What is premenstrual syndrome (PMS)?

• PMS is a group of symptoms related to the menstrual cycle.
• PMS symptoms occur in the week or two before your period and usually go away after your period starts.
• PMS may interfere with your normal activities at home, school, or work.
• Menopause (when your monthly periods stop) brings an end to PMS.
• PMS often includes both physical and emotional symptoms.

What causes PMS?

• The causes of PMS are not entirely clear, but some women may be more sensitive to changing hormone levels during the mentrual cycle.
• Stress does not seem to cause PMS, however it can make it worse.

What are the symptoms of PMS?

• Common symptoms are:
• Breast swelling and tenderness
• Fatigue and trouble sleeping
• Upset stomach, bloating, constipation, or diarrhea
• Headache
• Appetite changes or food cravings
• Joint or muscle pain
• Tension, irritability, mood swings, or crying spells
• Anxiety or depression
• Trouble concentrating or remembering
• Symptoms vary from one woman to another.
• If you think you have PMS, keep track of your symptoms and their severity for several months using our PMS Symptom Log. Bring the symptom log to your appointment with your doctor so he or she can review it with you.

How common is PMS?

• Estimates of the percentage of women affected by PMS vary. According to the American College of Obstetricians and Gynecologists up to 40% of menstruating women report some symptoms of PMS.
• Most of these women have symptoms that are farily mild and do not need treatment.
• Some women, perhaps 5-10%, have a more severe form of PMS.

What treatment is available for PMS?

• There is no single treatment that works for everyone.
• A combination of lifestyle changes and other treatment may be needed.
• If your PMS is mild, a healthier lifestyle may help you feel better and cope with your symptoms:
• Exercise regularly
• Get enough sleep
• Choose healthy food
• Avoid exess salt, sugary foods, caffeine, and alcohol, especially when you are having PMS symptoms.
• Don't smoke
• Find ways to minimize stress in your life
• Be sure that you are getting enough vitamins and minerals
• Take a multi-vitamin every day that includes 400 micrograms of Folic Acid.
• A Calcium supplement with Vitamin D can help keep bones strong and may help with PMS symptoms.
• In more severe cases, prescription medications such as birth control pills, Ibuprofen, or antidepressants may be needed. Talk to your doctor if you feel you need such treatment.
• Although PMS dose not seem to be related to abnormal hormone levels, some women respond to hormonal treatment with birth control pills.
• Another approach is to use birth control pills to stop ovulation from occurring. This can sometimes relieve some of the symptoms of PMS.
• There is evidence that a brain chemical (serotonin) plays a role in severe forms of PMS. Antidepressants that alter serotonin in the body have been shown to help many women with severe PMS.

What is Premenstrual Dysphoric Disorder (PMDD)?

• PMDD is a severe, disabling form of PMS.
• In PMDD the main symptoms are mood disorders such as depression, anxiety, tension, and persistent anger or irritability.
• These severe symptoms can lead to problems with day-to-day relationships and activities.
• Women with PMDD usually also have physical symptoms such as headache, joint and muscle pain, lack of energy, bloating, and breast tenderness.
• If you think you have PMDD it is important to make an appointment with your healthcare provider for a complete evaluation.