Premenstrual Syndrome

Most women feel physical or mood changes during the days before menstruation. When these changes affect a woman’s normal life, they are known as premenstrual syndrome (PMS).

Premenstrual syndrome can affect menstruating women of all ages and backgrounds. The cause of PMS is unclear. However, the symptoms can be managed in many women.

Symptoms
Premenstrual symptoms are a common part of the monthly cycle. In fact, at least 85 percent of women who menstruate have at least one premenstrual symptom.

Women with PMS experience a pattern of symptoms month after month. They also find that the symptoms interfere with some aspect of their family, social or work lives.
Common symptoms of PMS are:

  1. Emotional and behavioral symptoms
  2. Physical Symptoms

Diagnosis
To diagnose PMS, a doctor must confirm a pattern of symptoms. A woman’s symptoms must:

  1. Be present in the five days before her period for at least three menstrual cycles in a row
  2. End within four days after her period starts
  3. Interfere with some of her normal activities

Common symptoms of PMS are emotional and/or physical so keeping track of your symptoms can help your physician decide if you have PMS. Write down and rate any symptoms you feel every day for at least 2-3 months. Record the dates of your periods as well.

PMS or Something Else?
Symptoms of other conditions can mimic PMS. For instance, premenstrual dysphoric disorder (PMDD) is a severe type of PMS. PMDD affects a small percentage of women with PMS.

Depressive and Anxiety Disorders
These disorders are the most common conditions confused with PMS. The symptoms of depression and anxiety are much like the emotional symptoms of PMS. The symptoms of these disorders may worsen before or during a woman’s period. This makes some women think they have PMS.

Menopause
Women entering menopause may have PMS-like symptoms. These symptoms include mood changes and fatigue.

Other Conditions
Your doctor will want to rule out other conditions that share symptoms with PMS. These conditions include chronic fatigue syndrome, irritable bowel syndrome, and endocrine problems.

What You Can Do
Lifestyle and dietary changes often can relieve some PMS symptoms. Talk with your doctor about your symptoms and treatment options.

Aerobic Exercise
For many women, aerobic exercise lessens PMS symptoms.

Relaxation
Finding ways to relax and reduce stress can help women who have PMS.

Dietary Changes
Simple changes in your diet may help relieve the symptoms of PMS. A diet rich in complex carbohydrates may reduce mood symptoms and food cravings. Adding calcium-rich foods, like yogurt and leafy green vegetables, to your diet may also help. Reduce your intake of fat, salt, and sugar. Avoid caffeine and alcohol.

Dietary Supplements
Dietary supplements help lessen the symptoms of PMS in many women. Studies have shown that taking 1,200 mg of calcium a day can help reduce the physical and mood symptoms that are part of PMS.

Medications
Women with severe PMS may not feel relief with lifestyle or dietary changes alone. If these changes don’t reduce symptoms, your doctor may suggest medications.

Talk With Others
Talking with others about what you are going through can help. Sharing your feelings may help your family to support you more.

Finally …
Many women with PMS find relief with exercise and lifestyle changes. Others may find dietary supplements or medicines to be helpful. If you think you have PMS, talk with your doctor about ways to find relief. Simple changes may help improve your well-being.

This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months

Copyright © March 2010 The American College of Obstetricians and Gynecologists