• Premenstrual Syndrome

    (PMS; Premenstrual Tension Syndrome)


    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.


    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.

    Risk Factors

    PMS most often occurs in women aged 25-40 years. Other factors that may increase your chance of PMS include:
    • Stopping birth control pills
    • Major life stress
    • Depression


    PMS may cause:
    • Irritability
    • Mood swings
    • Anxiety
    • Depression
    • Diminished self-esteem
    • Difficulty concentrating
    • Sleep problems
    • Appetite changes, such as sugar and/or salt cravings, or overeating
    • Weight gain
    • Fatigue
    • Bloating
    • Headache
    • Breast swelling and tenderness
    • Palpitations
    • Lightheadedness
    • 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 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. Decreasing salt, sugar, and caffeinemay be advised. Eating small, frequent meals may also help.

    Vitamins and Minerals

    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

    Regular Exercise

    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:


    American Congress of Obstetricians and Gynecologists http://www.acog.org

    Women's Health—Office on Women's Health http://www.womenshealth.gov


    Health Canada https://www.canada.ca/en/health-canada.html

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org


    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.

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