Definition

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

Copyright © Nucleus Medical Media, Inc.

Causes

While the exact cause is not known, PMS may be related to certain factors (eg, environmental, metabolic, or behavioral factors) that may make a woman more vulnerable to the hormonal changes that occur during menstruation.

Risk Factors

Factors that may increase the risk of PMS include:

    
  • Age: 25-40
  • Going off birth control pills
  • Major life stress
  • Depression
  • Symptoms

    Symptoms may include:

        
  • Irritability
  • Mood swings
  • Anxiety
  • Depression
  • Diminished self-esteem
  • Difficulty concentrating
  • Sleep problems
  • Appetite changes (eg, sugar and/or salt cravings, overeating)
  • Weight gain
  • Fatigue
  • Bloating
  • Headache
  • Breast swelling and tenderness
  • Palpitations
  • Dizziness
  • Gastrointestinal upset
  • Muscle pain
  • Symptoms usually improve when bleeding starts (menstrual period).

    Diagnosis

    Your doctor will ask 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

    Treatment options include:

    Stress Management

    Stress may be managed through lifestyle changes. Relaxation techniques, deep breathing, massage , music, and hot baths can also help reduce stress .

    Dietary Changes

    Dietary changes may be helpful. Your doctor may recommend that you decrease your intake of salt, sugar, and caffeine . Eating small, frequent meals may also help.

    Vitamins and Minerals

    The following vitamin and mineral supplements might reduce PMS symptoms:

        
  • Vitamin E (400 IU)—may reduce breast tenderness
  • Calcium (1,000 mg)—may decrease bloating, depression, and aches
  • Magnesium (400 mg)—may decrease pain, fluid retention, and improve mood
  • Manganese (6 mg)—may help control symptoms of menstrual pain
  • Talk to your doctor before you take any supplements.

    Regular Exercise

    Exercising throughout the week may help to reduce your symptoms.

    Medications

    Your doctor may recommend medicine, such as:

        
  • Diuretics to reduce bloating and fluid retention.
  • Pain reliever to relieve cramps, headaches, and muscle aches
  • Birth control pills to reduce physical symptoms
  • Selective serotonin reuptake inhibitors to reduce emotional symptoms
  • Psychotherapy

    Women with severe PMS symptoms (called premenstrual dysphoric disorder ) 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.

    Prevention

    To help reduce your chance of getting PMS, take the following steps:

        
  • Manage stress.
  • Eat a healthy diet, one that is low in saturated fat and rich in whole grains and fruits and vegetables .
  • Consume less refined sugar, salt, and caffeine.
  • Do regular aerobic exercise.