What Increases Your Risk

Although the cause of premenstrual syndrome (PMS) is poorly understood, a number of risk factors have been noted among women with PMS.

Risk factors for PMS that you cannot control

• A family history of premenstrual syndrome (PMS)
• Age. PMS becomes increasingly common as women age through their 30s, and symptoms sometimes get worse over time.
• Previous anxiety, depression, or other mental health problems. This is a significant risk factor for developing premenstrual dysphoric disorder (PMDD).

Risk factors that you can control

• Lack of exercise
• High stress
• Vitamin B6, calcium, or magnesium deficiency
• High caffeine intake
• Poor diet

When To Call a Doctor

Many women have premenstrual syndrome (PMS) either before or during their menstrual periods. If you have severe symptoms, you may wonder whether you need to see your health professional for symptom treatment.

Call your health professional if:

• PMS symptoms regularly disrupt your life and keep you from doing your regular activities.
• You feel out of control because of PMS symptoms.
• PMS symptoms do not respond to home treatment.
• Significant PMS symptoms (such as depression, anxiety, irritability, crying, or mood swings) do not end after a couple of days of your menstrual period.

Watchful waiting

If PMS symptoms consistently occur for several months in a row, try home treatment measures. Many women find that making small changes in their lifestyle significantly improves their symptoms.

If home treatment does not improve your symptoms and they are severely disrupting your life, make an appointment for 3 months from now to see your health professional. Many health professionals will want you to complete a menstrual diary for at least two menstrual cycles before they can diagnose and treat PMS.

If you think you have PMS, keep track of the following in a menstrual diary(What is a PDF document?).

• Your symptoms and their severity
• Dates when symptoms occur
• Days that you ovulate (if you can tell when this happens)
• Days when you have your menstrual period

Who to see

Generally, your primary health professional can diagnose and treat premenstrual syndrome (PMS). If your health professional is not familiar with PMS, he or she can refer you to one who is.

Health professionals who can diagnose and treat PMS include:

• Nurse practitioners.
• Physician assistants.
• General practitioners.
• Family medicine doctors.
• Internists with training in women's health care.
• Gynecologists.

If you have severe PMS, you may need to consult a gynecologist to help develop a treatment plan. If your symptoms are mainly emotional or behavioral, or you have been diagnosed with premenstrual dysphoric disorder (PMDD), working with a psychiatrist or psychologist may help you find ways to manage your symptoms.

To prepare for your appointment, see the topic Making the Most of Your Appointment.