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Coping with PMS

Coping with PMS

Premenstrual syndrome (PMS) is a group of symptoms related to a woman's monthly menstrual cycle, according to the National Women's Health Information Center (NWHIC). As many as 85 percent of all women who have menstrual periods experience at least one PMS symptom. A small percentage of women, between 3 and 8 percent, have a more severe form of PMS, called premenstrual dysphoric disorder (PMDD).


PMS has many physical symptoms, though many of them have other possible causes. PMS symptoms occur one to two weeks before your period and usually go away when your period begins. The symptoms may be severe enough to interfere with your normal daily activities. When a woman goes through menopause, PMS ends.

Following are symptoms of PMS. Many women, however, experience these symptoms and do not have PMS.

  • Bloating, upset stomach, constipation, or diarrhea

  • Breast tenderness

  • Bloating or fluid retention

  • Swollen feet and ankles

  • Headaches

  • Food cravings

  • Acne

  • Low energy

  • Backache

  • Joint or muscle pain

  • Insomnia

  • Carbohydrate cravings/appetite changes

Many symptoms of PMS are similar to other conditions, including depression and anxiety disorders. Talk with your health care provider if you experience any of the following mental health symptoms to determine their cause and find the most effective treatment:

  • Mood swings

  • Irritability

  • Depression

  • Aggressiveness or hostility

  • Crying spells

  • Difficulty concentrating

  • Anxiety

  • Decreased interest in daily activities

  • Social withdrawal

Causes and diagnosis

Researchers aren't sure exactly what causes PMS, but it may be that some women are more sensitive to the change in hormone levels that occur during the menstrual cycle.

No tests are available to confirm PMS, but you should have a thorough exam to rule out other medical problems with similar symptoms. Some symptoms of PMS may mimic other health conditions, such as fatigue syndrome, irritable bowel syndrome, thyroid disease, and even perimenopause. So it's important to determine what's really behind the symptoms. A diagnosis of PMS is based on your symptoms, when they occur, and how much they affect your life.

To accurately diagnose PMS, your provider may ask you to keep a diary of your symptoms for about three months to see if they follow a pattern pointing to PMS. Record your cravings, aches and pains, and keep track of your food, sleep, and exercise.

PMS has no cure, but you can reduce or prevent many symptoms through lifestyle changes.

Self-care steps

  • Take ibuprofen if you have headaches, backaches, cramps, or breast tenderness.

  • Limit salt and drink plenty of fluids.

  • Avoid caffeine and alcohol.

  • Try eating smaller, more frequent meals to reduce bloating.

  • Exercise at least 30 minutes a day.

  • Get enough sleep.

  • Look for ways to manage your stress.

  • Eat plenty of fruits, vegetables, pasta, and whole-grain breads and cereals.

  • Take a daily multivitamin that includes 400 mcg of folic acid.

  • Increase your consumption of calcium and vitamin D; choose low-fat or nonfat dairy products or take a calcium and vitamin D supplement.


PMDD is a more severe form of PMS that can be disabling. Women are diagnosed with PMDD when they have 5 or more of the following symptoms during the week before their period:

  • Sadness or despair, thoughts of suicide

  • Tension or anxiety

  • Panic attacks

  • Mood swings or crying frequently

  • Excessive irritability or anger and conflict

  • Loss of interest in everyday activities and relationships

  • Trouble thinking or concentrating

  • Feeling tired or lacking energy

  • Changes in appetite, food cravings, or binge eating

  • Difficulty sleeping

  • Feeling out of control

  • Bloating, swollen or tender breasts, headaches, muscle or joint pain

Treatment is important, especially when PMS or PMDD interferes with your daily activities and role in life. When diet or lifestyle changes aren't enough, your health care provider may recommend medications to help manage hormonal fluctuations, such as oral contraceptives, or antidepressants to help with mood symptoms.

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