Some Important Facts About PMS

  • PMS stands for Premenstrual Syndrome.
  • PMS refers to a set of certain physical and psychological factors.
  • Physical symptoms of the premenstrual syndrome include breast tenderness and bloating. 
  • Specific symptoms such as mood swings, anger, and depression are not very uncommon during PMS. 
  • PMS happens in the latter half of a woman’s menstrual cycle.
  • The exact cause of PMS is not yet discovered, but the researchers believe that there is some link between your sex hormones and brain chemicals. 
  • PMS exhibit similar symptoms as in many other health conditions, and so you must be able to distinguish between the signs. 
  • The only way to distinguish between the symptoms of PMS and pregnancy in case of missing menstrual cycle is a pregnancy test. 

What Is Premenstrual Syndrome?

Premenstrual syndrome or (PMS) is a combination of physical, emotional, and psychological disturbances that happens after a woman’s ovulation and usually ends with the commencement of her menstrual flow. 

Some of the most common mood-related symptoms include mood swings, depression, irritability, crying, and oversensitivity. And some of the prevalent physical symptoms of PMS include bloating, fatigue, breast tenderness, appetite changes, and acne flare-ups. 

A severe form of premenstrual syndrome occurs in a small number of women and can cause significant loss of functions due to strikingly severe symptoms. This condition is generally referred to as premenstrual dysphoric disorder (PMDD). According to the American Psychiatric Association PMDD, symptoms like anger, anxiety, and irritability are eminent in PMDD. 

Other common symptoms Of PMDD:

  • Panic attacks
  • Depression
  • Suicidal thoughts
  • Extreme anxiety
  • Crying spells
  • Anger with severe mood swings
  • Insomnia
  • Lack of interest in regular activities
  • Painful cramping
  • Binge eating
  • Trouble thinking or focusing
  • Bloating

The changes in the level of some hormones in the body (estrogen and progesterone) are the prime reason behind the PMDD symptoms. It is believed that there is also some link between low serotonin levels and PMDD.

The doctor may order the following tests to eliminate the possibility of other medical conditions:

  • A physical exam
  • A gynecological exam
  • A liver function test
  • A complete blood count test

The doctor can also recommend a psychiatric evaluation in some cases. Family history or personal history of significant trauma, depression, substance use, or stress can activate or worsen your PMDD symptoms. 

Treatment Alternatives For PMDD

  • Daily exercise
  • A caffeine-free diet
  • Stress management 
  • Vitamin supplements such as vitamin B-6, magnesium, and calcium
  • Individual and group counseling

drospirenone and Ethinyl estradiol tablet (Yaz) – the only approved birth control pill by the FDA for treating PMDD. 

How Many Women Suffer From Premenstrual Syndrome?

Studies suggest that about 90% of women experience the symptoms of premenstrual syndrome at some of the other points in life. The exact prevalence of PMS has often been exaggerated by including all the women who experience some emotional or physical symptoms before the start of menstrual flow. It is believed that clinically significant PMS occurs in just 20-30% of women. The symptoms are generally more severe in women in the fourth decade of their life (aging between 30-39 years). It is estimated that about 3-8% of people have such severe symptoms.  

What Are The Signs & Symptoms Of PMS?

Different women experience different symptoms during premenstrual syndrome. You may get specific physical symptoms (gas, bloating) or emotional symptoms (sadness, anxiety, etc.). Your symptoms may even vary all throughout your life. 

Physical symptoms of PMS can include:

  • Swollen or tender breasts
  • Constipation or diarrhea
  • Bloating or a gassy feeling
  • Cramping
  • Headache or backache
  • Clumsiness
  • Lower tolerance for noise or light

Emotional or mental symptoms of PMS include:

  • Irritability or hostile behavior
  • Feeling tired
  • Sleep problems (sleeping too much or too little)
  • Appetite changes or food cravings
  • The trouble with concentration or memory
  • Tension or anxiety
  • Depression, feelings of sadness, or crying spells
  • Mood swings
  • Less interest in sex

Consult a healthcare specialist if your symptoms worsen with time or interfere with your regular activities. 

