Premenstrual syndrome (PMS)

Premenstrual syndrome (PMS) refers to the physical and emotional symptoms that some people experience in the one or two weeks before their period. The symptoms usually ease once the period starts.

Many people have one or two premenstrual symptoms, and most of the time these can be easily managed. Everyone experiences PMS differently, and symptoms can change from one menstrual cycle to the next.

If you have severe emotional and mood-related symptoms before your period, it may be premenstrual dysphoric disorder (PMDD), which affects about 3% to 8% of people. It is worth discussing symptoms like these with your doctor.

Symptoms of PMS#

Common physical symptoms include:

• cramping in the pelvic area
• breast tenderness or swelling
• abdominal bloating and fluid retention
• acne
• aches and pains
• headaches
• constipation, diarrhea, or both
• poor sleep and tiredness.

Symptoms can also be emotional, such as:

• irritability and anxiety
• a lower ability to cope
• mood changes and sadness
• trouble with concentration and memory.

PMS symptoms can be worse during the teenage years and in the lead-up to menopause, which may be due to changes in hormone levels.

What causes PMS?#

It is not clear why some people have PMS, but it may be related to how certain chemicals in the brain interact with the hormone progesterone. Other factors, such as lifestyle, stress levels and mental health, can also play a part.

Managing PMS#

There are many things you can do to manage PMS.

A healthy lifestyle can help reduce symptoms#

• Do about 30 minutes of moderate physical activity on most days.
• Eat a balanced diet that includes fruit and vegetables, wholegrains, lean protein and dairy.
• Drink plenty of water, and cut back on sugary, caffeinated and alcoholic drinks.
• Make time for things you enjoy.
• Try relaxation techniques such as yoga and meditation.
• Get enough sleep and rest.

Medicine and hormone treatments#

Your doctor may recommend different medicines depending on your symptoms. For example, antidepressants or anti-inflammatories may help with some symptoms, and hormonal treatments can be used to stop ovulation.

Natural therapies#

Natural therapies are part of a broad range of complementary and alternative medicines (CAM). Many people use complementary therapies such as acupuncture, naturopathy and herbs to help manage PMS, but more research is needed to understand how effective they are.

Supplements commonly used to manage PMS include:

• evening primrose oil
• calcium
• vitamin B6
• chaste tree (also called “chaste berry”)
• magnesium.

Get advice from a qualified, experienced health practitioner before using complementary therapies. Always tell your doctor if you are taking any complementary medicines, as they can affect other medicines.

When to see your doctor#

See your doctor if:

• PMS symptoms are bothering you
• symptoms stop you from doing things you normally do
• symptoms continue despite lifestyle changes
• you have severe emotional and mood-related symptoms
• medicine or hormonal treatments do not improve your symptoms.

Key points#

• PMS symptoms usually ease when your period starts, and most people have only one or two symptoms that can be easily managed.
• Everyone experiences PMS differently, and symptoms can change from cycle to cycle.
• A healthy lifestyle, and sometimes medicines or hormonal treatments, can help reduce symptoms.
• Discuss your symptoms with your doctor, especially if they are severe or do not improve.

Where to get help#