Premenstrual Syndrome (PMS): Symptoms and Treatment

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What is premenstrual syndrome?

Premenstrual syndrome is a group of emotional, physical, mental, and behavioural disturbances experienced by a woman before her menstrual cycle. Approximately 85 % of the women in this world experience PMS. Most of the women experience at least one symptom of PMS every month, prior to menstruation.

These symptoms occur in a woman around two weeks before her monthly period (i.e. during her period of ovulation). The signs become more intense 2-3 days prior to the period, and usually resolve a day or two after the period commences.

How does premenstrual syndrome occur?

PMS can affect menstruating women of any age, and the effect is different for each woman. For some women, the symptoms can vanish as soon as menstruation starts. For others, it can be so severe that it makes it hard to even get through the day. For these women, the PMS symptoms subside once the menstruation stops. Women stop experiencing PMS when they are pregnant or once they reach menopause. Women who have undergone hysterectomies can experience PMS every month even if at least one functional ovary is left.

How or why PMS symptoms occur is not clear, but several factors may be involved. Changes in hormones which can result in chemical changes in the brain, during the menstrual cycle, seem to be an important cause. Hormonal level changes may affect some women more than others. Other issues such as stress and emotional problems, such as depression, may make PMS symptoms worse.

Other possible causes can include:

  • an unhealthy diet resulting in low vitamins and minerals for the body

  • obesity

  • heavy smoking or alcohol drinking

  • too much of caffeine intake

  • leading a sedentary life

These factors can cause PMS symptoms such as anxiety, irritability, fatigue, depression, headache, back pain, food cravings, acne, swollen tender breasts, stomach bloating, constipation or diarrhea.

Who is prone to premenstrual syndrome?

Women who are at an increased risk of suffering from PMS :

  • have a family history of PMS

  • lead a sedentary lifestyle

  • take an unhealthy diet

  • drink a lot of alcohol

  • smoke heavily

  • are below 30 years of age

  • consume a high sugar diet

  • have more than two children

  • suffer from high-stress levels

  • take a diet low in vitamin B, calcium, and magnesium

  • do not exercise

  • are prone to take a lot of caffeine

What are the causes of premenstrual syndrome?

The causes of PMS have not yet been established.

Researchers, however, believe that:

  • Hormonal changes can cause PMS: A change in the hormones during the menstrual cycle can cause PMS. Levels of oestrogen and progesterone hormones rise and fall just prior to, and during a menstrual cycle. An increase in these hormones can cause mood swings, anxiety, and irritability.

  • Chemical changes in the brain can cause PMS: The change in hormones can also affect certain chemical levels in the brain. For instance, serotonin which can regulate our moods and make us happier may reduce with a change in the hormone level. This can directly affect our moods.

  • Physical and lifestyle factors can cause PMS: It has been observed that obese women are more likely to have PMS. Other lifestyle factors such as an unhealthy diet, heavy smoking and drinking, or too much stress can also cause PMS.

What are the symptoms of premenstrual syndrome?

The symptoms of premenstrual syndrome are:

  • acne

  • joint or muscle pain

  • trouble with concentration or memory

  • anxiety, irritability, mood swings

  • depression

  • swollen or tender breasts

  • constant fatigue

  • insomnia

  • bloated abdomen

  • abdominal pain or cramps

  • constipation or diarrhea

  • headache or backache

  • appetite changes or food cravings

  • nausea

  • sadness

When to see a doctor for premenstrual syndrome?

You need to visit a doctor if any of your symptoms especially your mood swings, depression, or abdomen, joint and muscle pains are interfering with your day to day activities, or if they do not go away even after menstruation has stopped.

Recurrent symptoms can also occur due to an underlying disorder such as:

What are the complications of premenstrual syndrome?

The complications of PMS include:

What is the treatment of premenstrual syndrome?

Medical Treatment


Many women experience relief from PMS symptoms through lifestyle changes alone. For aggravated cases though, your doctor may prescribe medicines for the symptoms such as:

  • antidepressants

  • nonsteroidal anti-inflammatory drugs

  • diuretics

  • hormonal contraceptives

  • painkillers

  • oestrogen-only patches and implants

Exercise


Exercising regularly can help you to get complete relief from PMS symptoms. Doing aerobics at least for two hours per week can help alleviate the symptoms. Other activities can include brisk walking, swimming, and cycling. These activities will help keep depression at bay.

Stretching and breathing exercises, such as yoga and pilates, will help reduce your stress levels.

Would you like to consult a doctor for Premenstrual Syndrome (PMS) ?

Questions answered by trusted doctors

Verified User
As my periods come near I start having major mood swings. I think things which destroy my personal life. I say things which hurt people. I don't even realise that I am doing wrong. But as soon as the blood flow starts I suddenly realise all the wrongs I have done but that ges too late for other people.
Dr. Amitabh Ghosh
Psychiatrist, Mumbai
this is common in some women during cycles. its due to hormones. speak to your gynecologist and she will refer you to some psychiatrist
Verified User
I had period last month on may 7 and again from may 29 I got periods symptoms like back pain weakness leg cramps and June 1st I got periods , I have menstruate cramps problem from begining itself  yesterday also I had seviour stomach pain back pain weakness leg cramps today mng I had headache and later I got fever this is the first time I got fever during my period
Kindly suggest what would be the problem
Dr. Prabhjot Manchanda
Obstetrician, Mumbai
Fever can be something else. There is some rise in temp during menses but not fever.
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Did you know?

Fatigue is a common symptom

The most commonly reported PMS symptom in India is 'fatigue/lack of energy' (68.3%), followed by 'decrease interest in work' (60.1%) and 'anger/irritability' (59.9%).

Poor health leads to PMS

PMS is associated with poor physical health and existing psychological distress.

Healthy lifestyle key to preventing PMS

A healthy lifestyle consisting of healthy diet and proper physical exercise is the first step to preventing and managing PMS.

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Home Remedies

Eat Small Meals

Eat small meals everyday and eat more frequently to help reduce bloating

Drink Plenty of Water and Natural Fruit Juices

Drinking water can keep you hydrated and juices can replenish essential vitamins and minerals. Being dehydrated can worsen your mood swings

Avoid Taking Excessive Salt

Eating excessively salty food will make your stomach feel bloated as it will lead to fluid retention

Take Foods Rich in Vitamin D

Eat foods such as eggs, cheese, mushrooms, and fishes such as fatty fish, like tuna, mackerel, and salmon. This will improve the physical and psychological symptoms of PMS

Eat plenty of green leafy vegetables and fruits

They are rich in vitamins and minerals and will ease your PMS symptoms.

Avoid smoking and alcohol

Smoking and drinking alcohol excessively can lead to more mood swings and also affect your energy levels thus leading to worsening of PMS symptoms
Book an appointment with a Gynecologist