Premenstrual Syndrome (PMS): Symptoms, Causes & Treatment

by | Apr 28, 2023 | Fertility

What is Premenstrual Syndrome (PMS)?

Premenstrual syndrome (PMS) is a common, yet often misunderstood, condition experienced by many women in the days leading up to their menstrual period. PMS is characterized by a wide range of physical, emotional, and cognitive symptoms that can vary in severity from woman to woman. Some common symptoms include mood swings, irritability, bloating, fatigue, and headaches. But what causes these symptoms, and why do they occur?

It’s believed that hormonal fluctuations, particularly in estrogen and progesterone levels, are the primary drivers of PMS symptoms. These hormonal changes can have a ripple effect throughout the body, leading to the varied and sometimes puzzling array of symptoms that women experience. But don’t worry, we’re here to help you better understand and manage this monthly visitor!


Premenstrual Syndrome (PMS): Prevalence and Impact on Women’s Lives

So, how common is PMS? Well, it’s estimated that up to 80% of menstruating women experience at least some PMS symptoms each month. That’s a staggering number when you consider the global population of women. It’s important to note that while some women may only experience mild symptoms, others can face significant challenges in their daily lives due to PMS.

Think about it: with the majority of women experiencing PMS symptoms, it’s no surprise that it can impact relationships, work, and overall quality of life. The emotional symptoms, like mood swings and irritability, can strain personal connections, while physical symptoms like fatigue and headaches can make it difficult to concentrate at work or school. It’s clear that PMS is more than just a minor inconvenience—it’s a condition that can have profound effects on women’s lives.


Symptoms of Premenstrual Syndrome (PMS) :

Emotional Symptoms:

EPremenstrual Syndrome (PMS) can be particularly challenging during PMS, as they often take a toll on our relationships and mental well-being. Let’s take a closer look at these common emotional symptoms:

  • Mood swings: Feeling like you’re on an emotional seesaw? Mood swings are a hallmark of PMS, with emotions ranging from happiness to sadness or anger in a matter of minutes. These fluctuations can be both exhausting and confusing.
  • Irritability: It’s no secret that PMS can make us feel more irritable than usual. This heightened sensitivity can lead to impatience, frustration, and even anger. Recognizing this irritability can help you better manage your reactions.
  • Anxiety and tension: PMS can amplify feelings of anxiety and tension, making it difficult to relax. Whether it’s worrying about everyday tasks or experiencing a general sense of unease, anxiety can be an unwelcome PMS companion.
  • Depression: For some women, PMS can trigger feelings of sadness, hopelessness, or even depression. It’s crucial to recognize these emotions and seek support if needed.


Physical Symptoms:

Along with emotional turbulence, PMS brings an array of physical symptoms that can be equally challenging to cope with:

  • Fatigue: Feeling more tired than usual? Fatigue is a common PMS symptom that can make it difficult to get through the day. Prioritizing rest and self-care is essential to combat this exhaustion.
  • Bloating and weight gain: PMS can cause bloating and water retention, leading to an uncomfortable sensation of fullness or weight gain. Opting for loose clothing and staying hydrated can help alleviate these symptoms.
  • Breast tenderness: Sore or swollen breasts are another common PMS symptom. Wearing a supportive bra and using a warm or cold compress can provide relief.
  • Headaches and migraines: PMS headaches or migraines can range from mild to debilitating. It’s essential to identify triggers and use appropriate pain management strategies to minimize discomfort.


Cognitive Symptoms:

Cognitive symptoms are often overlooked but can significantly impact daily functioning during PMS:

  • Difficulty concentrating: Do you find yourself struggling to focus on tasks or maintain attention during PMS? You’re not alone. This lack of concentration can be frustrating, so it’s essential to be patient with yourself.
  • Memory lapses: PMS can also cause forgetfulness or memory lapses, making it difficult to remember important details or appointments. Keeping a to-do list or using reminders can help you stay on track.


Uncommon and Severe/Worst PMS Symptoms:

While many women experience mild to moderate PMS symptoms, some individuals may face more severe or uncommon manifestations, including:

  • Intense food cravings
  • Insomnia or hypersomnia
  • Muscle or joint pain
  • Severe mood swings
  • Thoughts of self-harm or suicide

If you’re experiencing severe or extreme PMS symptoms, it’s crucial to seek professional help and support.


