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Premenstrual Syndrome (PMS)


Topic Overview

What is premenstrual syndrome (PMS)?

Most women have tender breasts, bloating, and muscle aches a few days before they start their menstrual periods. These are normal premenstrual symptoms. But when they affect your daily life, they are called premenstrual syndrome (PMS). PMS can affect your body as well as your mood. Sometimes it can make you change the way you act.

Some women first get PMS in their teens or 20s. Others don't get it until their 30s. The symptoms may get worse in your late 30s and 40s, as you approach perimenopause.

What causes PMS?

PMS is tied to hormone changes that happen during your menstrual cycle. Doctors don't fully know why premenstrual symptoms are worse in some women than in others. They do know that for many women, PMS runs in the family.

Not getting enough vitamin B6, calcium, or magnesium in the foods you eat can increase your chances of getting PMS. High stress, a lack of exercise, and too much caffeine can make your symptoms worse.

What seems like PMS might be caused by something else. Your treatment will change if your symptoms are not tied to PMS.

What are the symptoms?

PMS symptoms can affect your body, your mood, and how you act in the days or week leading up to your menstrual period.

Physical signs include:

  • Acne.
  • Bloating and tender breasts.
  • Food cravings.
  • Lack of energy.
  • Cramps.
  • Headaches.
  • Low back pain.

When you have PMS, you might also:

  • Feel sad, angry, or anxious.
  • Be less alert.
  • Find it hard to focus on tasks.
  • Want to withdraw from family and friends.
  • Act in a forceful or hostile way.

PMS symptoms can be mild or strong. If your symptoms are severe, you may have premenstrual dysphoric disorder (PMDD). But PMDD is very rare.

How is PMS diagnosed?

Your doctor will ask questions about your symptoms and do a physical exam. It's important to make sure that your symptoms aren't caused by something else, like thyroid disease.

Your doctor will want you to track your symptoms for 2 to 3 months by keeping a written record of how you feel. This is called a menstrual diary. It can help you track when your symptoms start, how bad they are, and how long they last. Your doctor can use this diary to help diagnose PMS.

How is it treated?

A few lifestyle changes will probably help you feel better. Eat healthy foods, get plenty of exercise, and take vitamin B6 and extra calcium. Cut back on caffeine, alcohol, chocolate, and salt. If you smoke, quit. For pain, try aspirin, ibuprofen (such as Advil or Motrin), or another anti-inflammatory medicine.

You will likely feel some relief from your symptoms after a few menstrual cycles. If you don't, talk to your doctor. He or she can prescribe medicine for many PMS problems, such as bloating.

There are other drugs you can take for more severe PMS symptoms. Selective serotonin reuptake inhibitors (SSRIs) can relieve both physical and emotional symptoms. Most women feel better after taking a low dose every day or only on premenstrual days.

Another treatment choice for moderate to severe symptoms is a type of birth control pill. It is sold as YAZ and Yasmin.

If you are taking medicine for PMS, talk with your doctor about birth control. Some medicines for PMS can cause birth defects if you take them while you are pregnant.

Frequently Asked Questions

Learning about premenstrual syndrome (PMS):

Being diagnosed:

Getting treatment:

Ongoing concerns:

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