PMS Vs. Pregnancy Symptoms

Understand the difference between the two conditions by looking at the following data –

PMS Symptoms:

  • No bleeding
  • A sudden increase in appetite
  • Acne

Pregnancy Symptoms:

  • Missed menstrual cycle
  • Nipple changes
  • Nausea or vomiting
  • Light vaginal bleeding

Overlapping Symptoms:

  • Stomach cramping
  • Mood swings
  • Breast tenderness
  • Fatigue
  • Headache
  • Constipation
  • Lower backaches

How Long Does The PMS Symptoms Exist?

The symptoms start developing after your ovulation. Ovulation occurs nearly two weeks before you get your period, so the symptoms usually appear during this time and fade after bleeding commences. 

However, there is no guarantee that your symptoms last only up to this period. Certain conditions can develop in which you can experience the symptoms even after your menstrual cycle is over or earlier in your cycle than you had estimated. 

What Causes PMS?

The exact cause of PMS is unknown. Although some of the following factors may be responsible:

  • Hormonal Changes: The signs and symptoms of PMS may transform with hormonal changes and disappear with menopause and pregnancy.
  • Depression: Some women with PMS have undetected depression, although depression only cannot bring about all the symptoms. 
  • Chemical Changes In The Brain: Changes in the brain chemical that’s believed to play a significant role in mood states can cause some of the PMS symptoms. Inadequate serotonin levels may lead to premenstrual depression, and also to food cravings, fatigue, and sleep disorders.

What Conditions Mimic PMS?

Following are some examples of medical conditions that mimic PMS:

  • Depression
  • Cyclic water retention (idiopathic edema)
  • Chronic fatigue
  • Hypothyroidism
  • Irritable bowel syndrome (IBS)

How Is PMS Diagnosed?

There are no particular physical findings or diagnostic tests that can accurately diagnose PMS. Your doctor may classify your symptoms as PMS if it is a part of your anticipatable menstrual pattern. 

To help recognize your premenstrual pattern, the doctor will note your signs and symptoms in a diary or calendar for at least two menstrual cycles. Mark the day when you first start noticing the symptoms of premenstrual syndrome, and also the day they disappeared. Also, make sure to mark the starting and ending day of your menstrual cycle. 

As PMS symptoms mimic various conditions, the doctor may also order a mood screening test for thyroid function tests to help provide an accurate diagnosis. 

What Are The Treatment Alternatives Available For PMS?

Following are the alternatives available for PMS treatment:

  • NSAIDs: NSAIDs or Nonsteroidal Anti-inflammatory drugs are taken before or at the onset of your period to relieve breast discomfort and cramping. Some of the popular NSAIDs for PMS are – ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve)
  • Antidepressants: These medications are taken regularly, but in some cases, its use remains limited to a couple of weeks before the menstrual cycle. Some of the standard antidepressants are – fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), sertraline (Zoloft). 
  • Diuretics: When limiting the salt intake and exercising aren’t sufficient to reduce the weight gain, bloating, and swelling of premenstrual syndrome, taking diuretics can help shed additional fluids from your kidney. A diuretic called Spironolactone (Aldactone) can help relieve your symptoms of PMS.
  • Oral Contraceptive Pills (OCPs): These are the prescription drugs used to deal with ovarian hormone fluctuations. Some studies lack enough evidence to support the statement that the use of oral contraceptives for PMS is effective. Some of the new birth control pills with better hormone formulations proved to be more effective for many women.
  • Analgesics: These are the painkillers generally given to treat menstrual cramps, pelvic discomfort, and headaches. Some of the common analgesics include ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox), and mefenamic acid (Ponstel). 
  • Benzodiazepines: Some studies indicate that benzodiazepine alprazolam (Xanax) can ease the depressive symptoms associated with severe PMS or PMDD. However, it has an addictive characteristic, and so is not the primary treatment for the condition. 
  • Ovarian Suppressors: The doctor may recommend the ovarian suppressors such as danazol (Danocrine) to reduce the production of the ovarian hormone. But, this particular drug comes with some severe side effects and therefore, cannot be taken for too long. 
  • Gonadotropin-releasing hormone (GnRH): A group of drugs called Gonadotropin-releasing hormone equivalents is found to be beneficial in treating some women with PMS. These medications cannot be given for an extended period as it reduces the bone density in women, which leads to bone thinning. Sometimes, the doctor prescribes GnRHs in combination with hormone supplementation to offer the desired effect. 

