Premenstrual Syndrome (PMS)

What is premenstrual syndrome (PMS)?

Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as Premenstrual syndrome or PMS. Symptoms usually stop once the period starts. It’s thought to be related to the changing hormone levels of the menstrual cycle. Lifestyle changes and sometimes medicine are used to treat PMS.

What causes PMS?

The cause of PMS is unclear. It seems to be related to hormone fluctuations in the body. Changes in brain chemicals may also play a role.

What are the symptoms of PMS?

Symptoms may be slightly different for each woman. The following are the most common symptoms of PMS.

• Emotional symptoms include the following:
  • Depression and Irritability
  • Angry outbursts
  • Anxiety and Confusion
  • Crying spells and Social withdrawal
  • Increased nap taking
  • Poor concentration and Insomnia
  • Changes in sexual desire
• Physical symptoms include the following:
  • Thirst and appetite changes (food cravings)
  • Breast tenderness
  • Bloating and weight gain
  • Gastrointestinal symptoms
  • Fatigue and Headache
  • Swelling of the hands or feet
  • Aches and pains
  • Skin problems
  • Abdominal pain

The symptoms of PMS may look like other conditions or medical problems. Talk with a healthcare provider for diagnosis.

Does PMS change with age?

Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse. PMS stops after menopause when you no longer get a period.

How is PMS diagnosed?

Aside from a complete medical history and physical and pelvic exam, there are very few additional tests. Your healthcare provider may ask that you keep a journal of your symptoms for several months to better assess the timing, severity, onset, and duration of symptoms. To diagnose PMS, a health care provider must confirm a pattern of symptoms. A woman’s symptoms must

• Be present in the 5 days before her period for at least three menstrual cycles in a row.
• End within 4 days after her period starts.
• Interfere with some of her normal activities

What is premenstrual dysphoric disorder (PMDD)?

If PMS symptoms are severe and cause problems with work or personal relationships, you may have premenstrual dysphoric disorder (PMDD). PMDD is a severe type of PMS that affects a small percentage of women. Drugs called selective serotonin reuptake inhibitors (SSRIs) can help treat PMDD in some women. These drugs are used to treat depression

How is PMS treated?

Your healthcare provider will consider your age, overall health, symptoms and other factors when finding the best treatment for you.

Lifestyle changes and sometimes medicines can help manage PMS symptoms.
Medicines include:

• Diuretics to reduce fluid buildup
• Nonsteroidal anti-inflammatory medicines, or NSAIDs, such as aspirin and ibuprofen, to reduce pain
• Birth control pills
• Medicines used to temporarily stop ovaries from making estrogen and progesterone
• Antidepressants

Lifestyle changes:

• Changing the diet to increase protein and decrease sugar and caffeine intake
• Vitamin supplements such as vitamin B-6, calcium, and magnesium
• Regular exercise

What dietary changes can help relieve PMS symptoms?

Following simple changes in your diet may help relieve the symptoms of PMS:

• Eat a food rich in complex carbohydrates. A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. Complex carbohydrates are found in foods made with whole grains, like whole wheat bread, pasta, and cereals. Other examples are barley, brown rice, beans, and lentils.
• Add calcium-rich foods, like leafy green vegetables and yougart, to your diet.
• Reduce your intake of salt, sugar and fat.
• Avoid caffeine and alcohol.
• Change your eating schedule. Eat six small meals a day rather than three large ones, or eat slightly less at your three meals and add three light snacks. Keeping your blood sugar level stable will help with symptoms.

Can PMS be prevented?

For some women, making lifestyle changes helps to reduce the occurrence of PMS symptoms. These changes may include:

• Get regular exercise 3 to 5 times each week
• Eat a well-balanced diet. You should eat more whole grains, vegetables, and fruits, while eat less salt, sugar, caffeine, and alcohol.
• Get enough sleep and rest
• Don’t smoke

When to call your healthcare provider

Call your doctor if you have symptoms of PMS that interfere with your ability to carry out your normal daily activities.