Premenstrual SyndromeSymptoms, Doctors, Treatments, Advances & More
Learn About Premenstrual Syndrome
Premenstrual syndrome (PMS) refers to a wide range of symptoms. The symptoms start during the second half of the menstrual cycle (14 or more days after the first day of your last menstrual period). These usually go away 1 to 2 days after the menstrual period starts.
PMS; Premenstrual dysphoric disorder; PMDD
The exact cause of PMS is not known. Changes in brain hormone levels may play a role. However, this has not been proven. Women with PMS may also respond differently to these hormones.
PMS may be related to social, cultural, biological, and psychological factors.
Most women experience PMS symptoms during their childbearing years. PMS occurs more often in women:
- Between their late 20s and 40s
- Who have had at least one child
- With a personal or family history of major depression
- With a history of postpartum depression or an affective mood disorder
The symptoms often get worse in late 30s and 40s as menopause approaches.
The most common symptoms of PMS include:
- Bloating or feeling gassy
- Breast tenderness
- Clumsiness
- Constipation or diarrhea
- Food cravings
- Headache
- Less tolerance for noises and lights
Other symptoms include:
- Confusion, trouble concentrating, or forgetfulness
- Fatigue and feeling slow or sluggish
- Feelings of sadness, depression, or hopelessness
- Feelings of tension, anxiety, or edginess
- Irritable, hostile, or aggressive behavior, with outbursts of anger toward self or others
- Loss of sex drive (may increase in some women)
- Mood swings
- Poor judgment
- Poor self-image, feelings of guilt, or increased fears
- Sleep problems (sleeping too much or too little)
Keep a daily diary or log for at least 3 months. Record the:
- Type of symptoms you have
- How severe they are
- How long they last
This record will help you and your health care provider find the best treatment.
A healthy lifestyle is the first step to managing PMS. For many women, lifestyle approaches are often enough to control symptoms. To manage PMS:
- Drink plenty of fluids like water or juice. Do not drink soft drinks, alcohol, or other beverages with caffeine. This will help reduce bloating, fluid retention, and other symptoms.
- Eat frequent, small meals. Do not go more than 3 hours between snacks. Avoid overeating.
- Eat a balanced diet. Include extra whole grains, vegetables, and fruit in your diet. Limit your intake of salt and sugar.
- Your provider may suggest that you take nutritional supplements. Vitamin B6, calcium, and magnesium are commonly used. Tryptophan, which is found in dairy products, may also be helpful.
- Get regular aerobic exercise throughout the month. This helps in reducing the severity of PMS symptoms. Exercise more often and harder during the weeks when you have PMS.
- Try changing your nighttime sleep habits before taking drugs for sleep problems.
Symptoms such as headache, backache, menstrual cramping, and breast tenderness may be treated with:
- Aspirin
- Ibuprofen
- Other NSAIDs
Birth control pills may decrease or increase PMS symptoms.
In severe cases, some medicines used to treat depression may be helpful. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are often tried first. These have been shown to be very helpful. You may also want to seek the advice of a counselor or therapist.
Other medicines that you may use include:
- Anti-anxiety drugs for severe anxiety
- Diuretics, which may help with severe fluid retention, which causes bloating, breast tenderness, and weight gain
Office
Joann Manson is a primary care provider, practicing in Endocrinologist in Boston, Massachusetts. Dr. Manson is rated as an Elite provider by MediFind in the treatment of Premenstrual Syndrome. She is also highly rated in 31 other conditions, according to our data. Her clinical expertise encompasses Menopause, Type 2 Diabetes (T2D), Coronary Heart Disease, Hormone Replacement Therapy (HRT), and Tubal Ligation.
Utah Valley Hospitalists
Dr. Julie Grover is an OB/GYN Hospitalist at Intermountain Health’s Utah Valley Obstetrics and Gynecology in Provo, Utah. She supports patients throughout Utah County, caring for patients who don't have their own doctor at Utah Valley Hospital, by responding to emergency situations, assisting other doctors when needed, and accepting high-risk patients transported from outlying hospitals. She treats normal and high-risk pregnancy, complications of pregnancy including preeclampsia, bleeding disorders, preterm labor, infections, and others.Dr. Grover has been a busy general OB/GYN, having practiced for 23 years. In April 2025, she shifted to a laborist position to have more family and personal time. With this change, she remains dedicated to delivering high-quality and considerate care to women in various circumstances.When not working, the Provo, Utah native enjoys hiking in Utah’s glorious mountains, practicing yoga, traveling to interesting places, and playing with her dogs. She has five biological children, two officially adopted, and a few unofficially adopted people she considers her children.Conditions Treated: Normal and high risk pregnancyComplications of pregnancyPreeclampsiaBleeding disordersPreterm laborInfectionsProcedures Performed: Normal vaginal deliveriesForceps deliveriesCesarean sectionsTubal ligationExternal cephalic versionAny other obstetric procedures needed. Dr. Grover is rated as an Advanced provider by MediFind in the treatment of Premenstrual Syndrome. She is also highly rated in 21 other conditions, according to our data. Her clinical expertise encompasses Painful Menstrual Periods, Menorrhagia, Menopause, Intrauterine Device Insertion, and Hormone Replacement Therapy (HRT). Dr. Grover is board certified in American Board Of Obstetrics And Gynecology. Dr. Grover is currently accepting new patients.
Erika Comasco practices practicing medicine in Uppsala, Sweden. Ms. Comasco is rated as an Elite expert by MediFind in the treatment of Premenstrual Syndrome. She is also highly rated in 3 other conditions, according to our data. Her clinical expertise encompasses Premenstrual Dysphoric Disorder, Premenstrual Syndrome, Postpartum Depression, Fetal Alcohol Syndrome (FAS), and Intrauterine Device Insertion.
Most women who are treated for PMS symptoms get good relief.
PMS symptoms may become severe enough to prevent you from functioning normally.
The suicide rate in women with depression is much higher during the second half of the menstrual cycle. Mood disorders need to be diagnosed and treated.
Contact or make an appointment with your provider if:
- PMS does not go away with self-treatment
- Your symptoms are so severe that they limit your ability to function
- You feel like you want to hurt yourself or others
If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
Summary: Premenstrual dysphoric disorder (PMDD) is a sex-specific depressive disorder where depressive symptom severity drastically changes in relation to menstrual cycle phase. It is characterized by late luteal phase symptoms of affective lability, irritability, depressed mood, and anxiety. A lot remains unclear and further studies are needed in order to improve the understanding of PMDD and to different...
Summary: Purpose: The aim of this project is to examine the effects of mandala painting and music performance interventions on premenstrual syndrome symptoms and quality of life. The hypotheses of the study are as follows: Coloring mandalas has a positive effect on premenstrual syndrome symptoms. Listening to music has a positive effect on premenstrual syndrome symptoms. Listening to music has a positive e...
Published Date: April 16, 2024
Published By: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Katzinger J, Hudson T. Premenstrual syndrome. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 212.
Mendiratta V, Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 35.
Sassarini J, McAllister K. Heavy menstrual bleeding, dysmenorrhea and premenstrual syndrome. In: Magowan B, ed. Clinical Obstetrics and Gynaecology. 5th ed. Elsevier; 2023:chap 7.