One important thing to consider is that these medications are helpful in treating mood swings, but may be ineffective for physical symptoms of PMS. For maximum improvement of the condition, a woman needs to have a proper diet, suitable medications, and daily physical activity. 

Also Read: Safe Sex Tips For Females

Natural Remedies To Relieve PMS Pain And Other Symptoms

You can hope for some improvement in the symptoms of PMS by making slight lifestyle modifications. Some of them are listed below:

  • Diet: You need to increase the intake of complex carbohydrates and limit the consumption of sugar – this is one of the most common dietary recommendations for women with PMS. Some women may get helped by reducing sodium intake, which can reduce water retention, bloating, breast tenderness, and swelling. There is a close link between the PMS symptoms and caffeine, and so it is recommended to limit your caffeine intake. 
  • Exercise: To improve the symptoms of PMS, kindly stick to a regular exercise routine. Specific aerobic activities like swimming, jogging, brisk walking, and cycling release dopamine, endorphins, and serotonin, and it also has a positive influence on sleep and energy. 
  • Stress Management: Yoga, meditation, and specific breathing exercises are some natural remedies to alleviate stress and encourage relaxation. Several women feel more confident and attuned to their requirements in the weeks before the start of their menses. Use this feeling of yours productively by giving time to expressing emotions, relaxing, and giving priority to your own life. 
  • Calcium: Many supplements are thought of improving PMS symptoms, although calcium supplement has proved to exhibit a more consistent therapeutic effect than others. 

In the latest study, some women were made to intake placebo or calcium supplements for a three-month duration. It was found that the participants who took calcium experienced a 48% decline in their symptoms.  

Following foods are high in calcium which you can incorporate in your diet:

  • Dairy products
  • Leafy green vegetables
  • Almonds
  • Sesame seeds
  • Chia seeds
  • Dried figs
  • Soy milk
  • Tofu
  • White beans
  • Kale
  • Mustard and collard greens
  • Oranges
  • Sweet potatoes
  • Broccoli

Agnus Castus: It is the chaste tree berry that is often used as a herbal supplement to ease the symptoms of PMS. It can cause some side effects or may not be appropriate for some women (with some conditions or those taking certain medications). Therefore, consult your health care specialist before taking agnus castus. 

Get A Full Eight Hours Of Sleep: The symptoms of PMS can leave you completely drained out, and in this case, a full eight hours of sleep can be very beneficial. Additionally, it can provide you with a fresh, confident look, no matter how awful you feel from inside. 

Split Up You Meal Routine: Instead of three big meals, take about six smaller ones. Eating more often can help stabilize your blood sugar levels and make you feel better. 

Join A Self-Support Group: PMS can make performing the regular activities very difficult or can compel you to think that you’re incapable of performing appropriately. Join a self-support group, talk with others, and try to relieve your emotional strain. 

Exercises To Reduce PMS Pain & Other Symptoms

Studies suggest that specific exercises can significantly reduce PMS symptoms in young and adolescent women. Physical activities can improve your general health and ease your anxiety and nervous tension. Exercising releases endorphins, which contribute to ecstatic feeling like “runner’s high.” Do the low-impact exercises as it can benefit your PMS pain and several other symptoms such as:

  • Muscle tone
  • Cardiovascular fitness
  • Increases self-esteem
  • Decreases fluid retention
  • Walking
  • Swimming
  • Dancing
  • Strengthens heart
  • Improves overall wellbeing

Is There A Cure For PMS?

  • Widespread recognition of PMS has attracted a broad range of research interests in the treatment and management of the symptoms of PMS.
  • Although there is no “cure” for PMS at this time, there are many options for managing its signs and symptoms.
  • The first priority is an accurate diagnosis.
  • Other medical or psychological conditions should be detected and treated.
  • Proper diet, lifestyle modifications, and exercise can improve your health and consequently reduce your symptoms. 
  • If all these things aren’t that effective for you, try over-the-counter and prescription medications. 
  • Many women can control their symptoms efficiently and continue to lead productive lives. 


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