Causes of Premenstrual Syndrome (PMS) :

To better understand and manage premenstrual syndrome (PMS), it’s crucial to explore its underlying causes. Let’s delve into hormonal fluctuations, lifestyle factors, and genetic influences that contribute to PMS.

Hormonal Fluctuations:

Hormonal changes play a significant role in PMS symptoms. Here’s how estrogen, progesterone, and serotonin contribute to this monthly rollercoaster:

  • Estrogen and progesterone: These hormones naturally fluctuate throughout the menstrual cycle. Their imbalances during the premenstrual phase can trigger PMS symptoms like mood swings, irritability, and bloating.
  • Serotonin: This neurotransmitter is responsible for regulating mood, appetite, and sleep. Fluctuations in estrogen and progesterone levels can influence serotonin production, potentially contributing to PMS symptoms like depression and cravings.


Lifestyle Factors: How Daily Life Influences PMS

Our daily habits can either exacerbate or alleviate Premenstrual Syndrome (PMS) symptoms. Let’s examine the role of diet, stress, and sleep in PMS:

  • Diet: Consuming a diet high in salt, sugar, or caffeine can worsen PMS symptoms like bloating, irritability, and mood swings. On the other hand, a balanced diet rich in whole foods and essential nutrients can help reduce these symptoms.
  • Stress: High-stress levels can amplify PMS symptoms by exacerbating hormonal imbalances and impacting overall well-being. Adopting stress-reduction techniques like mindfulness, exercise, and relaxation can help minimize PMS-related distress.
  • Sleep: Poor sleep can intensify PMS symptoms by affecting hormone regulation and emotional well-being. Prioritizing restful sleep and maintaining a consistent sleep schedule can help improve PMS symptoms.


Genetic Factors: The Role of Family History and Gene Variations

Genetics can also play a role in PMS susceptibility:

  • Family history of PMS: Women with a family history of PMS may be more prone to experiencing the condition themselves. This suggests a possible genetic link.
  • Gene mutations and variations: Research is ongoing, but some studies indicate that specific gene mutations or variations may be associated with an increased risk of PMS or more severe symptoms.


PMS Diagnosis:

To accurately diagnose PMS, it’s essential to consider specific criteria, keep a symptom diary, and differentiate PMS from other conditions.

Criteria for Diagnosis:

To be diagnosed with PMS, a woman must meet certain criteria:

  • Symptoms occur during the five days before the menstrual period for at least three consecutive cycles.
  • Symptoms disappear within four days of menstruation onset and remain absent until at least cycle day 13.
  • Symptoms significantly interfere with daily life or relationships.

Keeping a Symptom Diary

Tracking symptoms in a diary can help identify patterns and provide valuable information for healthcare providers. Record physical, emotional, and cognitive symptoms, along with their severity, for at least two to three menstrual cycles.


Differentiating PMS from Other Conditions

PMS can mimic or be confused with other conditions, such as:

  • Premenstrual dysphoric disorder (PMDD): PMDD is a severe form of PMS characterized by extreme emotional and behavioral symptoms. Accurate diagnosis is crucial, as PMDD often requires more intensive treatment.
  • Thyroid disorders: Hypothyroidism and hyperthyroidism can share some PMS symptoms like mood swings, fatigue, and weight changes. A healthcare provider can rule out thyroid issues through blood tests.
  • Anxiety and depression: These mental health conditions can also present with symptoms similar to PMS, such as mood changes, irritability, and fatigue. It’s essential to differentiate between PMS and ongoing mental health concerns, as treatment approaches may differ.

By ruling out these conditions, healthcare providers can accurately diagnose PMS and recommend appropriate management strategies.


Treatments for PMS:

Pharmacological Treatments for PMS: 

Medications can play a significant role in managing PMS symptoms. Discover the over-the-counter and prescription options available to alleviate discomfort and improve mood.

Over-the-Counter Medications: Quick Relief at Your Fingertips

  • Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help alleviate PMS-related pain, such as headaches, cramps, and backaches. These medications work by reducing inflammation and blocking pain signals.
  • Diuretics: Over-the-counter diuretics can help relieve bloating and water retention associated with PMS. These medications increase urine output, helping to reduce excess fluid in the body.


