Premenstrual Syndrome (PMS): 37 Symptoms, Definition, Treatment (original) (raw)

What is PMS (premenstrual syndrome)?

About 90% of women experience PMS symptoms at one point in their life.

About 90% of women experience PMS symptoms at one point in their life.

Premenstrual syndrome (PMS) is a combination of emotional, physical, and psychological disturbances that occur after ovulation, typically ending with the onset of menstrual flow. The most common mood-related symptoms are irritability, depression, crying, oversensitivity, and mood swings. The most common physical symptoms are fatigue, bloating, breast tenderness (mastalgia), acne flare-ups, and appetite changes with food cravings.

A more severe form of PMS, known as premenstrual dysphoric disorder (PMDD), also known as late luteal phase dysphoric disorder, occurs in a smaller number of women and leads to significant loss of function because of unusually severe symptoms. The American Psychiatric Association characterizes PMDD as a severe form of PMS in which anger, irritability, and anxiety or tension are especially prominent.

How many women suffer from PMS?

About 90% of women experience premenstrual symptoms at some point in their lifetime, but clinically significant PMS (which is moderate to severe in intensity and affects a woman's functioning) occurs in 20% to 30% of women. It is generally most severe in women in their 4th decade of life.

What are the symptoms and signs of PMS?

A great variety of symptoms have been attributed to PMS. Women can have PMS of varying duration and severity from cycle to cycle. The most frequent mood-related symptoms of PMS include:

  1. anger and irritability,
  2. anxiety,
  3. tension,
  4. depression,
  5. crying,
  6. oversensitivity, and
  7. exaggerated mood swings.

The most frequent physical signs and symptoms of PMS include:

  1. fatigue,
  2. bloating (due to fluid retention),
  3. weight gain,
  4. breast tenderness,
  5. acne,
  6. sleep disturbances with sleeping too much or too little (insomnia), and
  7. appetite changes with overeating or food cravings.

PMS vs pregnancy symptoms

A great variety of symptoms have been attributed to PMS and some may resemble pregnancy symptoms. Women can have PMS of varying duration and severity from cycle to cycle. The most frequent mood-related or psychological symptoms of PMS include:

How long do PMS symptoms and signs last?

The duration of PMS varies among women. Most women experience the symptoms for a few to several days in the week prior to the onset of their menstrual period. Some women may have symptoms for a shorter or longer time period, but symptoms of PMS typically start after ovulation (the mid-point in the monthly menstrual cycle).

SLIDESHOW Premenstrual Syndrome (PMS): Track and Prevent Symptoms See Slideshow

What causes PMS?

The cause of PMS is complicated and not fully understood. More research is needed, but it is believed PMS results from the alterations in or interactions between the levels of sex hormones including progesterone and brain chemicals known as neurotransmitters such as gamma-aminobutyric acid (GABA), serotonin, and catecholamine.

Other possible causes of PMS include:

PMS does not appear to be specifically associated with any personality factors or specific personality types.

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What conditions mimic PMS?

Some examples of medical conditions that can mimic PMS include:

The hallmark of the diagnosis of PMS is the symptom-free interval after the menstrual flow and before the next ovulation. If there is no such interval and the symptoms persist throughout the cycle, then PMS may not be the proper diagnosis. PMS can still be present and aggravate symptoms related to the other conditions, but it cannot be the sole cause of constant or non-cyclic symptoms. Blood or other tests may be ordered to help rule out other potential causes of symptoms.

Another way to help make the diagnosis of PMS is to prescribe drugs that stop all ovarian function. If these medications produce relief of the troublesome symptoms, then PMS is most likely the diagnosis.

How do you diagnose PMS?

The most helpful diagnostic tool is the menstrual diary, which documents physical and emotional symptoms over months. If the changes occur consistently around ovulation (mid-menstrual cycle) and persist until the menstrual flow begins, then PMS is probably the accurate diagnosis. Keeping a menstrual diary not only helps the healthcare professional to make the diagnosis but also promotes a better understanding by the patient of her own body and moods. Once the diagnosis of PMS is made and understood, the patient can better cope with the symptoms.

