What Is Premenstrual Syndrome (PMS)?
Premenstrual Syndrome (PMS) refers to the physical and emotional changes that occur in women before their menstrual period. Symptoms can include breast tenderness, nausea, withdrawal, sadness, irritability, and tension. Nearly 150 different symptoms have been associated with PMS. About 75% of menstruating women experience these symptoms to varying degrees.
While symptoms vary from person to person, PMS may be mild for some and significantly affect daily life for others. In 20–40% of women, symptoms impact work and social functioning. In 2.5–5%, the condition is more severe and may be diagnosed as Premenstrual Dysphoric Disorder (PMDD), the most intense form of PMS. PMDD diagnosis requires at least five of the following symptoms during most menstrual cycles over the past year.
At least one of the following must be present:
- Noticeable depressed mood and feelings of hopelessness
- Severe anxiety, tension, or restlessness
- Mood swings, sudden sadness, or heightened sensitivity to rejection
- Persistent irritability or anger
Additional common symptoms include:
- Loss of interest in daily activities
- Difficulty concentrating
- Fatigue or excessive sleepiness
- Overeating or loss of appetite
- Sleep disturbances
- Breast tenderness, bloating, headaches, muscle pain, or weight gain
These symptoms typically worsen before menstruation and ease once bleeding begins. However, PMS is often hard to distinguish from other conditions such as depression, anxiety disorders, or thyroid dysfunction.
What Causes PMS?
The exact cause of PMS is not fully understood. It is believed to result from a combination of genetic, hormonal, and environmental factors. Hormonal fluctuations, especially drops in progesterone or rapid changes in estrogen, may trigger symptoms. Low serotonin levels can contribute to depression, while GABA deficiency may increase anxiety. Elevated prolactin can cause breast tenderness. Other contributors may include vitamin deficiencies, blood sugar imbalances, and increased prostaglandin activity.
Treatment Approaches for PMS
There is no single treatment for PMS. Management focuses on reducing symptoms. The first step is making lifestyle adjustments. Regular exercise increases endorphin levels, improving mood and reducing premenstrual symptoms. Reducing salt, sugar, caffeine, and alcohol intake, while increasing calcium, magnesium, and vitamin B6, can be beneficial. Nutrition programs tailored for PMS are also increasingly popular.
In more severe cases or with PMDD, medical treatment may be needed. Pain relievers like ibuprofen or naproxen can help with headaches; sumatriptan may be used for migraines; bromocriptine for breast tenderness; and spironolactone for bloating. Birth control pills can help regulate hormones and reduce symptoms in some women.
Antidepressants that increase serotonin (such as fluoxetine or fluvoxamine) may be effective for those with intense mood symptoms. These are typically prescribed for short-term use during the luteal phase under medical supervision. Additional supportive treatments may include vitamin B6, omega-3 fatty acids, calcium, vitamin E, evening primrose oil, vitex agnus-castus, and ginkgo biloba.
Our Recommendations for Managing PMS
At our clinic, we take a holistic and personalized approach to diagnosing and managing PMS. We recommend tracking symptoms daily for several months to help with accurate diagnosis and to assess treatment effectiveness.
Remember, PMS and PMDD do not have to control your life. Avoid unnecessary stress, engage in regular physical activity, and share your feelings with trusted friends or support groups. If your symptoms become severe or begin to significantly affect your quality of life, it’s important to consult a women’s health specialist without delay.
Any medication should be used only under medical supervision. Avoid self-prescribed or hearsay treatments. This way, you can protect your health and take one step closer to the quality of life you deserve.