Prescription Medications: Targeted Therapies for More Severe Symptoms

  • Hormonal contraceptives: Birth control pills, patches, or vaginal rings can help regulate hormonal fluctuations and reduce PMS symptoms. They work by suppressing ovulation and stabilizing hormone levels throughout the menstrual cycle.
  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can help manage severe mood-related PMS symptoms, such as depression, irritability, and anxiety. These medications work by increasing the availability of mood-regulating neurotransmitters in the brain.
  • Anti-anxiety medications: In some cases, benzodiazepines may be prescribed for short-term relief of severe PMS-related anxiety. However, these medications should be used cautiously due to the potential for dependence and side effects.


Non-Pharmacological Treatments:

In addition to medications, lifestyle changes can have a significant impact on PMS symptom management. Explore the benefits of diet, exercise, stress management, and sleep in addressing PMS.

Diet and Nutrition: Fueling Your Body for Better PMS Management

  • Importance of a balanced diet: Consuming a nutrient-rich diet can help reduce PMS symptoms by providing essential vitamins, minerals, and antioxidants. Focus on whole foods, such as vegetables, fruits, whole grains, proteins, and healthy fats.
  • Foods to avoid or limit: Reduce your intake of salt, sugar, caffeine, and alcohol, as these can exacerbate PMS symptoms like bloating, irritability, and mood swings.
  • Supplements to consider: Certain supplements, such as calcium, vitamin B6, and magnesium, may help alleviate PMS symptoms. Always consult a healthcare provider before starting any new supplement regimen.

Exercise: Moving Your Way to PMS Relief

  • Types of exercise: Engaging in regular physical activity, such as walking, swimming, yoga, or strength training, can help alleviate PMS symptoms by releasing endorphins and promoting overall well-being.
  • Benefits and frequency: Exercise can improve mood, reduce stress, and promote better sleep. Aim for about 30-40 minutes of moderate-intensity exercise most days of the week.

Stress Management: Finding Calm Amid the PMS Storm

  • Relaxation techniques: Practices like deep breathing, meditation, and progressive muscle relaxation can help reduce PMS-related stress and anxiety.
  • Cognitive-behavioral therapy (CBT): CBT is a type of talk therapy that can help identify and change negative thought patterns and behaviors associated with PMS. It can be an effective tool in managing mood swings and emotional symptoms.
  • Support groups: Connecting with others who experience PMS can provide valuable emotional support and practical advice for managing symptoms. Look for local or online support groups to share experiences and learn from others facing similar challenges.

Sleep: Prioritizing Rest for a Better PMS Experience

  • Importance of sleep hygiene: Quality sleep is essential for overall health and can help reduce PMS symptoms. Prioritize sleep by creating a comfortable sleep environment and establishing a consistent bedtime routine.
  • Establishing a sleep routine: Develop a regular sleep schedule, aiming for 7-9 hours of sleep per night. Establish relaxing bedtime rituals, such as reading or taking a warm bath, to signal to your body that it’s time to wind down.


Alternative and Complementary Therapies for PMS:

Sometimes, traditional treatments may not be enough or you may be looking for a more holistic approach. Discover how acupuncture, herbal remedies, and aromatherapy can complement your existing PMS management plan.


Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to promote healing and balance. Some studies suggest that acupuncture may help reduce PMS symptoms such as pain, mood swings, and bloating by improving blood flow and regulating hormonal imbalances. Consider seeking a licensed acupuncturist to explore this alternative treatment option.

Herbal Remedies:

Many women turn to herbal remedies as a natural approach to managing PMS symptoms. Some commonly used herbs include:

  • Chasteberry (Vitex agnus-castus): This herb has been used for centuries to treat menstrual irregularities and PMS symptoms, potentially by regulating hormone levels.
  • Evening Primrose Oil: Rich in gamma-linolenic acid (GLA), evening primrose oil may help alleviate breast tenderness and mood swings associated with PMS.
  • St. John’s Wort: Often used as a natural remedy for depression, St. John’s Wort may also help alleviate mood-related PMS symptoms.

Always consult with a healthcare provider before starting any herbal remedy, as they can interact with medications and cause side effects.


Aromatherapy uses essential oils extracted from plants to promote well-being. Some essential oils, such as lavender, clary sage, and chamomile, may help relieve PMS symptoms like anxiety, stress, and pain. Try diffusing essential oils, adding them to a warm bath, or using a diluted blend for massage. It’s important to use high-quality, pure essential oils and follow proper safety guidelines.

