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PMS: Premenstrual Syndrome: Causes, Symptoms & Treatments

PMS: Premenstrual Syndrome: Causes, Symptoms, and Treatments

A surprise tear shed when you least expect, weight gain, tender chests….

If you’re like most people, the arrival of your monthly period is usually marked by one or more premenstrual symptoms. This makes sense since, during this time, the uterus is physically changing from a lush home for the fetus to an evacuation zone for the uterine lining.

Even though PMS is normally used in pop culture to define any premenstrual symptom, only a few people label their symptoms as PMS (premenstrual syndrome). Premenstrual symptoms are deeply rooted in your biology, but if they interfere with your life each month, you should consider learning more about handling or addressing PMS.

premenstrual syndrome
Premenstrual syndrome (PMS) – Symptoms and causes

Most women tend to blame themselves for PMS, and this shouldn’t happen because it is a medical condition that can be fixed via treatments and therapies. The most fundamental thing is to ensure you inform your gynecologist or NP to find the best solution.

We have chosen to write this article to help you know everything currently known about PMS, the best treatment option, and some evidence for treating the condition with various therapies, medications, supplements, and lifestyle choices. All this is done to equip you with the information you need to feel at your best all through your menstrual cycle.

What is PMS?

Some people still believe that premenstrual syndrome is a cultural phenomenon, but it is an actual clinical condition with clear-cut treatment plans. The condition’s definition is centred on numerous premenstrual symptoms (to be outlined in the next section), which coincide with hormonal fluctuations triggered by the menstrual cycle.

When should you expect PMS symptoms?

Symptoms of premenstrual syndrome usually start when progesterone and estrogen levels drop during the luteal phase – the second half of your menstrual cycle.

When will PMS end?

The symptoms you experience can stop shortly after you start menstruating.

How long can PMS last?

Although most women may have PMS only for some days, it can last for about two weeks between ovulation and menstruation.

PMS Symptoms Vs. Pregnancy Symptoms
PMS Symptoms Vs. Pregnancy Symptoms

What are PMS symptoms?

A few days before menstruation starts, you may experience a wide range of symptoms that affect your body, behaviour and emotions. Since people are unique, an individual’s PMS may be utterly different from another person’s. Over 200 varying premenstrual periods have been reported, so that we will mention a few of the popular ones here.

Some of the common emotional symptoms include:

  • Anxiety
  • Mood swings
  • Depression
  • Libido changes
  • Crying spells
  • Irritability
  • Difficulty concentrating
  • Sleep pattern disruption 
  • Confusion

Some popular physical symptoms of PMS include:

  • Headaches
  • Bloating
  • Weight gain
  • Food cravings
  • Breast tenderness
  • Hands and feet swelling
  • Skin problems
  • Gastrointestinal upset
  • Body aches and pain

Some women’s worst component could be headaches, while others could be diarrhea or insomnia and mood swings. This means that there isn’t a fixed way for women to experience PMS.

Your PMS version may include some symptoms, all or none. What’s more, the only requirements for symptoms to qualify as premenstrual symptoms is their occurrence in the days that lead up to your period and end some days before you start menstruating.

Do PMS symptoms worsen with age?

PMS symptoms can sometimes get worse as you approach menopause. Since hormone changes may be less predictable later on in your reproductive years, there is a chance that mood changes will follow suit. Low levels of estrogen during menopause can also cause intense mood swings.

What makes PMS a syndrome?

It’s common to experience one premenstrual syndrome, even though it might not affect your life – the prevalence of this is about 80% or higher. But to qualify as a syndrome, most experts in the medical field agree that premenstrual symptoms don’t necessarily have to exist merely but must significantly affect someone’s ability to handle their day-to-day activities. Studies suggest that close to 15% of women get distressed by the symptoms.

Currently, two more conditions resemble PMS:

Premenstrual dysphoric disorder (PMDD): About 2% to 6% of women who get their periods experience a more severe kind of PMS known as a premenstrual dysphoric disorder. Unlike PMS, this condition requires a diagnosis from medical experts.

