PMS: Key Q&A

What is premenstrual syndrome (PMS)?

Premenstrual syndrome (PMS) is a group of physical, emotional and behavioral symptoms that commonly occur in the two weeks prior to menstruation. There are more than 150 symptoms attributed to PMS. Common symptoms include irritability, mood swings, anxiety, depressed mood, appetite changes, fluid retention and fatigue. Contrary to popular belief, menstrual cramps are not considered a symptom of PMS.

Does every woman experience PMS?

The National Women's Health Research Center (NWHRC) estimates that 75 percent of women of childbearing age experience PMS and 40 percent have symptoms bad enough to require treatment. While the symptoms and severity vary from woman to woman, most women experience PMS at some point in their lives.

Some factors put women at higher risk for PMS, including:

Past history of depression or postpartum depression
Family history of PMS
Children (women with children are more likely to experience more severe symptoms)
Lack of regular physical activity

What is PMDD?

Premenstrual dysphoric disorder (PMDD) is a condition similar to PMS but significantly more severe. About 3 to 8 of women experience PMDD according to the NWHRC. While the symptoms are similar, PMDD is considered a separate disorder from PMS and is diagnosed under stringent guidelines issued by the American College of Obstetricians and Gynecologists (ACOG).

What causes PMS?

The exact cause of PMS is unknown, although there are several factors that appear to contribute to its occurrence. Some women are particularly sensitive to the normal fluctuations of hormone production during the menstrual cycle, while others react to the changes in serotonin, a brain chemical that affects mood. Women with vitamin deficiencies and those who consume excessive salt, sugar, caffeine or alcohol may also experience PMS symptoms more frequently.

What is a menstrual diary?

A menstrual diary is a tool used to diagnose PMS. First doctors rule out any underlying medical conditions that could be causing symptoms. Then patients use a menstrual diary to record the type of symptoms experienced and when they occur during the menstrual cycle. If symptoms occur in a predictable pattern in the two weeks before menstruation and then cease when menstruation begins, PMS is diagnosed.

Can lifestyle changes help with PMS?

Lifestyle changes may be enough to eliminate mild PMS symptoms and can also lessen moderate to severe symptoms. These include eating a well-balanced diet, taking vitamins, exercising and reducing stress. Getting enough rest is also important. Your body may have different sleep requirements at different times during your cycle.

What medications are used to treat PMS?

Over-the-counter pain medications and anti-inflammatories help many women with PMS symptoms. Doctors may also prescribe diuretics (water pills), birth control pills, antidepressants, anti-anxiety drugs and other medications.

Can PMS be prevented?

Because its cause is unknown, there is no known way to prevent PMS. However, making lifestyle changes can help prevent or reduce the severity of symptoms.