Overview

Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.

Still, you don't have to let these problems control your life. Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome.

Symptoms

The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.

Emotional and behavioral symptoms

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration

Physical signs and symptoms

  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea

For some, the physical pain and emotional stress are severe enough to affect their daily lives. Regardless of symptom severity, the signs and symptoms generally disappear within four days of the start of the menstrual period for most women.

But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of PMS is called premenstrual dysphoric disorder (PMDD).

PMDD signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.

When to see a doctor

If you haven't been able to manage your premenstrual syndrome with lifestyle changes and the symptoms of PMS are affecting your health and daily activities, see your doctor.

Causes

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

  • Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
  • Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.
  • Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.
Dec. 16, 2014
References
  1. Frequently asked questions. Gynecologic problems FAQ057. Premenstrual syndrome. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Premenstrual-Syndrome-PMS. Accessed Nov. 2, 2014.
  2. Yonkers KA, et al. Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder. http://www.uptodate.com/home. Accessed Nov. 2, 2014.
  3. Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 2, 2014.
  4. Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Nov. 2, 2014.
  5. Goldman L, et al. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Nov. 2, 2014.
  6. Marjoribanks J, et al. Selective serotonin reuptake inhibitors for premenstrual syndrome (Review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001396.pub3/abstract. Accessed Nov. 2, 2014.
  7. Natural medicines in the clinical management of premenstrual syndrome. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Nov. 2, 2014.
  8. Khayat S. Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN Obstetrics and Gynecology. 2014;792708:1.
  9. Jang SH, et al. Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: Systematic review. BMC Complementary and Alternative Medicine. 2014;14:1.

Premenstrual syndrome (PMS)