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Premenstrual Syndrome

Premenstrual Syndrome: Symptoms and Treatments

Mood Disorders, Premenstrual Syndrome, Menopause Center Los AngelesPremenstrual syndrome is a collection of emotional and physical symptoms that some women experience in the few days leading up to their period. Women who experience these symptoms every month may find them tedious and uncomfortable. Symptoms may range from mild to severe, but luckily there are a few relatively simple methods that can relieve PMS.

Symptoms of PMS

Each patient experiences PMS in different ways, but there are common symptoms that typically mark the onset of PMS.

  • Depression/anxiety
  • Crying easily
  • Short temper
  • Confusion
  • Difficulty concentrating
  • Social withdrawal
  • Increase or decrease in sexual desire
  • Insomnia

Many patients report physical symptoms as well as emotional. These range from mild to severe and can include:

  • Food cravings
  • Increased or decreased appetite
  • Swelling and tenderness in the breasts
  • Abdominal bloating
  • Weight gain (less than 4 lbs)
  • Abdominal cramps
  • Gastrointestinal problems
  • Fatigue
  • Headaches
  • Swollen hands and feet
  • Skin problems

Furthermore, PMS can aggravate the symptoms of other disorders. Women who suffer from depression, anxiety, migraines, allergies, and asthma all report worsening symptoms in the few days before their period starts.

Diagnosing PMS

Although many women casually claim experiences with PMS, the syndrome can be diagnosed by a doctor. In order to diagnose PMS, a consistent pattern of symptoms must:

  • Start within the 5 days leading up to, and the 4 days following, the first day of your period
  • Disturb your normal routine for at least 3 consecutive months

Your doctor will be able to make a diagnosis more easily if you keep a diary of your symptoms in the months leading up to your appointment. Be sure to record the date your period starts and ends, and any emotional and physical symptoms.

PMS is often mistaken for other serious health conditions with similar symptoms. If you are experiencing the symptoms listed here, please make an appointment with your gynecologist or general practitioner. He or she will want to rule out other illnesses such as depression, anxiety, chronic fatigue syndrome, thyroid problems, irritable bowel syndrome, and perimenopause. It’s actually quite common for women to misdiagnose themselves. About half of the women who seek treatment for PMS will be diagnosed with depression or anxiety disorder.

PMS Treatment

Most cases of PMS can be treated with some simple lifestyle changes and home remedies. Your doctor can provide you with some tips for changes in diet and routine, such as:

  • Avoid drinks that contain alcohol or caffeine.
  • Replace simple sugars with complex carbohydrates. Choose whole grain breads, cereals, brown rice, beans, barley, oats, and lentils.
  • Take a calcium supplement or add calcium-rich foods to your diet, such as dairy and leafy greens. Try to get about 1,200mg per day, unless otherwise instructed by your doctor.
  • Take a magnesium supplement to help with bloating, tenderness, and emotional symptoms.
  • Cut down on salty and fatty foods.
  • Try eating several small meals each day instead of three large ones. This will help your blood sugar remain stable throughout the day and may help reduce irritability and uncomfortable gastrointestinal symptoms.
  • Get plenty of sleep and set a regular sleeping routine to combat fatigue and insomnia.
  • Teach yourself relaxation methods. Some women find that meditation, yoga, stretching, and massage therapy can help them deal with the aches and stresses of PMS.
  • Exercise regularly. Daily aerobic exercise, even when you’re not experiencing PMS, can help with emotional as well as physical symptoms. Any type of aerobic exercise is beneficial. While many women enjoy high-intensity exercises like running, other women might prefer low-impact activities like walking, biking, or swimming.

Medical Treatment for PMS

If lifestyle changes aren’t helping your symptoms, you can ask your doctor about medical treatment options.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Ibuprofen, found in Advil and Motrin, and naproxen are commonly used for relieving pain associated with PMS. You can buy these over-the-counter or you can talk to your doctor about prescription-strength doses.

Hormonal contraceptives

Birth control pills and other hormonal contraceptive methods have been helpful for reducing symptoms in many women. These methods work by stabilizing your hormones, which cut down on the monthly fluctuations that can promote PMS. For some women, certain birth control methods may not help or can even aggravate symptoms. You may need to try a few different options before finding one that works for your body.


Taking antidepressants in the two weeks leading up to your period can reduce the emotional symptoms of PMS. One example is called Sarafem (fluoxetine). Anti-anxiety medications have also been helpful. Your doctor may have you try a few before finding one that helps.


Also known as “water pills,” diuretics help with fluid retention that causes bloating. Ask your doctor before taking NSAIDs with diuretics as this combination may lead to kidney problems.

Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder is a rare illness related to PMS. If your premenstrual symptoms are so severe that they regularly interfere with work or your personal relationships, your doctor may have you evaluated for PMDD. Medical treatment for PMDD is typically similar to that of depression, and may require a prescription for SSRIs (selective serotonin reuptake inhibitors).

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