Premenstrual syndrome (PMS) is a collection of symptoms that occur regularly in relation to the menstrual cycle. Symptoms may begin anywhere from 5 to 11 days before the onset of menses and resolve with menses or shortly thereafter. An exact cause of PMS has not been identified; however, it may be related to social, cultural, biological, and psychological factors or a combination of factors. PMS can occur with apparently normal ovarian function. It is estimated to affect 70 to 90% of women sometime during their childbearing years. About half of these women is thought to have PMS symptoms severe enough to interfere with daily living activities. Risk increases in women between 20 to 40 years of age, women with at least 1 child, and women with a family or personal medical history of depression.
Symptoms vary considerably and may include:
Headache, backache
Abdominal pain, tenderness, cramps, bloating, nausea
Swelling of ankles, feet, hands; weight gain
Breast tenderness
Fatigue, lethargy, sluggishness
Anxiety, irritability, depression
Decreased tolerance to sensory stimuli (lights, noise)
Changes in sex drive
Difficulty concentrating, forgetfulness
What your doctor can do:
Diagnose PMS by taking a thorough medical history, performing a physical exam, and possibly other diagnostic tests to rule out other conditions. There is no definitive test for the diagnosis of PMS.
Prescribe hormonal supplements, pain medication, diuretics (water pills to decrease fluid retention that causes tissue swelling and weight gain), or anti-anxiety medications as needed. Medication therapy depends on the specific symptoms present.
Recommend nutritional supplements such as vitamin B6, Calcium, and Magnesium.
What you can do:
Keep a log and note everything possible about your symptoms: when they begin and end, severity, and anything that makes it worse or brings relief. Share this info with your doctor.
Work closely with your doctor to determine the most effective treatments
Start an exercise program with your doctor’s permission and advice. In general, try to exercise at least 3-5 times a week.
Get plenty of rest and eat a well-balanced diet. Talk to your doctor about specific diet recommendations for you.
Decrease consumption of foods containing added caffeine (soft drinks, coffee, or tea), salts, or sugar, and limit alcoholic beverages. Monitor to see if they play a role in your symptoms.
What you can expect:
Many women obtain significant relief with symptom-specific treatment and lifestyle changes.
Possible complications include interference with activities of daily living.
Contact your doctor if your symptoms persist or worsen with treatment, if treatment side effects are bothersome, or if you develop new symptoms.
