menstrual period. About 75 percent of women experience PMS at some point during their reproductive years. Treatments like NSAIDs, birth control pills, and antidepressants help to relieve PMS symptoms. Some women find that lifestyle changes like exercise, a well-balanced diet, and relaxation techniques improve their symptoms.
Resources We Trust Mayo Clinic: Premenstrual Syndrome (PMS) Office on Women’s Health: Premenstrual Syndrome (PMS) The American College of Obstetricians and Gynecologists: Premenstrual Syndrome (PMS) Mind: Premenstrual Dysphoric Disorder (PMDD) International Association for Premenstrual Disorders (IAPD): Support