Premenstrual syndrome (PMS) is a group of symptoms linked to the menstrual cycle. PMS symptoms occur 1 to 2 weeks before your period (menstruation or monthly bleeding) starts. The symptoms usually go away after you start bleeding. PMS can affect menstruating women of any age and the effect is different for each woman. For some people, PMS is just a monthly bother. For others, it may be so severe that it makes it hard to even get through the day. PMS goes away when your monthly periods stop, such as when you get pregnant or go through menopause.
What causes PMS?
The causes of PMS are not clear, but several factors may be involved. Changes in hormones during the menstrual cycle seem to be an important cause. These changing hormone levels may affect some women more than others. Chemical changes in the brain may also be involved. Stress and emotional problems, such as depression, do not seem to cause PMS, but they may make it worse. Some other possible causes include:
Low levels of vitamins and minerals
Eating a lot of salty foods, which may cause you to retain (keep) fluid
Drinking alcohol and caffeine, which may alter your mood and energy level
What are the Symptoms of PMS?
PMS often includes both physical and emotional symptoms, such as:
Tension, irritability, mood swings, or crying spells
Anxiety or depression
Symptoms vary from woman to woman.
How do I know if I have PMS?
Your doctor may diagnose PMS based on which symptoms you have, when they occur, and how much they affect your life. If you think you have PMS, keep track of which symptoms you have and how severe they are for a few months. Record your symptoms each day on a calendar or tracking form. Take this form with you when you see your doctor about your PMS.
Your doctor will also want to make sure you don’t have one of the following conditions that shares symptoms with PMS:
Problems with the endocrine system, which makes hormones
How Common is PMS?
There’s a wide range of estimates of how many women suffer from PMS. The American College of Obstetricians and Gynecologists estimates that at least 85 percent of menstruating women have at least 1 PMS symptom as part of their monthly cycle. Most of these women have fairly mild symptoms that don’t need treatment. Others (about 3 to 8 percent) have a more severe form of PMS, called premenstrual dysphoric disorder (PMDD).
In more severe cases of PMS, prescription medicines may be used to ease symptoms. One approach has been to use drugs that stop ovulation, such as birth control pills. Women on the pill report fewer PMS symptoms, such as cramps and headaches, as well as lighter periods.
Certain vitamins and minerals have been found to help relieve some PMS symptoms. These include”
Calcium with vitamin D (1000 milligrams)
Magnesium (400 milligrams)
Vitamin B-6 (50 to 100 mg)
Vitamin E (400 milligrams)
Some women find their PMS symptoms relieved by taking supplements such as:
Evening primrose oil
Talk with your doctor before taking any of these products. Many have not been proven to work and they may interact with other medicines you are taking.
What is Premenstrual Dysphoric Disorder (PMDD)?
A brain chemical called serotonin may play a role in Premenstrual Dysphoric Disorder (PMDD), a severe form of PMS. The main symptoms, which can be disabling, include:
Feelings of sadness or despair, or even thoughts of suicide
Feelings of tension or anxiety
Mood swings or frequent crying
Lasting irritability or anger that affects other people
Lack of interest in daily activities and relationships
Trouble thinking or focusing
Tiredness or low energy
Food cravings or binge eating
Feeling out of control
Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain
You must have 5 or more of these symptoms to be diagnosed with PMDD. Symptoms occur during the week before your period and go away after bleeding starts.
Making some lifestyle changes such as those in the Lifestyle Changes section may help ease PMDD symptoms.
Antidepressants called selective serotonin reuptake inhibitors (SSRIs) have also been shown to help some women with PMDD. These drugs change serotonin levels in the brain. The Food and Drug Administration (FDA) has approved 3 SSRIs for the treatment of PMDD:
Paroxetine HCI (Paxil CR)
Some birth control pills have been approved by the FDA to treat PMDD. Talk to you doctor about which ones might work for you. Individual counseling, group counseling, and stress management may also help relieve symptoms.