Premenstrual syndrome (PMS) refers to a wide range of physical and emotional symptoms that occur one to two weeks before a woman starts her monthly period. The symptoms usually subside after the period begins.

According to The American College of Obstetrics and Gynecology, at least 85% of women who menstruate have at least one premenstrual symptom. Most women have fairly mild symptoms that can be managed with diet and lifestyle changes, but a small minority (about three to eight percent) has a more severe form of PMS called premenstrual dysphoric disorder (PMDD).

Causes and Risk Factors

The cause of PMS has not been identified, but it is thought that it may be related to social, cultural, biological, and psychological factors. The changing hormone levels during the menstrual cycle seem to be closely associated with PMS.

PMS is thought to occur more often in women between their late 20s and 40s, as well as women who have at least one child or who have a history of postpartum depression or affective mood disorder. The symptoms of PMS typically get worse in the late 20s and 30s.

Symptoms and Treatment

A variety of physical or emotional symptoms have been associated with PMS. The most common symptoms include:

  • Headache
  • Backache, joint pain
  • Abdominal cramps or heaviness
  • Abdominal fullness, feeling gaseous
  • Breast swelling, tenderness
  • Weight gain
  • Acne flare-ups
  • Bloating
  • Constipation or diarrhea
  • Food cravings
  • Less tolerance for noises and lights
  • Sleeping problems
  • Feeling tired
  • Irritability, anxiety
  • Mood swings, crying spells, depression

Making healthy lifestyle changes, such as regular exercise and a balanced diet can help to relieve PMS symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve, Naprosyn) can ease many symptoms of PMS.

It's also important to keep a record of the type of symptoms you have, how severe they are, and how long they last. You should keep this "symptom diary" for at least three months. It will help your doctor make an accurate PMS diagnosis and recommend appropriate treatment. For severe PMS symptoms, your doctor may prescribe antidepressants, diuretics, oral contraceptives, or hormone therapy.

Visit the PMS Learning Center for more information.