Premenstrual Syndrome (PMS)

By Wendy Innes. May 7th 2016

Premenstrual syndrome, or PMS for short, is a condition that is often the brunt of jokes on late night television, but for millions of women, it is a fact of life during every single month of their child bearing years. Here women can find all the information they need to be able to cope and better understand PMS.

What Is It?

PMS refers to a wide range of symptoms that occur in conjunction with the luteal phase of a woman’s monthly menstrual cycle. They can range from very mild to moderately uncomfortable and bothersome, though most women’s daily lives are not seriously impacted by PMS. According to the American Academy of Family Physicians (AAFP), at least 85 percent of women experience some type of PMS symptoms each month.


There is a condition that is very similar to PMS that can severely affect the lives of the women affected by it known as premenstrual dysphoric disorder (PMDD). PMDD is different from PMS, though it isn’t uncommon for those with PMDD to believe that they just have a bad case of PMS.

According to the Mayo Clinic, PMDD is severe enough to cause extreme shifts in moods that can affect work as well as damage personal relationships. Though it’s estimated that many women have PMS, it’s thought that only 8 percent of those with PMS symptoms actually fit the diagnostic criteria for PMDD.


There are a number of symptoms associated with PMS. It’s important to know that PMS is a diagnosis of exclusion, meaning that because the symptoms are so broad and varied, all other possible diagnoses will be ruled out before a diagnosis of PMS can be made. In order to do this, the woman’s doctor may ask her to keep a journal of her PMS symptoms.

Physical  Symptoms

  • Fatigue
  • Abdominal fullness or feeling gassy
  • Bloating
  • Constipation or diarrhea
  • Headache
  • Breast tenderness
  • Loss of sex drive (though some women experience an increase in sex drive)
  • Food cravings
  • Acne flare up
  • Sleep problems
  • Slow or lethargic movements

Mental and Emotional Symptoms

  • Confusion
  • Difficulty Concentrating
  • Mood swings
  • Depression
  • Anxiety
  • Irritability
  • Feelings of guilt or fear
  • Crying spells
  • Forgetfulness
  • Poor judgment
  • Poor self image
  • Social withdrawal

Causes and Risk Factors

No one really knows for sure what causes PMS, but like many conditions it’s thought that a combination of factors plays a role.

  • Cyclical hormonal changes are thought to play a large role in the symptoms that occur during PMS. As reproductive hormone levels change throughout a woman’s menstrual cycle, PMS symptoms increase. This is also the reason that PMS symptoms disappear with pregnancy and menopause.
  • Changes in brain chemicals that coincide with changes in hormones also contribute to PMS symptoms. Changes in the level of serotonin, a neurotransmitter in the brain, can trigger some of the mental and emotional symptoms associated with PMS.
  • A woman’s diet can play a role in her PMS symptoms. Women who have a diet that is deficient in certain nutrients experience more PMS symptoms than those whose diets aren’t deficient in nutrients. In addition those who have diets high in salt, or who consume a lot of caffeine or alcohol also experience more PMS symptoms than those women who don’t.
  • Undiagnosed depression and stress may play a role in the severity of PMS symptoms, but overall they will not cause PMS.

Those most at risk for developing PMS are women who are:

  • In their late 20s to early 40s
  • Have had at least one child
  • Have a family history of any type of depression


There are several treatment options available for women with PMS and these options will vary based on severity of symptoms.

  • For many women simple lifestyle changes are enough to control PMS symptoms. Things like drinking plenty of water and eating a healthy diet with small frequent meals every few hours can help relieve some symptoms.
  • Some vitamins and minerals may help. Vitamin B6, calcium, magnesium and vitamin E have been shown to be helpful, especially if those women whose diets are deficient.
  • Physical activity. Regular moderate exercise is also helpful for treating some of the physical symptoms of PMS, such as the bloating and abdominal discomfort.
  • Medication. For those with more severe symptoms, prescription medication may be required. Medications are prescribed to reduce the emotional symptoms or to alter the menstrual cycle.
  • Birth control pills. Birth control pills are often used to alter the menstrual cycle and reduce the symptoms associated with the hormonal changes that occur during the cycle. Anti-depressants are also used occasionally to treat the emotional symptoms associated with PMS.

PMS isn’t the end of the world, although for a couple weeks out of the month it can feel like it for many women. However with effective treatment, women can find relief for their symptoms and get back to a normal life.


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