Premenstrual Syndrome

What is premenstrual syndrome (PMS)?

From: MedlinePlus, National Library of Medicine

Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The symptoms may range from mild to severe.

What is premenstrual dysphoric disorder (PMDD)?

From: MedlinePlus, National Library of Medicine

Premenstrual dysphoric disorder (PMDD) is a severe type of PMS. With PMDD, the symptoms are severe enough to interfere with your life. PMDD much less common than PMS.

What causes premenstrual syndrome (PMS)?

From: MedlinePlus, National Library of Medicine

Researchers don't know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others.

What are the symptoms of premenstrual syndrome (PMS)?

From: MedlinePlus, National Library of Medicine

PMS symptoms are different for everyone. You may get physical symptoms, emotional symptoms, or both. Your symptoms may also change throughout your life.

Physical symptoms may include:

Emotional symptoms may include:

• Breast swelling and tenderness
• Acne
• Bloating and weight gain
• Headache
• Joint pain
• Backache
• Constipation or diarrhea
• Food cravings
• Irritability
• Mood swings
• Crying spells
• Depression
• Anxiety
• Sleeping too much or too little
• Trouble with concentration and memory
• Less interest in sex

How is premenstrual syndrome (PMS) diagnosed?

From: MedlinePlus, National Library of Medicine

You may wish to see your health care provider if your symptoms bother you or affect your daily life.

There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed with PMS, your symptoms must:

• Happen in the five days before your period for at least three menstrual cycles in a row
• End within four days after your period starts
• Keep you from enjoying or doing some of your normal activities

Your provider may wish to do tests to rule out other conditions which may cause similar symptoms.

What are the treatments for premenstrual syndrome (PMS)?

From: MedlinePlus, National Library of Medicine

No single PMS treatment works for everyone. If your symptoms are not severe, you may be able to manage them with:

Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.

Some women take certain herbal supplements for PMS symptoms. But there is not enough evidence to prove that supplements are effective for PMS. Check with your provider before taking any vitamins or supplements.

If you are not able to manage your PMS symptoms, your provider may suggest prescription medicines. These medicines may also be used to treat PMDD. They include:

Dept. of Health and Human Services Office on Women's Health

• Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen, to help ease cramps, headaches, backaches, and breast tenderness
• Getting regular exercise
• Getting enough sleep
• Eating healthy foods
• Avoiding salt, caffeine, sugar, and alcohol in the two weeks before your period
• Hormonal birth control, which may help with the physical symptoms of PMS. But sometimes they may make the emotional symptoms worse. You may need to try several different types of birth control before you find the right one.
• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which may help with emotional symptoms.
• Diuretics ("water pills") to reduce symptoms of bloating and breast tenderness.
• Anti-anxiety medicine to ease symptoms of anxiety.

Which doctor should you see?

The suggested department for discussing Premenstrual Syndrome is Obstetrics and Gynaecology, with a obstetrician-gynaecologist as the relevant type of clinician. Obstetrician-gynaecologist; paediatric services for children as appropriate.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How do age, pregnancy status and reproductive goals affect the assessment?
• Which changes in bleeding, pain or general health need prompt review?
• What are the benefits and risks of the available options in this situation?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.