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Premenstrual Syndrome (PMS)


The Manual's Editorial Staff

Reviewed/Revised Nov 2023
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What is premenstrual syndrome (PMS)?

Premenstrual syndrome (PMS) is the set of physical and mental symptoms you may have around the time of your menstrual period. The symptoms bother some women more than others.

  • PMS may be partly caused by changes in your hormone levels during your menstrual cycle

  • Some women have a more severe form of PMS that interferes with daily life, called premenstrual dysphoric disorder

  • You can ease your symptoms by being active, not eating certain foods and drinks, and sometimes by taking medicine

What causes PMS?

PMS is partly caused by the rise and fall of certain female hormones in your body, such as estrogen and progesterone.

PMS may run in families.

What are the symptoms of PMS?

Symptoms can begin up to 10 days before your period and usually end when your period starts. Symptoms may get worse and last longer as you get closer to menopause Menopause Menopause is when women stop having periods (stop menstruating) and can no longer get pregnant. Menopause usually happens after age 40. In the United States, the average age for menopause is... read more Menopause (when you stop having periods).

Mental and emotional symptoms can include:

Physical symptoms can include:

  • Breast fullness or tenderness

  • Cramps, heaviness, or pressure in your lower belly

  • Headaches

  • Bloating

  • Weight gain

  • Constipation

  • Difficulty falling asleep or remaining asleep

  • Acne

  • Feeling sick to your stomach or throwing up

  • Tired or low energy

  • Back pain, joint and muscle pain

The following disorders aren't PMS. But if you have one of these, your symptoms of that disorder may get worse during PMS:

If your PMS is so bad it interferes with your daily life, you may have a severe form called premenstrual dysphoric disorder.

How can doctors tell if I have PMS?

Doctors can tell if you have PMS based on your symptoms and when they happen.

How do doctors treat PMS?

Some things may help your PMS symptoms:

  • Get at least 7 hours of sleep each night

  • Be active regularly

  • Lower your stress by doing meditation or relaxation exercises

  • Eat more protein and calcium (for example, fish and milk)

  • Eat less salt, sugar, and caffeine (for example, chips, cookies, and coffee)

Doctors may have you take:

  • Vitamins and supplements, such as vitamin D, calcium, and magnesium

  • Diuretics (water pills), which make you urinate more and may help ease bloating

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, to help with headaches, cramps, or joint and muscle pain

  • Birth control pills

If you have severe PMS symptoms or premenstrual dysphoric disorder, doctors may have you take:

  • Antidepressants (medicine that helps your mood)

  • A hormone called a GnRH agonist so your ovaries make a smaller amount of female hormones

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