When to Seek Professional Help:

While many women can successfully manage PMS symptoms with lifestyle changes and alternative therapies, there are times when professional help is necessary. Consider seeking medical advice if:

  1. Your symptoms are severe: If PMS symptoms are interfering with your daily life, work, or relationships, it’s time to consult a healthcare provider.
  2. You suspect an underlying condition: Sometimes, PMS symptoms can mask other health issues, such as thyroid disorders or endometriosis. A healthcare professional can help rule out or diagnose these conditions.
  3. You’re considering new treatments: Before starting any new treatment, including herbal remedies or supplements, it’s essential to discuss your options with a healthcare provider.
  4. Your current treatments aren’t working: If you’ve tried various treatments and are still struggling with PMS symptoms, a healthcare professional can help you explore additional options, such as prescription medications or therapy.



Premenstrual syndrome (PMS) is a common yet complex condition that affects a large number of women worldwide. By understanding its symptoms, causes, and treatment options, you can take control of your health and improve your quality of life. From conventional pharmacological treatments to alternative and complementary therapies, there’s a diverse range of options available to address PMS symptoms. Always consult with a healthcare provider before starting any new treatment plan, and remember that seeking professional help is crucial when symptoms become severe or unmanageable. By taking a proactive approach and exploring various treatment options, you can successfully manage PMS and lead a healthier, happier life.



Q: How long does PMS last?

A: Premenstrual syndrome (PMS) typically lasts for a few days to a week before menstruation begins.

Q: When do premenstrual symptoms start?

A: PMS symptoms usually start one to two weeks before the period and go away shortly after menstruation begins.

Q: What are uncommon PMS symptoms?

A: Uncommon PMS symptoms may include insomnia, acne, constipation, or dizziness.

Q: How can I relieve PMS naturally?

A: Some natural ways to relieve PMS symptoms include regular exercise, reducing caffeine and alcohol intake, getting enough sleep, and eating a balanced diet.

Q: How to reduce PMS?

A: PMS can be reduced by adopting healthy habits like regular exercise, reducing stress, getting enough sleep, and avoiding foods that can trigger symptoms.

Q: Which hormone causes PMS?

A: The hormonal changes that occur during the menstrual cycle, specifically changes in estrogen and progesterone levels, are believed to be the cause of PMS.

Q: Do you gain weight during PMS?

A: Yes, some women may experience weight gain during PMS due to water retention.

Q: How many days before the period is PMS normal?

A: PMS symptoms can start one to two weeks before the period and typically last for a few days to a week.

Q: What are the 7 symptoms of PMS?

A: Common PMS symptoms include bloating, breast tenderness, mood swings, fatigue, irritability, headaches, and food cravings.

Q: What are signs of no period?

A: Signs of no period can include missed periods, reduced menstrual flow, or a complete absence of menstrual bleeding. Other possible causes include pregnancy, menopause, or certain medical conditions.

Q: How is premenstrual syndrome diagnosed?

A: PMS is typically diagnosed based on a woman’s reported symptoms and their timing in relation to her menstrual cycle.

Q: Does PMS cause infertility?

A: PMS itself does not directly cause infertility, but some conditions that can cause PMS symptoms, such as endometriosis, may affect fertility.

Q: What is discharge before the period?

A: Discharge before the period refers to a thick, white, or clear vaginal discharge that can occur in the days leading up to menstruation.

Q: Can PMS symptoms change over time?

A: Yes, PMS symptoms can vary from cycle to cycle and may change over time as a woman ages.

Q: How can I tell if my symptoms are PMS or something else?

A: The best way to determine if your symptoms are due to PMS or another condition is to track them over time and discuss them with your healthcare provider.

Q: Are there any long-term health risks associated with PMS?

A: While PMS itself is not associated with any long-term health risks, some conditions that cause PMS symptoms, such as endometriosis or polycystic ovary syndrome, may have long-term health implications.

Q: Can men experience similar symptoms?

A: While men do not have menstrual cycles, they may experience similar symptoms, such as irritability, fatigue, and changes in libido, due to hormonal changes.

Q: Will my PMS symptoms go away after menopause?

A: PMS symptoms typically improve or disappear after menopause when a woman’s hormone levels stabilize.

Q: How to reduce PMS mood swings?

A: Strategies for reducing PMS mood swings include regular exercise, stress reduction techniques, a healthy diet, and getting enough sleep. In some cases, medications or supplements may also be recommended.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 10,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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