Premenstrual syndrome (PMS) is a disorder marked by physical and emotional symptoms. It affects women 1-2 weeks before the beginning of their menstrual period.
The Menstrual Flow
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While the exact cause is not known, PMS may be related to certain factors (environmental, metabolic, or behavioral) that may make a woman more vulnerable to the hormonal changes that occur during menstruation.
PMS most often occurs in women aged 25-40 years. Other factors that may increase your chance of PMS include:
birth control pills
- Major life stress
PMS may cause:
- Mood swings
- Diminished self-esteem
- Difficulty concentrating
- Sleep problems
- Appetite changes, such as sugar and/or salt cravings, or overeating
- Weight gain
- Breast swelling and tenderness
- Gastrointestinal upset
- Muscle pain
Symptoms usually improve when bleeding starts (menstrual period).
You will be asked about your symptoms and medical history. A physical exam will also be done.
You will be asked to keep a detailed record of your monthly physical and emotional symptoms. If caused by PMS, these symptoms will likely occur 1-2 weeks before your menstrual period. You may have PMS if symptoms occur at the same phase of the menstrual cycle each month.
Treatment options include:
Stress may be managed through lifestyle changes. Relaxation techniques, deep breathing,
massage, music, and hot baths can also help
Dietary changes may be helpful. Decreasing salt, sugar, and
caffeinemay be advised. Eating small, frequent meals may also help.
The following vitamin and mineral supplements might reduce PMS symptoms:
- Vitamin E may reduce breast tenderness
- Calcium may decrease bloating, depression, and aches
- Magnesium may decrease pain, fluid retention, and improve mood
- Manganese may help control symptoms of menstrual pain
Exercising throughout the week may help to reduce symptoms.
Medications to treat PMS include:
- Diuretics to reduce bloating and fluid retention.
- Pain relievers to relieve cramps, headaches, and muscle aches
- Birth control pills to reduce physical symptoms
- Antidepressants to reduce emotional symptoms
Women with severe PMS symptoms may benefit from
cognitive behavioral therapy. Therapy may reduce negative emotions and enhance problem-solving skills in relationships. It may also manage obstacles, frustrations, and discomfort.
To help reduce your chance of getting PMS, take the following steps:
Premenstrual syndrome. American Congress of Obstetricians and Gynecologists website. Available at:
https://www.acog.org/~/media/For%20Patients/faq057.pdf?dmc=1&ts=20120824T1006488269. Updated May 2015. Accessed September 7, 2017.
Premenstrual syndrome. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T113966/Premenstrual-syndrome. Updated October 5, 2016. Accessed September 7, 2017.
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. Updated February 6, 2017. Accessed September 7, 2017.
4/14/2009 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T113966/Premenstrual-syndrome: Brown J, Shaughn O'Brien PM, Marjoribanks J, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. 2009;(1):CD001396.
Last reviewed September 2017 by EBSCO Medical Review Board
Beverly Siegal, MD, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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