Premenstrual exacerbation: Most people can also experience a premenstrual exacerbation, a condition that happens when other general health conditions (such as migraines, asthma, or mood disorders) affect someone throughout the month but get worse a few days to the menstruation period. Approximately 50% of migraines in women are cycle-related, whereas period-triggered asthma exacerbation is reported in about 40% of asthmatic women. Menstruation also exacerbates anxiety.

PMS definitions and prevalence estimates

PMS estimates can vary depending on how a condition is defined. However, this becomes an issue when trying to understand how popular PMS is in various countries – the systematic reviews on the topic are currently challenged by the varying definitions of PMS from one country to another.  Here is an excellent example of this:

One review revealed that the country with the least PMS prevalence was France (at 12%), while the nation that leads was Iran (at 98%). However, if you examine the data closely, you will notice a difference. When the Iranians narrowed down their premenstrual syndrome defined as the French study, the 98% statistic reduced to 16%.

What can you do to relieve your P.M.S symptoms?
What can you do to relieve your PMS symptoms?

Why do some women experience PMS while others do not?

Those who have researched PMS agree that there is little information about why this condition occurs. While fluctuating hormone levels greatly influence the premenstrual syndrome, it is not directly linked to an overabundance or deficiency of any specific hormone. The condition also appears to be tied to the brain chemistry due to its impact on neurotransmitter signalling (the chemical messaging of nerve cells), particularly for GABA and serotonin.

Additionally, various risk factors are linked with PMS, even though researchers cannot necessarily confirm that one causes the other. Stress, alcohol consumption, cigarette smoking, genetics, and depression have all been known to worsen PMS symptoms.

Regardless of these theories and associations, experts still cannot come up with a concise answer for this fundamental question of what leads to PMS. We hope to see more studies here soon.

How should PMS be treated?

At the moment, there isn’t a one-size-fits-all solution for treating premenstrual symptoms.  Usually, the less bothersome symptoms don’t necessarily need any treatment other than your general acceptance. You can manage other symptoms through nutrition and lifestyle changes. Medical intervention is recommended for those who suffer from severe PMS, PMDD, or experience challenging symptoms.

If the symptoms affect your quality of life, you should consider talking to your doctor or NP. This includes any symptoms that affect your work, nutrition, exercise, pain levels, sleep, relationships, or general ability to enjoy life.

Here are some recommended treatments for PMS and what research says about them.

Lifestyle changes to help Premenstrual Syndrome

Exercise: Most resources recommend getting aerobic physical activity regularly to reduce the symptoms of PMS and enjoy other potential health benefits. But, a meta-analysis on this aspect concluded that the results would vary from one person to another.

Stress management: Because stress levels are linked with PMS severity, health experts recommend picking up habits or methods to reduce stress. For instance, you may try meditation, yoga, breathing exercises, reading books, connecting with nature, or any other activity that can assist you in relieving stress.

Several small studies have outlined the benefits of different stress-relieving techniques – such as classic music chakra meditation- but most studies lack appropriate controls or could be biased. Ultimately, there’s no harm in incorporating these habits into your lifestyle, provided they make you feel more relaxed. There are no extensive studies to support their efficacy in treating PMS symptoms, which does not mean that they do not work.

Nutritional choices: Different studies have shown a clear link between nutritional choices and premenstrual symptoms. For instance, Western-style eating (high in salt, sugar, fat, calories, and low in whole grains) is often associated with PMS symptoms. So, if you choose to manage your PMS through a nutritional approach, you will need to maintain a food diary to note what works best for you.

Vitamins and Supplements for Premenstrual Syndrome

Calcium: The ACOG (American College of Obstetricians and Gynecologists) recommends taking a supplement of 1,200 mg of calcium every day to minimize the emotional and physical symptoms of PMS. Several studies have noted positive effects from taking calcium supplements, and reviews on the topic have suggested that it is an affordable and less risky intervention to consider.

Magnesium: There is some evidence that recommends taking a dose of 250 mg of magnesium every day to minimize premenstrual symptoms. Studies done so far have observed low magnesium levels in the red blood cells of PMS patients. But due to conflicting evidence from other researches, the jury is out on the supplement.

Other supplements: Most women are accustomed to taking additional vitamins and supplements for premenstrual symptoms. Some of the common ones contain micronutrients or the Chasteberry herb. However, it is hard to tell what supplements may work better than the rest without further studies.

