Symptoms of premenstrual syndrome (PMS) vary widely from woman to woman and can range from mild to severe. Although women with PMS can experience abdominal cramps, menstrual cramps (dysmenorrhea) are not considered a PMS symptom because they occur during, not before, menstruation.

There are more than 150 symptoms associated with PMS. Most fall into one of two categories – physical or emotional/behavioral.

The most common physical symptoms include:

• Abdominal cramps, pain or fullness
• Breast swelling and tenderness
• Fatigue
• Bloating or fluid retention
• Headache
• Backache
• Swelling of ankles, feet and hands
• Muscle spasms
• Weight gain
• Acne flare-up
• Nausea
• Constipation or diarrhea
• Food cravings
• Less tolerance for noises and light

The most common emotional/behavioral symptoms include:

• Irritability, hostility or aggressive behavior
• Anxiety or depression
• Difficulty concentrating
• Forgetfulness
• Low self-esteem
• Paranoia
• Changes in sex drive

Severe behavioral or emotional symptoms may indicate premenstrual dysphoric disorder (PMDD).