Premenstrual Syndrome (PMS)

Four out of ten menstruating women suffer from premenstrual syndrome (PMS). A syndrome is a group of signs and symptoms that indicate a disorder. There have been as many as 150 symptoms associated with PMS. The most common ones are:

  • Irritability.
  • Anxiety.
  • Depression.
  • Headache.
  • Bloating.
  • Fatigue.
  • Feelings of hostility and anger.
  • Food cravings, especially for chocolate or sweet and salty foods.

The exact cause or causes for PMS are not known. There are many theories. One points to low levels of the hormone progesterone. Others link it to nutritional or chemical deficiencies. One thing is certain, though, to be classified as PMS, symptoms must occur between ovulation and menstruation; that is, anytime within 2 weeks before the menstrual period and disappear shortly after the period begins.

For some women, symptoms are slight and may last only a few days before menstruation. For others, they can be severe and last the whole two weeks before every period. Also worth noting is that other disorders women experience such as arthritis or clinical depression may be worse during this same premenstrual period. This is known as premenstrual magnification (PMM).
PMS is often confused with depression. An evaluation by your doctor can help with a correct diagnosis.


Treatment for PMS may include:

  • Medical management with medicines such as:
    • The prescribed hormone progesterone (suppositories or an oral form).
    • Water pills such as Spironolactone (Aldactone).

  • Dietary changes such as:
    • Eating 5-6 light meals a day, instead of 3 large ones. Not skipping meals.
    • Avoiding sweets.
    • Limiting salt and fat.
    • Avoiding caffeine and alcohol.
    • Vitamin supplements especially B6.
    • Adequate intake of calcium and magnesium.

  • Lifestyle changes such as: Regular exercise, which includes 20 minutes of aerobic exercise such as walking or aerobic dance at least 3 times a week.
  • Limiting and learning to deal with stress.
  • PMS usually stops with menopause.

Questions to Ask

Are symptoms of PMS such as anxiety, depression and anger that leads to aggression, making you feel suicidal?

Yes: Seek Care

Do PMS symptoms make you feel out of control and unable to live your daily life?

Yes:See Doctor

Do you still have PMS symptoms after your period starts?

Yes:Call Doctor

Have you tried the self-care procedures and still don’t feel better?

Yes:Call Doctor

Self-Care Procedures

  • Exercise 3 times a week for 20 minutes. Swimming, walking and bicycling all relax your muscles and help you lose water weight.
    Eat 5-6 small meals a day instead of 3 large ones. Choose: Whole grains, fruits and vegetables; good food sources of calcium such as skim milk, non-fat yogurt, collard greens, kale, calcium-fortified cereals and juices and sources of magnesium such as spinach, other green, leafy vegetables and whole grain cereals.
  • Limit salt, fat and sugar. This will help keep your breasts from getting sore. It will also cut down on your body’s estrogen. Estrogen is a hormone that may cause PMS.
    If you need to satisfy a food craving, do so in moderation. For example, if you crave chocolate, have a small chocolate bar or add chocolate syrup to skim milk. If you crave salt, eat a small bag of pretzels.
  • Stay away from caffeine, alcohol and cigarettes for 2 weeks before your period is due.
  • These vitamin supplements seem to help some women. Ask your doctor what amount, if any, is good for you.
    • Vitamin E.
    • Vitamin B6.
    • Calcium.
    • Magnesium.
    • L-tyrosine, an amino acid.
  • Take naps if you need to.
  • Learn to relax. Try deep breathing, meditation, yoga or taking a hot bath.
  • Try to avoid stress when you have PMS.

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Written by American Institute for Preventive Medicine

Explore Wellness in 2021