The monthly period is a time when women experience changes in their bodies. With every cycle, the uterus sheds its lining to regenerate a new one. This monthly phenomenon is menstruation. Premenstrual syndrome or PMS includes symptoms that occur a few days before the period. Women may experience mood swings, cramps, bloating, headaches, and tender breasts.

Women will see and feel signs that their period is on the way and will come soon. All women experience at least one sign that tells them that the cycle is close. The symptoms can change in each woman with age. For example, if a woman today has only cravings, but a few years later, she could experience bloating and mood swings as well. Some women may also find it difficult to understand that the symptoms being experienced are PMS or something else. One way to self diagnose PMS is to check if the same symptoms occur at least five days before the period and for three months in a row. If yes, then it is PMS.

For some women, it is a normal experience, with food cravings or tender breasts. But for some of the days before the menstrual cycle occurs can be really hard. If these changes drastically affect a woman’s life, then the condition is known as a premenstrual symptom of PMS. The physical signs can include a bloated stomach, hunger, headache, and cramps, to name a few. Studies show that around 85% of women experience PMS in some form or the other. Those who experience severe symptoms are known to have the premenstrual dysphoric disorder or PMDD.

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What Causes Premenstrual Syndrome

PMS (Premenstrual Syndrome) is a very common thing in women these days; however, Physicians don’t exactly know what causes it. There are obvious hormonal changes, and it is understood that the physical changes inside the body and the body chemistry lead to these symptoms. Certain factors can accelerate the condition and make it difficult for women on those days.

  • Depression: Some women experiencing extreme PMS do have undiagnosed depression, which can lead to mood swings. However, it must be noted that depression on its own, doesn’t cause all symptoms.
  • Changes in the brain: There are chemical changes that occur in the human brain before periods. If there are fluctuations in serotonin, which is a brain chemical transmitter, then it could trigger the premenstrual symptoms. Low amounts of this chemical can contribute to food craving, food problems, fatigue, and premenstrual depression.
  • Hormonal changes: The symptoms and signs of PMS may change with hormonal changes over each cycle. They also disappear during menopause and pregnancy.

Women who smoke, don’t sleep or exercise enough, drink a lot of alcohol, eat an excess of red meat, sugar, or salt, are under stress or depressed can experience stronger symptoms. Women with health issues like allergy, asthma, and migraines can also experience exacerbated symptoms. If the woman manages her health issues well, then she could possibly get more comfortable in the time before her period. Regular exercise, a good diet, and plenty of snooze time are also good during this time. Movement is shown to relieve the pain in PMS, but again, it is different for everyone. 

Symptoms Related to Premenstrual Syndrome

Premenstrual syndrome can occur at any age between puberty and menopause in women. However, the common age when it may become a problem is between the late twenties and early thirties. Though the underlying causes of PMS aren’t too well understood, the symptoms can get worse with stress and age. Women who have had hysterectomies and have just one ovary can still feel the effects of PMS. Heredity can also play a role if it runs in the family.

  • Physical

Physical symptoms are those that show up on the body, and the woman can see or feel it. They are:

  • Fatigue – feeling tired during the time frame before the period for no apparent reason.
  • Abdominal bloating – the stomach feels large and swollen, without any other reason to cause it.
  • Weight gain – some women gain weight during this time, but it goes away soon after.
  • Muscle or joint pain – joints and muscles start paining, making everyday life a little difficult.
  • Headache – throbbing pain in the head.
  • Acne or pimples – this can happen due to hormonal changes and lead to outbreaks.
  • Breast tenderness – breasts feel tender, and even a slight touch can be painful.
  • Diarrhea – this is very common as loose motions can accompany the onset of the period.
  • Constipation – Constipation is when one is unable to pass stools easily.
  • Swollen limbs – the hands and legs can swell up, making it uncomfortable for the woman.
  • Alcohol intolerance– the woman may not feel like touching alcohol during this time, even if she is ok with it at other times.
  • Behavioral

PMS can have other symptoms that aren’t physical. They can be emotional and behavioral, as well.