Vitamins and Supplements for Premenstrual Syndrome
Vitamins and Supplements for Premenstrual Syndrome

Therapeutic treatment for Premenstrual Syndrome

Cognitive Behavioral Therapy (CBT): Although PMS is not mainly a mental health disorder, this therapy has established a clear history of improving the symptoms of different body-based or somatic diseases. Many studies have found CBT to be ideal for improving PMS symptoms, but more rigorous reviews on the studies still claim that there is not enough evidence to make clear-cut conclusions on its usefulness.

Alternative therapies: There are few studies on various alternative therapies, and thus, there is not enough clinically documented evidence for medical experts to recommend alternative therapies for treating PMS. But, individually, many women who have suffered PMS symptoms report a significant improvement from alternative therapies like acupuncture and other similar practices. Therefore, if you come across an alternative therapy that seems to work for you and does not pose any risks, you should go with it.

Medication for Premenstrual Syndrome

Antidepressants: One popular first-line treatment for premenstrual symptoms related to mood is selective serotonin reuptake inhibitors (SSRIs). Several controlled clinical trials support this recommendation, and depending on how the data is interpreted, PMS sufferers can notice a mild to moderate improvement. This means that the antidepressants may not be suitable for everyone, so if you choose this treatment option be sure to work with a healthcare provider to determine the best antidepressant to take. The doctor will also decide whether you should take the medication every day or on the days that lead up to your expected menstruation.

Non-steroidal anti-inflammatory drugs: Some of the physical symptoms of PMS like abdominal cramping, joint pain, and breast tenderness can be improved when you take over-the-counter pain relievers such as naproxen or ibuprofen.

Diuretics (water pills): Diuretics are ideal for managing any discomfort associated with water retention. Talk to your doctor if you would like to try a diuretic, so they can determine if it’s suitable and discuss potential side effects and interactions with any drugs you could be taking.

Hormonal contraceptives and hormone therapies: While there is mixed proof on the effectiveness of using birth control pills with drospirenone and other hormones, some people endorse these medications for ovulation prevention as PMS treatment. This medication may reduce premenstrual symptoms, but it also induces mood changes. Therefore, it is essential to discuss these options with your physician to determine if it’s the best solution for you.

Regardless of the treatment method you choose, be sure to track your PMS symptoms to know what improves or worsens them. The information we have shared will help you find the best treatment that works for you to avoid options that could have adverse effects.

When is the best time to discuss PMS symptoms with your healthcare provider?

Experts from the mayo clinic recommend managing PMS symptoms yourself by adopting some lifestyle changes before seeking medical advice. However, if PMS symptoms are disrupting your daily life, do not hesitate to consult your healthcare provider right away. When you get the right physician, they will assist you in determining if you have any other condition like PMDD and then assist you in ruling out underlying health problems that sometimes masquerade as premenstrual symptoms. The medical experts will also assist you in sorting through the treatments and research and finding the correct treatment technique for your symptoms.

Those who like taking the DIY treatment options and are advised to avoid supplements and other therapeutics that relevant medical authorities haven’t approved, as they may contain ingredients that could be harmful or have no clinical value.

If you usually experience premenstrual symptoms that interfere with your life, we hope the information on this post will make your life easier. Remember, you can choose to make some lifestyle changes, give yourself a dose of self-compassion or seek medical intervention. The symptoms you experience are real, so don’t be tempted to ignore them.

Main takeaways

  • Premenstrual syndrome doesn’t have a consistent definition, but it’s marked by a number of symptoms that can affect your daily life.
  • Premenstrual symptoms include over 200 emotional and physical symptoms towards the end of a menstrual cycle.
  • Very little is known about the causes of PMS. However, we know that its occurrence is linked to the change in progesterone and estrogen levels during the menstrual cycle’s luteal phase.
  • Various therapies, medications, vitamins, supplements, and lifestyle habits are regularly recommended for handling premenstrual syndrome. Some have clinical research to back them up, while others don’t.


Premenstrual syndrome (PMS) affects emotions, physical health on selected days of a menstrual cycle, read on to learn more about PMS