Exploring Premenstrual Syndrome: Causes, Symptoms, and Treatment

Premenstrual syndrome (PMS)


Premenstrual syndrome (PMS) presents with a diverse range of indications, such as mood swings, breast tenderness, food cravings, fatigue, irritability, and depression. Statistics suggest that up to three out of every four women who menstruate have encountered some manifestation of premenstrual syndrome.

These symptoms typically follow a consistent pattern, but the degree of physical and emotional changes during PMS can vary from subtle to intense. However, you need not allow these challenges to dictate your life. Through treatments and lifestyle modifications, you can effectively lessen or cope with the signs and symptoms of premenstrual syndrome.


The potential indications of premenstrual syndrome (PMS) are extensive, yet most women typically only encounter a subset of these issues. These signs and symptoms can be categorized into emotional and behavioral aspects, as well as physical manifestations.

Emotional and Behavioural Signs and Symptoms:

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings, irritability, or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration
  • Change in libido

Physical Signs and Symptoms:

  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain due to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhoea
  • Alcohol intolerance

For some individuals, the physical discomfort and emotional strain can be significant enough to impact their daily lives. Regardless of symptom severity, most signs and symptoms generally resolve within four days, after the onset of menstruation.

However, a minority of women experience debilitating symptoms every month, known as premenstrual dysphoric disorder (PMDD). PMDD signs and symptoms encompass depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability, and tension.


Diagnosing premenstrual syndrome (PMS) lacks distinctive physical findings or specific lab tests. Instead, your doctor might associate a particular symptom with PMS if it aligns with your predictable premenstrual pattern.

To ascertain this pattern, your doctor may request you to document your signs and symptoms in a calendar or diary for at least two menstrual cycles. It is essential to record the onset and cessation of PMS symptoms, as well as the commencement and conclusion of your menstrual period.

Various conditions, such as chronic fatigue syndrome, thyroid disorders, and mood disorders like depression and anxiety, can mimic PMS. In such cases, your healthcare provider may conduct tests like thyroid function tests or mood screenings to ensure an accurate diagnosis.


For numerous women, making lifestyle adjustments can provide relief from PMS symptoms. However, depending on the severity of the symptoms, your doctor may recommend one or more medications to address premenstrual syndrome.

The effectiveness of medications in alleviating symptoms varies from woman to woman. Commonly prescribed medications for PMS include:

  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and others have proven successful in reducing mood-related symptoms. SSRIs are typically the primary treatment for severe PMS or premenstrual dysphoric disorder (PMDD). While these medications are generally taken daily, some women with PMS may use antidepressants only in the two weeks leading up to menstruation.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs):Ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), taken before or at the onset of your period, can help alleviate cramping and breast discomfort.
  • Diuretics: When exercise and salt restriction are insufficient in reducing weight gain, swelling, and bloating associated with PMS, diuretics, such as Spironolactone (Aldactone), can assist in eliminating excess fluid through the kidneys.
  • Hormonal contraceptives: These prescribed medications prevent ovulation, potentially providing relief from PMS symptoms.

Self Care

You can effectively manage or alleviate premenstrual syndrome symptoms by adopting changes in your eating habits, exercise routine, and daily approach. Consider these suggestions:

Modify your diet

  • Opt for smaller, more frequent meals to minimize bloating and the feeling of fullness.
  • Restrict the intake of salt and salty foods to reduce bloating and fluid retention.
  • Prioritize foods high in complex carbohydrates, such as fruits, vegetables, and whole grains.
  • Ensure an adequate intake of calcium by choosing calcium-rich foods. If dairy products are not suitable or if your diet lacks sufficient calcium, a daily calcium supplement may be beneficial.
  • Steer clear of caffeine and alcohol.
  • Incorporate exercise into your regular routine
  • Engage in at least 30 minutes of brisk walking, cycling, swimming, or other aerobic activities most days of the week. Regular exercise can enhance overall health and alleviate specific symptoms like fatigue and low mood.
  • Reduce stress
  • Prioritize sufficient sleep.
  • Practice progressive muscle relaxation or deep-breathing exercises to alleviate headaches, anxiety, or insomnia.
  • Explore relaxation techniques such as yoga or massage to unwind and diminish stress.
  • Record your symptoms for a few months

Maintain a record to identify triggers and the timing of your symptoms. This proactive approach allows you to implement strategies that may effectively reduce or mitigate the impact of these symptoms.

Alternative medicine

Here’s the current understanding of the efficacy of complementary methods utilized to alleviate premenstrual syndrome symptoms:

  • Vitamin Supplements: Calcium, magnesium, vitamin E, and vitamin B-6 have been suggested to provide relief from symptoms, but the evidence supporting their effectiveness is limited or insufficient.
  • Herbal Remedies: Some women claim relief from PMS symptoms through the use of herbs like ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil, and St. John’s wort. However, scientific studies on the effectiveness of herbs for PMS symptom relief are scarce.

