Premenstrual syndrome (PMS)

• Premenstrual syndrome (PMS) is a combination of physical and emotional symptoms occurring during the weeks before your period.
• PMS symptoms can vary in intensity, with the more severe forms impacting everyday life. 
• Lifestyle factors can contribute to the severity of PMS. Making healthy lifestyle changes can help reduce your symptoms.

Premenstrual syndrome (PMS) is a condition that affects millions of women all around the world. It's a complex condition that can cause various physical and psychological symptoms. These symptoms can range in intensity from mild to severe and can have an impact on your everyday activities. In this article by Ada's medical team, you can find more information on the condition to better understand what PMS is, which symptoms you may experience, and how you can find relief.

PMS is short for premenstrual syndrome. It’s a term used to describe a number of physical and emotional symptoms which you can experience in the weeks leading up to your period. It can affect anyone of childbearing age, especially women in their 30s. 1 2

Premenstrual syndrome symptoms can be both physical or psychological. The signs of PMS can be different for anyone and can vary from month to month. PMS symptoms can be experienced in the weeks before your period as a result of changes in your hormonal cycle. The symptoms of PMS can be divided into physical symptoms, psychological symptoms and changes in mood or behavior. 1 2

The most common physical signs of PMS are: 1 2

• Bloating
• Cramping
• Constipation or diarrhea
• Swollen or tender breasts
• Headaches
• Backaches
• Trouble with concentration or memory
• Greasy hair
• Skin issues
• Weight gain
• Nausea
• Muscle and joint pain
• Swelling of the extremities

PMS can cause emotional symptoms as well, such as: 1 2

• Feeling sad, upset, anxious, or emotional 
• Quickly feeling irritated or agitated 
• Feeling tense
• Mood swings
• Depressed mood

With PMS, you can also notice behavioral changes such as: 1 2

• Tiredness
• Trouble sleeping or insomnia
• Food cravings
• Less interest in sex

A high percentage of women experience at least some of these symptoms before their period. For most women, these symptoms are mild, although for others, they may be so severe that daily activities can become difficult. If you're experiencing severe PMS symptoms, you may have premenstrual dysphoric disorder (PMDD), a chronic condition that requires medical attention. 1 2

The exact cause of premenstrual syndrome is still uncertain, although scientists believe that it has to do with the fluctuations in hormones during the menstrual cycle. In the weeks before your menstruation, estrogen levels fluctuate. Estrogen levels have an effect on the production of several substances, including dopamine and serotonin. This can explain many symptoms of PMS, such as tiredness, mood changes, and the feelings of depression and sadness. 3

Research also indicates that lifestyle factors are an important trigger for PMS. A less active lifestyle, poor sleep quality, and an excess consumption of sugar, junk food and coffee have been associated with PMS. 3

In order to be diagnosed with PMS, other conditions that may cause your symptoms should be ruled out first. If you experience symptoms that are in line with typical signs of PMS during the weeks before your period and other conditions are excluded, then your physician may diagnose you with PMS. It’s also common for your physician to ask you to keep a diary of your symptoms for at least 2 menstrual cycles. This can help your physician to diagnose you with PMS.

PMS symptoms go away on their own, but there are some things that you can do to relieve your symptoms and reduce the impact on your everyday activities: 

Lifestyle modifications are key in reducing PMS symptoms. These may include: 3 1

• Regular exercise
• Stress reduction
• Healthy sleeping habits
• Following a healthy, balanced diet 
• Avoid cigarettes and excessive alcohol

Certain medications or treatments may also help you find relief. Your healthcare provider may advise you of any of the following PMS treatments: 3 1

• Painkillers such as ibuprofen or paracetamol to ease the pain
• Cognitive behavioral therapy to recognize certain behaviors and develop coping strategies 
• Certain oral contraceptives to improve severe PMS or PMDD.
• Herbal medicine such as Vitex agnus-castus, which improves PMS-associated mood swings
• Selective serotonin reuptake inhibitors to improve emotional symptoms

PMS symptoms are very common and can occur in women of childbearing age. Some women may only experience mild symptoms, whereas others can experience severe symptoms that can impact everyday activities. In order to reduce the symptoms of PMS, you can make lifestyle alterations and consult with your healthcare provider for additional therapies. 

Q: What are 5 common PMS symptoms? 
A: Common PMS symptoms include mood swings, tender breasts, fatigue, irritability, and food cravings. However, there are many other possible symptoms. 

Q: Is nausea a symptom of PMS?
A: In some cases, women with PMS can experience nausea. However, there are also other possible causes of nausea. You should contact your healthcare provider if you are unsure of what is causing your symptoms. 

Q: When does PMS start? 
A: PMS can start around childbearing age and is most frequent in women aged 25-35. The symptoms of PMS usually start 1 to 2 weeks before the period and disappear afterward.

Q: What is the difference between PMS and PMDD? 
A: PMDD (premenstrual dysphoric disorder) is a form of severe PMS. It’s a chronic condition that can affect your mood and physical well-being. 

Q: How to deal with premenstrual syndrome? 
A: You can relieve your PMS symptoms before your period by making healthy lifestyle choices such as living an active life, reducing your stress levels, and maintaining a healthy, balanced diet. If necessary, your healthcare provider can also prescribe you with medication to reduce your PMS symptoms.