An A TO Z Guide to Premenstrual Syndrome (PMS), Its Symptoms & Treatment

January 30, 2021

PMS-Causes & Treatment

What is Premenstrual Syndrome?

Premenstrual syndrome, commonly known as PMS is a set of physical & emotional symptoms that normally occur 2-7 days before menstruation (sometimes up to 14 days). They usually end with the onset of your period or within a few days of it.

The intensity of premenstrual syndrome symptoms and their duration vary a lot from one woman to another. The most common symptoms are pronounced fatigue, tender and swollen breasts, swelling of the lower abdomen, headache, irritability & mood swings in periods.

What percentage of women are affected with PMS (PMS mood swings)?

Almost 75% of fertile women experience mild symptoms the day before or around the time of their period, such as mild uterine cramps. This does not prevent them from continuing their normal activities and it is, all in all, not very inconvenient. Between 20%-30% of women have symptoms severe enough to interfere with their daily activities.

The premenstrual dysphoric disorder (PMDD) is a PMS including very pronounced psychological symptoms. It would affect 2% to 6% of women on an average.

PMS Causes & Diagnosis

The criteria for establishing the diagnosis of premenstrual syndrome have long remained poorly defined. A new classification from the International Society for Premenstrual Disorders (ISPMD) clarifies the situation. For example, it has been established that for the diagnosis of PMS, symptoms must have occurred during the majority of menstrual cycles in the past year. In addition, PMS mood swings & other symptoms should be completely absent for at least 1 week per month.

At first glance, certain situations can be confused with PMS, such as premenopause and depression.

PMS Symptoms in Detail

Most women with PMS can experience many of the PMS symptoms mentioned here, but not necessarily all of them.

1. Emotional symptoms: mood swings, irritability, anxiety, difficulty in concentrating, feeling of depression or depression;
2. Pronounced fatigue;
3. Mood swings in periods;
4. Sleep disorders (insomnia or hypersomnia);
5. Headaches or migraines;
6. A decrease in sexual desire;
7. Cravings for sweet or savory foods;
8. Abdominal cramps (due to spasms of the uterus);
9. Muscle pain, especially in the lower back;
10. PMS Symptoms caused by fluid retention: swelling of the lower abdomen, tender and swollen breasts, sore or heavy legs, weight gain;
11. An acne breakout.

PMS can also intensify symptoms of other health problems. Migraines or chronic pain can be stronger and difficult to bear, also attacks of asthma, epilepsy or allergies.

PMS Treatment

The effectiveness of PMS treatment varies from woman to woman. Solutions may work wonderfully for some women and not work for others. Sometimes you have to try a few PMS treatments before you find the right one. Usually, a 3 month trial period is suggested.

Life habits-

The lifestyle changes mentioned below are enough to provide some comfort to women with mild or moderate symptoms.

Physical exercise-

Exercising regularly, throughout the month (20 to 30 minutes per day, 3 to 5 times per week) and not just for the few days that PMS symptoms last, results in general improvement.

The aerobic exercise (walking, swimming, bicycling, jogging, dancing, etc.), in particular, increase blood flow to various organs and thus help regulate fluctuations of sex hormones. In addition to providing a feeling of well-being and pleasure, physical activity allows you to release the excess energy accumulated in the event of stress or, on the contrary, to refuel, if necessary.


When a healthy lifestyle is not enough to relieve symptoms, medication can be used. Nevertheless, the drug strategy must always be combined with a healthy lifestyle.

Nonsteroidal anti-inflammatory drugs (NSAIDs)-

They relieve cramps and reduce breast tenderness. To be effective, they must be taken during the week before menstruation as well as the first days of menstruation. Ibuprofen (Advil®, Motrin®) and naproxen (Anaprox®, Naprosyn®) are the most used in these situations. Be careful . NSAIDs should not be used at the same time as diuretics

Continuous oral contraceptives-

Besides acting as a contraceptive, it is a good way to stop PMS because ovulation is prevented. This option is interesting, for example, in case of severe migraines at the end of the cycle or during menstruation. All pills can be taken continuously, but some have been designed for this purpose (eg Seasonale®).

Estrogen and progestogen patches-

Taking estrogen has been shown to be effective for many women. It must be accompanied by the taking of a progestogen in order to avoid the side effects of estrogen taken in isolation. This method is not contraceptive and it is not recommended to become pregnant while using estrogen in the form of patches. You should therefore use a method of contraception during sexual intercourse (for example, condoms or a Mirena® IUD).


Two families of antidepressants, selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, can effectively relieve certain symptoms of PMS (more specifically irritability). It is generally suggested that you take antidepressants during the 2 weeks before your period. The dosage is lower than for the treatment of depression.

Premenstrual syndrome – Causes & Treatment


These drugs promote the elimination of fluids and can reduce symptoms related to fluid retention (weight gain, leg pain or heavy legs, etc.). Due to their potentially serious side effects, they are hardly used in the treatment of PMS any more, except in rare cases. Spironolactone (Aldactone®) is the only diuretic to be used for this indication. A low-salt diet is often enough to limit fluid retention.

Food supplements

Eat 3 balanced meals daily , at regular times, without skipping meals. This helps maintain a stable sugar level;

Doctors are increasingly recommending calcium and magnesium supplements for women with PMS because studies have shown these minerals to have beneficial effects. Researchers believe PMS could be, in part, a manifestation of calcium deficiency.

Stress: fight it-

Given the climate of tension that PMS causes, it is desirable not to overload your schedule on critical days. Try to find solutions to better cope with situations that generate stress (reorganize your schedule, settle a conflict, etc.). Any approach that provides a state of relaxation is a useful complement (deep breathing, meditation, yoga, massages, etc.).

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