Family Health|Kids and Teens|Women

Premenstrual Syndrome (PMS)

Last Updated September 2023 | This article was created by editorial staff and reviewed by Beth Oller, MD

What is PMS?

Premenstrual syndrome (PMS) is the name for a group of symptoms that you may experience up to 14 days before your period (menstruation). The symptoms usually stop soon after your period starts.

About half of women who experience PMS also have another health problem, which may get worse in the time before their menstrual period. These health problems share many symptoms with PMS, including:

 PMS Symptoms

Most women feel some mild discomfort before their periods. But if you have PMS, you may feel so anxious, depressed, or uncomfortable that you can’t cope at home or at work. Your PMS symptoms may be worse some months and better others.

It is common for you to have some of these symptoms:

  • Acne
  • Back pain
  • Bloated abdomen
  • Changes in appetite, including cravings for certain foods
  • Constipation
  • Crying spells
  • Diarrhea
  • Depression
  • Fast heartbeat
  • Feeling irritable, tense, or anxious
  • Feeling tired
  • Headache
  • Hot flashes
  • Joint pain
  • Mood swings
  • Not feeling as interested in sex
  • Tender and swollen breasts
  • Trouble concentrating
  • Trouble sleeping
  • Swollen hands or feet
  • Wanting to be alone
  • Weight gain

If your PMS symptoms are severe, you may have a condition called premenstrual dysphoric disorder (PMDD). This is especially true if your anxiety and depression feelings are extreme.

What causes PMS?

No one knows for sure what causes PMS. It seems to be linked in part to changes in hormone levels during the menstrual cycle. PMS is not caused by stress or psychological problems, although these may make PMS symptoms worse.

How is PMS diagnosed?

Your doctor will ask you to keep track of your symptoms on a calendar. If your symptoms follow the same pattern each month, you may have PMS.

Your doctor may want to examine you and do some tests to rule out other possible problems. They may also want to talk about your eating habits, exercise habits, your work, and your family.

Can PMS be prevented or avoided?

PMS can sometimes be prevented by controlling hormone fluctuations with hormone-containing contraceptives, for example. For some women, eating a healthy diet and exercising regularly may ease PMS symptoms.

PMS treatment

There is no cure for PMS, but taking medicine may help. No single PMS treatment works for everyone, according to the National Institutes of Health (NIH). Consider taking over-the-counter pain relievers, such as ibuprofen, aspirin, or naproxen, to help ease cramps, headaches, backaches, and breast tenderness. Depending on your PMS symptoms and how severe they are, your doctor may prescribe medicine for you.

You may need to try more than one medicine to find the treatment that works best for you. Medicines that your doctor can prescribe include diuretics, antidepressants, and birth control pills.

What are diuretics?

Diuretics help your body get rid of extra sodium and fluid. They can ease bloating, weight gain, breast pain, and abdominal pain. Diuretics usually are taken just before you would normally experience these symptoms in your menstrual cycle and can be stopped when they are no longer needed.

Do antidepressants help?

Antidepressants can help with the severe irritability, depression, and anxiety that some women experience as part of PMS. These medicines are usually taken every day, even when you feel fine.

What about birth control pills?

Your doctor may talk to you about taking birth control pills (often just called “the pill”) or other hormone-containing contraceptives to help ease some of your PMS symptoms. Birth control pills help by evening out your hormone levels throughout your cycle. Some women’s PMS symptoms get a lot better when they take birth control pills. However, the pill can also cause side effects of its own, and it doesn’t help all women.

What about medicines I can buy without a prescription?

You can buy medicines without a prescription to help with the symptoms of PMS. These medicines usually combine aspirin or acetaminophen with caffeine, antihistamines, or diuretics. Some brand names include Midol, Pamprin, and Premsyn PMS.

Some over-the-counter pain relievers can also help. These include ibuprofen (brand names: Advil, Motrin), ketoprofen (brand name: Orudis KT), and naproxen (brand name: Aleve).

These medicines can work well for mild or moderate PMS. Talk to your doctor before you try one of these drugs.

Living with PMS

Managing your PMS begins with knowing what your PMS symptoms are and when they happen. Then you can change your diet, exercise, and schedule to get through each month as smoothly as possible.

Try not to get discouraged if it takes some time to find tips or medicine that help you. Treatment varies from one person to another. Your doctor can help you find the right treatment.

What about vitamins and other home remedies?

You may have read that some vitamins and other supplements, such as vitamin B6, vitamin E, magnesium, manganese, and tryptophan, can help relieve PMS. There haven’t been many studies about these treatments, and it’s possible that they could do more harm than good. For example, vitamin B6 and vitamin E can cause side effects if you take too much of them. Talk to your doctor if you’re thinking of trying any of these vitamins or supplements.

On the other hand, taking calcium pills may reduce symptoms of water retention, cramps, and back pain. Taking about 1,000 mg of calcium a day probably won’t be harmful, especially because calcium has so many other benefits, such as being good for your bones.

Tips on controlling PMS symptoms

  • Eat complex carbohydrates (such as whole grains and whole-grain breads, pasta, and cereals), fiber, and protein. Cut back on sugar and fat.
  • Avoid salt for the last few days before your period to reduce bloating and fluid retention.
  • Cut back on caffeine to feel less tense and irritable and to ease breast soreness.
  • Avoid alcohol. Drinking it before your period can make you feel more depressed.
  • Try eating up to 6 small meals a day instead of 3 larger ones.
  • Get aerobic exercise. Work out up to 30 minutes, 4 to 6 times a week.
  • Get plenty of sleep—about 8 hours a night.
  • Keep to a regular schedule of meals, bedtime, and exercise.
  • Try to schedule stressful events for the week after your period.

Questions to ask your doctor

  • Could my symptoms be caused by something other than PMS?
  • What over-the-counter medicine might help relieve my symptoms?
  • Would birth control pills help?
  • What lifestyle changes should I make to help relieve my symptoms?
  • What should I do if my symptoms don’t get better or get worse?
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