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What Is PMS?

Medically Reviewed by Neha Pathak, MD on September 13, 2021

You probably get some signs that your period is coming. For most women, it’s no big deal -- maybe tender breasts or a taste for sweets. But for others, the days before their period are harder. If it messes with your daily life, you might have premenstrual syndrome (PMS).

Your period is a natural part of your life. And you can do anything you would do any other time of the month. If PMS is a problem for you, there are ways to manage it.

PMS is a group of changes that can affect you on many levels. They can be physical, emotional, or behavioral. The changes come 1 to 2 weeks before your period. Once your period starts or soon after it starts, they'll go away.

What Are the Symptoms of PMS?

Most women have at least one sign of PMS each month. But it’s not the same for everyone. It can change as you get older. It can be hard to know if you just have a few symptoms before your period, or if it’s really PMS.

One way to think about it is to ask the question: “Do these changes get in the way of my regular life? Do they cause trouble at work or with family and friends?” If you answer yes, it might be PMS. Another way to know is if you have symptoms in the 5 days before your period, for 3 months in a row.

Women with PMS deal with it in lots of ways. You can make changes to improve your diet, sleep, and exercise. You can also learn ways to relax your mind and body. If what you try doesn’t seem to work, you could talk to your doctor.

What Is PMS Like?

PMS shows up in many different ways. Everything in this list could be a sign of PMS. But most women get just a few of these, not all of them.

Physical signs

Emotional signs

  • Tense or anxious
  • Depressed
  • Crying
  • Mood swings
  • Can’t sleep
  • Don’t want to be with people
  • Feel overwhelmed or out of control
  • Angry outbursts

Behavioral signs

  • Forget things
  • Loss of mental focus
  • Tired

Girls and women who still get their period can get PMS. But it’s most common in women who:

What Causes PMS?

Even though PMS is common, doctors don’t know exactly what causes it. It probably has to do with changes in your body chemistry around the time of your period.

Some conditions affect PMS, but don’t cause it. PMS can be brought on, or can get worse if you:

  • Smoke
  • Are under lots of stress
  • Don’t exercise
  • Don’t sleep enough
  • Drink too much alcohol or eat too much salt, red meat, or sugar
  • Are depressed

Women with other health problems may find that those problems get worse before their period. Some of those are migraine headaches, asthma, and allergies.

What Can I Do to Manage PMS?

There are lots of ways to manage PMS. Even if you can’t totally fix it, it’s nice to know you have the power to help yourself. These ideas might help:

  • Exercise about 30 minutes a day.
  • Eat healthy foods like whole grains, fruits, and vegetables.
  • Try to get enough calcium from foods (think dairy, green leafy vegetables, and canned salmon).
  • Avoid salt, caffeine, and alcohol.
  • Don’t smoke.
  • Get plenty of sleep.
  • Work to lower stress.
  • Track your moods and symptoms in a journal.
  • Try over-the-counter pain relievers like ibuprofen, acetaminophen, or naproxen. Be sure to follow the dosing instructions exactly as it says on the label.

Some women take vitamins and minerals like folic acid, magnesium, vitamin B-6, vitamin E, and calcium with vitamin D. Others find that herbal remedies help. If you take any vitamins or supplements, check with your doctor first to make sure they are safe for you.

How Can My Doctor Help With PMS?

If you’ve tried different things but still have bad PMS, it’s probably time to get help. Make an appointment with your doctor or gynecologist. They’ll ask about your symptoms, your health, and medicines you take. They may take some blood tests to make sure the problem is PMS and not something else.

If you have notes about your symptoms, bring them to the appointment. Plan ahead about the questions you want to ask. That way, you’ll get the best help from your doctor.

Your doctor may suggest a treatment plan including:

  • Talk therapy, a way to feel better and learn new skills to overcome challenges by talking with a mental health counselor.
  • Over-the-counter (OTC) medicines
  • Prescription medications

Your doctor has several types of medicine to consider.

NSAIDs. Nonsteroidal anti-inflammatory drugs are painkillers that can also reduce inflammation (swelling). You can buy ones like aspirin, ibuprofen, and naproxen over the counter, or your doctor may prescribe a stronger dosage of these drugs.

Diuretics. If you retain water when you have PMS, you may gain a little weight and feel very bloated. Your doctor might prescribe a diuretic, which is medicine that helps you shed the extra water weight through natural means (by peeing more often).

Be sure to tell your doctor if you’re taking any other medications, especially NSAIDs. Taking NSAIDs and diuretics at the same time can damage your kidneys.

Antidepressants. There’s a connection between PMS and depression: Roughly half of women who go to their doctor for PMS also have it, as well as anxiety. PMS often causes mood problems, including depression during the time of the month that PMS symptoms appear, even among women who don’t have it at other times.

If your doctor thinks your depression needs treatment, they may prescribe an antidepressant. There are many antidepressants, and people respond differently to them, so it may take time to find one that’s right for you.

You may have success with selective serotonin reuptake inhibitors (SSRIs), including:

It can take 3 to 4 weeks before you see any benefits from an SSRI.

Birth control pills (hormone-regulating pills). Many women with PMS have fewer unpleasant symptoms when they take birth control pills. This is probably because, when you take them, you don’t ovulate (release an egg from your ovary each month). Doctors think that not ovulating is probably the reason for milder PMS symptoms.

Taking the pill also is more likely to improve your cramps, headaches, or other body aches, and help with the way PMS affects your moods.

WebMD Medical Reference

Sources

SOURCES:

Massachusetts General Hospital, MGH Center for Women’s Mental Health: “PMS & PMDD.”

Office on Women’s Health, U.S. Department of Health and Human Services: “Premenstrual syndrome.”

Harvard Medical School, Patient Education Center: “Premenstrual Syndrome (PMS).”

Mayo Clinic, Diseases and Conditions: “Premenstrual syndrome,”  “Premenstrual syndrome (PMS), Symptoms,” “Premenstrual syndrome (PMS): Treatments and drugs.”

American College of Obstetricians and Gynecologists: “FAQ, Premenstrual Syndrome,” “Premenstrual syndrome (PMS).”

American Society for Reproductive Medicine: “Noncontraceptive benefits of birth control pills.”  

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