  • Depressed mood – feelings of sadness.
  • Anger and hostility – the woman may lose her temper on small things.
  • Anxiety – there may be feelings of unease and nervousness.
  • Mood swings – there may be movement between happiness and sadness without any apparent triggers.
  • Irritability – a woman may get irritated quite fast on small issues.
  • Tension – stress and mental unease.
  • Increase or decrease in appetite
  • Tearfulness or crying spells – women tend to feel emotional at this time.
  • Difficulty sleeping – amnesia for a short while is common.
  • Difficulty in concentration – because the body is uncomfortable, the woman may find it difficult to concentrate.
  • Forgetfulness – this is a common symptom.
  • Social withdrawal – women may not feel like socializing.
  • Libido changes – she may be disinterested in sex for a short while.
  • Feeling overwhelmed – strong feelings and emotions.
  • Fatigue – the woman may feel tired more than normal.
  • The emotional stress and physical pain are quite debilitating for some women and affects their life negatively. Regardless of severity, the symptoms and signs disappear four days after the cycle has begun. This is so for most women. But some may have disabling symptoms every month. This is known as PMDD or premenstrual dysphoric disorder.

Premenstrual Syndrom Diagnosis 

When a woman goes through PMS, it is difficult to say for sure that her symptoms are PMS. There are no tests or physical findings to diagnose premenstrual syndrome for sure. If something is a part of a woman’s predictable menstruation pattern, then the doctor may conclude it is PMS. It is difficult to diagnose, as psychological or physical conditions can worsen or mimic PMS symptoms.

To establish a pattern, the doctor may ask a woman to record the signs in a diary for at least two months. The woman has to mark the first day she sees the signs, and the last day they occur. She also needs to note down the start of the cycle and the end as well.

A menstrual diary is one way to diagnose PMS. It holds information on emotional and physical symptoms over months at a time. Changes are consistently occurring around the time of ovulation and remaining until the cycle begins a probable diagnosis, which is accurate. A menstrual diary can help doctors, but it also helps a woman in understanding her body better. Once the diagnosis is complete, the treatment or management can be better.


If the symptoms or signs of PMS are mild, then women can manage it with exercise, sleep, and diet. But if the symptoms make a woman feel worse every month, then its best to see a doctor. Once the doctor talks to the woman and has a diagnosis, then he/she may prescribe medicines or give some other options.

  • NSAIDS: The drugs – Nonsteroidal anti-inflammatory, are painkillers which reduce swelling or inflammation. Women can get them over the counter, or the doctor may prescribe a stronger dosage. Naproxen, ibuprofen, and aspirin are common NSAIDS. They can reduce aches and cramps, thus making management of symptoms easier. These are taken at the time or before the onset of the period and can relieve breast discomfort or cramping.
  • Diuretics: Some women feel bloated and gain weight at that time of the month if they retain water in the body. Some medicines help in weight reduction by getting rid of the excess water naturally – through urination. These are diuretics like spironolactone. If a woman is on this drug, then she will be advised to consume less salt as it retains water in the body. Women must tell the doctor if they are on other medications, especially NSAIDS, as the combination of that and diuretics is harmful to kidneys.
  • Antidepressants: Depression and PMS are linked, as around 50% of women who experience it during PMS also have anxiety and depression normally. PMS can lead to mood swings and issues like depression, even if women don’t have it normally. If the doctor says that the depression has to be treated, then he/she may prescribe an antidepressant. Some find success with SSRIs like Sertraline, Paroxetine, or Fluoxetine. It can be around 3-4 weeks before a woman notices a change in the mood and feelings.
  • Birth Control Pills: Birth control pills aren’t just for managing unwanted pregnancies. It also has hormones that regulate the levels in the body. When a woman consumes this, she doesn’t ovulate and hence has milder symptoms.

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  • Can PMs be treated?

When the symptoms and signs of PMS are moderate and mild, then they can be managed with lifestyle changes. But if the symptoms are severe and interfere in normal life, then there are medical treatment options. Depending on the case and severity, a medical professional may prescribe medications as well.

  • Can special supplements or diet help with relieving PMS symptoms?

Women must talk to a doctor before taking any supplements and making huge dietary changes. It is said that 1200 mg of calcium can help during PMS. Magnesium supplements can help in managing mood swings, breast tenderness, and bloating. One study also shows that the consumption of vitamin E can reduce signs of PMS.

Complex carbohydrates reduce food cravings. Many advise a calcium-rich diet along with a reduction in intake of salt, fat, alcohol, and caffeine. Changes in eating schedules like six small meals throughout, is also good.

  • What relaxation methods help in relieving symptoms of PMS?

Relaxation helps when a person is stressed or irritated. Meditation, breathing exercises, yoga, and massage therapy are good ways to calm down and relax. Some therapies, like hypnosis and biofeedback, are also used. Sleeping well is also crucial to relaxation during the day.