The diagnosis of PMS can be difficult because many medical and psychological conditions can mimic or worsen symptoms of PMS. There are no blood or laboratory tests to determine if a woman has PMS. When laboratory tests are performed, they are used to exclude other conditions that can mimic PMS.

What are the treatments for PMS?

The treatment of PMS can sometimes be as challenging as making the diagnosis of PMS. Various treatment approaches have been used to treat this condition. Some measures lack a solid scientific basis but seem to help some women. Other treatments with a sound scientific basis may not help all patients.

General management includes a healthy lifestyle including:

All of the above have been recommended and may help symptoms in some women. Furthermore, some studies suggest that calcium and magnesium supplements may provide some benefits.

What natural herbal remedies relieve PMS pain and other symptoms?

Natural home remedies that can help relieve PMS pain and other symptoms include:

Herbal remedies that may help relieve PMS symptoms include:

Talk to your doctor before taking any herbs or other supplements.

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What medications relieve PMS pain and other symptoms?

A variety of medications are used to treat the different symptoms of PMS. Medications include diuretics, analgesics, oral contraceptives, antidepressants, and drugs that suppress ovarian function.

It is important to know that these drugs, although useful in treating mood disturbances in some women, are not necessarily effective in treating the physical symptoms. Often, it is a combination of diet, medications, and exercise that is needed to afford the maximum improvement from the many symptoms of PMS.

What exercises relieve PMS pain and other symptoms?

Evidence suggests that exercise can help relieve some of the symptoms of PMS in adolescents and young women. Physical activity improves general health and helps relieve nervous tension and anxiety. Exercise is believed to release endorphins. Endorphins contribute to euphoric feelings such as the "runner's high" experienced after prolonged exercise. Endorphins are chemical messengers for nerves (neurotransmitters) that affect mood, perception of pain, memory retention, and learning.

"Low-impact" aerobic exercises are less stressful on the joints and avoid the muscle and joint pounding of more "high-impact" exercises like jogging and jumping rope. Benefits of exercise for PMS pain and other symptoms include:

Is there a "cure" for PMS?

Medically Reviewed on 1/11/2024

References

Arman, A. et al. Beneficial role of calcium in premenstrual syndrome: a systematic review of current literature. Sept 2020. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716601/>

Cetin, N.S. and A.S. Kirca. The effect of a mindfulness-based stress reduction program on premenstrual symptoms: a randomized controlled trial. J Midwifery Womens Health. 2023 Sept-Oct. <https://pubmed.ncbi.nlm.nih.gov/37335817/>

T. Hudson. Ginkgo is effective for relief of PMS symptoms. Natural Medicine Journal. Jan 2014. <https://www.naturalmedicinejournal.com/journal/ginkgo-effective-relief-pms-symptoms>

Jiayuan, Z. et al. Acupuncture for premenstrual syndrome at different intervention time: a systemic review and meta-analysis. Evid Based Complement Alternat Med. 2019. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614973/>

M. Mohaddese. Evening primrose (Oenothera biennis) oil in management of female ailments. J Menopausal Med. 2019.<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718646/>

Moreno, MA, MD, MEd, MPH, et al. Premenstrual Syndrome. Medscape. Updated: Sep, 01, 2016. <https://emedicine.medscape.com/article/953696-overview>

Mount Sinai. "Black cohosh." "St. John's Wort."

NIH StatPearls. "Premenstrual Syndrome."

Planned Parenthood. "What is PMS (Premenstrual Syndrome)?"

S. Tsai. Effect of yoga exercise on premenstrual symptoms among female employees in Taiwan. Int J Environ Res Public Health. 2016 July. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962262/>

SleepFoundation.org. "PMS and Insomnia."