What is premenstrual syndrome (PMS)?

Many people feel changes in their body or mood in the days before their period. If these symptoms happen every month and affect your daily life, you may have premenstrual syndrome (PMS).1

What are the common symptoms of PMS?

PMS is the name for a combination of symptoms that start 1–2 weeks before your period. Most people have mild PMS symptoms.2 Severe symptoms may be a sign of premenstrual dysphoric disorder (PMDD).

Emotional PMS symptoms2

  • Anxiety
  • Difficulty focusing
  • Exhaustion
  • Food cravings
  • Irritability
  • Less interest in sex
  • Mood changes
  • Sadness or crying
  • Trouble sleeping or sleeping too much

Physical PMS symptoms2

  • Constipation or diarrhea
  • Feeling bloated or gassy
  • Feeling clumsy
  • Headache or back pain
  • Sensitive to loud sounds or bright lights
  • Sore or swollen breasts
  • Stomach cramps

Does PMS affect other health problems?

Around half of people who need help with PMS also have another health problem. Many of these health problems have symptoms that are a lot like PMS. In the days leading up to your period, symptoms of other health problems may worsen, such as:2, 3

What causes PMS?

Doctors aren’t sure exactly what causes PMS. Hormone changes during the menstrual cycle might be part of the reason. PMS happens more often for women whose moods are sensitive to changes in hormones during their periods. These changes can affect some people more than others.2

PMS is more common in people who:2

  • Have a lot of stress
  • Have family members with depression
  • Have had depression themselves, or had depression after having a baby

Your PMS symptoms can also change as you get older. PMS may feel worse when you are in your late 30s or 40s and getting close to menopause. Before menopause, your hormone levels can go up and down in ways that are hard to predict. Because of this, you might notice mood changes, or they might get worse. PMS goes away after menopause because you won’t get your period anymore.2

How is PMS diagnosed?

There isn’t an official test to diagnose PMS. Your doctor will look for a pattern in your symptoms to diagnose PMS. You may have PMS if your symptoms:1, 2

  • Happen in the 5 days before your period for at least 3 periods in a row
  • Go away within 4 days after your period starts
  • Make it harder to do some of your normal activities

It helps to keep track of your symptoms. Every day for 2 or 3 months, write down how you feel and when you have your period. This record can help your doctor see if you have PMS.

Tips to manage PMS symptoms

Here are a few tips that may help PMS symptoms become easier to manage:2

  • Exercising throughout the month may help with mood, energy and focus4
  • In the 2 weeks before your period, try not to eat or drink things with high levels of caffeine, salt or sugar
  • Getting enough sleep, about 8 hours each night, may help with anxiety, depression and mood swings
  • Find healthy ways to deal with stress, like writing, yoga, massage or meditation
  • Don’t smoke, as it can worsen PMS symptoms

Taking 1,200 milligrams (mg) of calcium each day can help with physical symptoms and mood changes. Magnesium can help with bloating, sore breasts and mood. Vitamin E might also help with PMS symptoms.1

Medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help with pain. Talk to your doctor before taking NSAIDs. Using these medicines for a long time can hurt your stomach or cause ulcers.

Many products say they can help with PMS, but most haven’t been tested or proven to work. Before taking any PMS product or supplement, talk to your doctor. Taking too much or mixing them with other medicines can be unsafe.1

Treatment options for severe PMS

Treatment depends on how hard your symptoms are to manage. If your symptoms are severe, your doctor may prescribe medicine. For example, hormonal birth control may lessen physical symptoms.

If you have severe PMS symptoms that make it hard to do your job or get along with others, you may have premenstrual dysphoric disorder (PMDD). PMDD is a rare and serious form of PMS. Antidepressant medicines can help some people with PMDD.1

Talk to your doctor if you have questions about or think you may have PMS or PMDD.

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