PMS: Symptoms, causes, diagnosis and treatment.

Premenstrual syndrome (PMS) is a group of symptoms that occur before the first day of a woman's period. Some women experience mild abdominal cramps for several hours, while others may experience severe pain and mood swings in the two weeks before their period begins.

PMS is often diagnosed based on when symptoms appear. When the consequences are particularly onerous, hormone levels or imaging tests may be needed to determine if a woman has a medical condition.

There are natural therapies and medical procedures that can help ease the effects of PMS, and you can talk with your doctor to determine which method is best for you.

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The premenstrual phase usually lasts a few days before your period, but it can start two weeks before your period starts. For symptoms to be considered part of PMS, they must appear within two weeks of a woman's period and must not be present for the rest of the month. PMS can begin at any age when a woman begins menstruating.

There are a number of physical, emotional, and cognitive effects that can occur as part of PMS.

Common symptoms of PMS include :

While you may experience some of these effects, it is unlikely that you will experience all the different symptoms that can occur with PMS.

Many teens experience PMS, and symptoms for all women can change with age. For example, a woman who may be prone to PMS-related outbursts may not experience them for many years, but may develop abdominal cramps and weight gain a few days before her period.


Some women experience particularly unpleasant effects of PMS, which can interfere with relationships, work, and general well-being.

The serious consequences of PMS include:

  • Marriage or relationship problems
  • Difficulty raising children
  • Decrease in academic performance or academic performance.
  • Loss of interest in communication.
  • Suicidal thoughts

If you experience depression due to PMS, you may have a form known as premenstrual dysphoric disorder (PMDD) .


The effects of PMS are caused by hormonal changes that occur during a woman's menstrual cycle. Estrogen and progesterone are the main hormones in a woman's body. These hormones fluctuate throughout a woman's menstrual cycle. Before your period starts, estrogen levels drop and progesterone levels rise.

There is also a pattern of cyclical physiological changes that occur throughout the body in the weeks and days leading up to menstruation, including metabolic variations, neurotransmitter changes, and vascular changes. The neurotransmitters serotonin (associated with mood) and gamma-aminobutyric acid (GABA, associated with rest) are most closely associated with PMS .

All of these physiological changes, as well as hormone levels, cause PMS symptoms.

Some of the hormonal and physiological patterns of the menstrual cycle and their effect on PMS include:

  • Hormonal changes cause breast tenderness and swelling
  • Hormonal changes cause the uterus to contract (leading to abdominal / uterine cramps)
  • Metabolic changes affect appetite, weight, bloating, and energy levels.
  • Changes in neurotransmitters affect mood, sleep, digestive symptoms, and can trigger migraines.
  • Vascular changes can affect migraines and cause swelling of the hands and feet.

Experts suggest that changes in estrogen and progesterone trigger other physiological effects of PMS. While most women experience very similar patterns during their menstrual cycle, there are some subtle differences between women, which is why not all women experience the exact same symptoms. PMS.


Various screening tools are used to diagnose PMS. Generally, healthcare providers use a medical history or questionnaire to diagnose this condition. There are no blood tests or other diagnostic tests that can confirm the diagnosis of PMS.

Among the criteria for diagnosing PMS, your symptoms should go away during or immediately after your period and not reappear until two weeks before your next period. And they shouldn't be related to drugs (including hormone replacement), alcohol, or drugs.

You can keep a calendar to keep track of when symptoms appear.

Menstrual cycle calendar

The easiest way to determine if you have PMS is to track your symptoms for two to three months on a standard calendar. The menstrual cycle calendar can help you and your healthcare provider know if you have cyclical symptoms that coincide with your menstrual cycle.

To complete the menstrual calendar, follow these steps:

  1. The first day you start bleeding, write the first day on your calendar.
  2. Write down any symptoms you experience that day and rate each one on a scale of 1 to 10.
  3. Do this every day for two to three months.

The true symptoms of PMS don't appear until day 13, so any symptoms you experience early in your cycle may have a different cause. However, you should include any symptoms that you experience on days 1 through 13 on your calendar.


PMDD is a serious form of PMS that affects approximately 3% to 8% of menstruating women. According to the Diagnostic and Statistical Manual of Mental Disorders, to be diagnosed with PMDD, a woman must experience at least five of the following symptoms during the premenstrual phase of her cycle and not at other times :

  • Feelings of sadness or hopelessness or suicidal thoughts.
  • Severe stress, tension, or anxiety
  • Panic attacks
  • Inappropriate mood swings and crying spells.
  • Persistent irritability or anger affecting other people.
  • Loss of interest in normal daily activities and relationships.
  • Inability to concentrate or focus
  • Lethargy
  • Binge

Differential diagnosis

You may need a diagnostic test to look for hormonal or uterine problems if you have severe physical symptoms and / or irregular bleeding. This type of evaluation may include blood tests that check hormone levels and imaging tests that look at the uterus or ovaries.

If your symptoms don't recur, your healthcare provider may consider other conditions, such as depression, anxiety, gastrointestinal problems, or thyroid disease.

Watch out

There are ways to manage PMS. Some women benefit from supplementation or over-the-counter therapy, while others may require prescription medications. Lifestyle approaches can also be helpful.

The need for treatment depends on the severity of your symptoms and how they affect your life. You can discuss your symptoms with your doctor, who will recommend the best treatment for you.

Treatment for PMS may include:

  • Over-the-counter pain relievers: If you have cramps, headaches, or breast tenderness , medications like Advil (ibuprofen) or Tylenol (acetaminophen) can help.
  • Supplements : some women are deficient in vitamins such as vitamin C, magnesium , or vitamin B12. Changes in appetite can cause this nutrient deficiency, and supplements can help with PMS symptoms, as well as symptoms of nutritional deficiencies.
  • Prescription pain relievers: If you have severe cramps, migraines, or depression, you may be prescribed medication to relieve symptoms.
  • Hormone therapy : For some women, hormone therapy with oral contraceptives , estrogen replacement therapy, or progesterone cream can help reduce the effects of PMS. Note that hormones can have a great effect on fertility and may be contraindicated in women at risk of breast, ovarian, or uterine cancer.
  • Acupuncture or Acupressure : Research shows that these alternative treatments can reduce some of the symptoms of PMS in some women.

Keep in mind that your PMS symptoms can change when you use birth control, and you may need a new approach to treatment when your symptoms change.

Lifestyle adjustments

There are also non-medical approaches that can help reduce some of your symptoms. Women with mild cramps can be relieved by placing an ice pack on their stomach for a few minutes.

It is helpful for women with mild mood swings to talk to a counselor or close friend. Habits like exercise, journaling, or even just knowing that mood swings are hormonal can help prevent breakouts that can ruin a relationship.

Get the word of drug information

PMS is very common. While most women can function normally at any time of the month, the condition can be problematic for some women. If PMS is interfering with your life, it is important to speak with your doctor to try to alleviate your physical and emotional symptoms so that you can function in the best way possible.

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