Premenstrual Syndrome (PMS)

Many people notice changes in their body and mood in the days before their period. You may feel more tired, more emotional or have trouble sleeping. These changes are common and usually part of something called premenstrual syndrome (PMS).

PMS affects millions of people each month. And while it’s a normal part of the menstrual cycle, that doesn’t mean it’s enjoyable. Learn the causes of PMS and how to manage it so you can feel more in control of your health.

What is PMS?

PMS, or premenstrual syndrome, is a group of physical and emotional symptoms that happen one to two weeks before your period starts. These symptoms usually stop once your period begins or shortly after.

Most people who menstruate have one or more symptoms of PMS. Most of the time, these symptoms can be easily managed. 

If symptoms are intense or severe, it could be something more serious, such as premenstrual dysphoric disorder (PMDD). This condition causes more intense emotional symptoms that can affect daily life. 

What causes PMS?

Experts don’t know the exact cause of PMS, but it’s likely linked to changes in your hormones during your menstrual cycle. As your body gets ready for your period, hormone levels like estrogen and progesterone rise and fall. These hormonal changes can affect brain chemicals like serotonin, which help control your mood, sleep and appetite. 

Other factors that may make PMS worse include:

• Stress
• Poor sleep
• Not enough exercise
• Unhealthy eating habits
• Conditions like irritable bowel syndrome or depression
• Genetics (if a parent or sibling had PMS, you may have it too)

Common symptoms of premenstrual syndrome 

PMS symptoms can affect you physically and mentally. Here are some of the most common symptoms.

Physical symptoms of PMS

• Bloating
• Breast tenderness or swelling
• Headaches
• Cramps
• Back pain
• Fatigue (feeling very tired)
• Acne
• Trouble sleeping
• Diarrhea or constipation
• Changes in appetite (cravings or eating more than usual)

Emotional symptoms of PMS

• Mood swings
• Irritability or quick to anger
• Sadness or crying more easily
• Anxiety
• Trouble focusing or concentrating
• Feeling overwhelmed

You may not have all these symptoms every month. Some months may feel harder than others. Tracking how you feel before your period can help you understand your own pattern.

When PMS is more serious

For some people, PMS can be severe. A small number of women experience a condition called PMDD. It can cause more intense emotional symptoms that can make it hard to manage work, school or your daily life.

PMDD is serious but can be treated. It’s important to talk to your health care provider if you have any of these symptoms:

• Feel very depressed before your period
• Have thoughts of hurting yourself
• Can’t keep up with daily tasks
• Feel like PMS is taking over your life

How is PMS diagnosed?

There isn’t a single test for PMS. Your provider will ask questions about your symptoms, when they happen and how they affect your life. They may recommend keeping a symptom diary for at least two months to better understand your pattern.

Your provider might also check for other health issues whose symptoms look similar to PMS, such as depression, anxiety, thyroid problems or perimenopause.

How to manage PMS symptoms

You don’t have to wait for PMS symptoms to pass each month. You can take steps to feel better now. 

• Move your body: Exercise helps release feel-good chemicals called endorphins. Even a short walk, stretching or dancing in your living room can ease cramps, improve your mood and reduce stress.
• Use over-the-counter (OTC) medicine: Anti-inflammatory drugs like ibuprofen or acetaminophen can help with cramps or headaches. Diuretics (water pills) may help reduce bloating and breast tenderness. 
• Choose healthy foods: Eat more fruits, vegetables, whole grains and lean proteins. Cut back on salt, sugar and caffeine, which can make bloating and mood swings worse. Learn more tips about nutrition during your menstrual cycle.
• Get enough sleep: While PMS can affect your sleep, aim for seven to nine hours each night. A regular sleep schedule can help balance your mood and energy levels.
• Try relaxation techniques: Meditation, deep breathing, yoga and tai chi can help calm your mind and body. Even 10 minutes of quiet time can make a difference.

When to see a doctor for PMS

It’s always okay to ask for help. You should see a provider if:

• PMS symptoms are affecting your daily life
• You feel anxious, sad or overwhelmed before your period
• OTC medicine and healthy habits aren’t helping
• You’re unsure if your symptoms are from PMS or something else

Your provider may suggest other treatments like:

• Hormonal birth control: These can help balance hormones and reduce symptoms.
• Antidepressants: Low doses of selective serotonin reuptake inhibitors (SSRIs) may help with mood changes, anxiety and PMDD. These medications can be used either during the time of PMS symptoms (the two weeks before your period) or continuously.
• Supplements: Calcium, magnesium and vitamin B6 may help with certain symptoms. Talk to your provider first before trying any supplement.
• Therapy: Talking with a therapist or behavioral health specialist, especially using cognitive behavioral therapy (CBT), can help you manage stress and emotions.

Your treatment plan should work for your life and body. What helps someone else might not be right for you.

Supporting teens through PMS

If you’re caring for a teen who’s starting their period, they may experience PMS for the first time. You can support them by:

• Talking openly about periods and body changes
• Helping them track their cycle and symptoms
• Encouraging healthy habits like sleep, movement and balanced meals
• Reassuring them that it’s okay to ask questions and ask for help

You’re not alone

You don’t have to manage PMS on your own. Banner Health specialists offer personalized care for all forms of PMS and menstrual health concerns. Our providers can help you find relief -  whether you’re dealing with mild symptoms, PMDD or need guidance, treatment or someone to listen to your concerns. 

Schedule an appointment today.