It’s crucial to note that herbal remedies are not regulated by the Food and Drug Administration, lacking a documented record of product safety or effectiveness. Consult with your doctor before considering any herbal products, as they may have potential side effects or interact with other medications. For instance, St. John’s wort can reduce the effectiveness of birth control pills.

  • Acupuncture: This involves the insertion of sterilized stainless steel needles into specific points on the body. Some women report symptom relief after undergoing acupuncture treatment.

Preparing for your appointment

Initiating your consultation with your family doctor or primary care provider is the typical starting point. However, in certain situations, when arranging your appointment, you might be directed to a specialist focusing on conditions related to the female reproductive tract (gynecologist).

To ensure a productive appointment, consider the following suggestions and understand what to anticipate during your consultation:

What you can do:

  • Check for any pre-appointment instructions. When scheduling, inquire if there are any necessary preparations.
  • Record all symptoms you are currently experiencing, even those seemingly unrelated to the reason for your appointment.
  • Compile a list of crucial medical information, encompassing any ongoing conditions and the names of medications, vitamins, or supplements you are taking.
  • Formulate questions for your doctor and jot them down. Bring a notepaper and a pen to document information during your discussion.

For addressing premenstrual syndrome, some essential questions may include:

  • What measures can I take to alleviate PMS symptoms?
  • Will my PMS symptoms naturally resolve over time?
  • Could my symptoms indicate a more serious medical condition?
  • Do you recommend specific treatments for PMS symptoms, and what are the available options?
  • Is there a generic alternative to the prescribed medication?
  • Are there any informational materials or websites you recommend?
  • Feel free to pose any additional questions that come to mind during your appointment.

What to expect from your doctor:

  • Your doctor will likely inquire about various aspects, such as:
  • The severity of your symptoms.
  • On which days of your menstrual cycle do your symptoms peak?
  • Whether you experience symptom-free days.
  • If you can predict the onset of your symptoms.
  • Factors that may exacerbate or alleviate your symptoms.
  • The impact of your symptoms on daily activities.
  • Any recent experiences of feeling down, depressed, or hopeless.
  • Personal or familial history of psychiatric disorders.
  • Previous treatments attempted and their efficacy.

In conclusion

In conclusion, the treatment for Premenstrual Syndrome (PMS) encompasses a multifaceted approach tailored to individual needs. Lifestyle modifications, such as dietary adjustments, regular exercise, and stress reduction techniques, can significantly alleviate symptoms for many women. Medications, including antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, and hormonal contraceptives, may be prescribed based on symptom severity.

Alternative therapies, such as vitamin supplements and herbal remedies, are available, though their effectiveness varies and should be approached with caution. Seeking guidance from healthcare professionals is crucial to determine the most appropriate treatment plan.

It is advised to maintain open communication with your healthcare provider, address concerns, ask questions, and actively participate in the decision-making process. Regular monitoring and adjustments to the treatment plan may be necessary to optimize symptom management and improve overall well-being. 

More Detail: https://www.patientsmedical.com/physicians/Dr-Emine-Cosar-Gynecologist-and-Obstetrician.aspx

Frequently Asked Questions about Premenstrual Syndrome (PMS)

What is Premenstrual Syndrome (PMS)?

PMS refers to a combination of physical and emotional symptoms that many women experience in the days leading up to their menstrual period.

What are the common symptoms of PMS?

Common symptoms include mood swings, irritability, tender breasts, food cravings, fatigue, and depression.

How prevalent is PMS?

It is estimated that as many as three out of four menstruating women experience some form of PMS.

When should I see a doctor for PMS symptoms?

If your symptoms significantly interfere with daily life or if you have concerns about their severity, it’s advisable to consult with a healthcare professional.

What lifestyle changes can help manage PMS symptoms?

Dietary modifications, regular exercise, stress reduction techniques, and adequate sleep are lifestyle changes that can contribute to symptom relief.

What medical treatments are available for PMS?

Medications such as antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, and hormonal contraceptives may be prescribed based on symptom severity.

Are there alternative treatments for PMS?

Some women find relief with vitamin supplements and herbal remedies, although their effectiveness varies. It’s crucial to consult with a healthcare provider before trying alternative therapies.

How can I track and manage my PMS symptoms?

Keeping a record of symptoms and noting triggers and patterns can help identify effective strategies for symptom management. Discussing this information with your healthcare provider can inform your treatment plan.

Can PMS be confused with other medical conditions?

Conditions like chronic fatigue syndrome, thyroid disorders, and mood disorders may share symptoms with PMS. Seeking professional medical advice and undergoing appropriate tests can help differentiate between them.

Is there a cure for PMS?

While there is no cure, various treatments, and lifestyle adjustments can effectively manage and alleviate PMS symptoms for many women. Finding the right combination may require consultation with a healthcare professional. 

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