(PMS; Premenstrual Tension Syndrome)
DefinitionPremenstrual syndrome (PMS) is a disorder marked by physical and emotional symptoms. It affects women 1-2 weeks before the beginning of their menstrual period.
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CausesWhile the exact cause is not known, PMS may be related to certain factors (environmental, metabolic, or behavioral) that may make a woman more vulnerable to the hormonal changes that occur during menstruation.
Risk FactorsPMS most often occurs in women aged 25-40 years. Other factors that may increase your chance of PMS include:
- Going off birth control pills
- Major life stress
SymptomsPMS may cause:
- Mood swings
- Diminished self-esteem
- Difficulty concentrating
- Sleep problems
- Appetite changes, such as sugar and/or salt cravings, or overeating
- Weight gain
- Breast swelling and tenderness
- Gastrointestinal upset
- Muscle pain
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will also be done.You will be asked to keep a detailed record of your monthly physical and emotional symptoms. If caused by PMS, these symptoms will likely occur 1-2 weeks before your menstrual period. You may have PMS if symptoms occur at the same phase of the menstrual cycle each month.
TreatmentTreatment options include:
Stress ManagementStress may be managed through lifestyle changes. Relaxation techniques, deep breathing, massage, music, and hot baths can also help reduce stress.
Dietary ChangesDietary changes may be helpful. Your doctor may recommend that you decrease your intake of salt, sugar, and caffeine. Eating small, frequent meals may also help.
Vitamins and MineralsThe following vitamin and mineral supplements might reduce PMS symptoms:
- Vitamin E may reduce breast tenderness
- Calcium may decrease bloating, depression, and aches
- Magnesium may decrease pain, fluid retention, and improve mood
- Manganese may help control symptoms of menstrual pain
Regular ExerciseExercising throughout the week may help to reduce your symptoms.
MedicationsMedications to treat PMS include:
- Diuretics to reduce bloating and fluid retention.
- Pain relievers to relieve cramps, headaches, and muscle aches
- Birth control pills to reduce physical symptoms
- Antidepressants to reduce emotional symptoms
PsychotherapyWomen with severe PMS symptoms may benefit from cognitive behavioral therapy. Therapy may reduce negative emotions and enhance problem-solving skills in relationships. It may also manage obstacles, frustrations, and discomfort.
PreventionTo help reduce your chance of getting PMS, take the following steps:
- Manage stress
- Eat a healthy diet, one that is low in saturated fat, and rich in whole grains and fruits and vegetables
- Consume less refined sugar, salt, and caffeine
- Do regular aerobic exercise
American Congress of Obstetricians and Gynecologists
Office on Women's Health
The Society of Obstetricians and Gynaecologists of Canada
Premenstrual syndrome. American Congress of Obstetricians and Gynecologists website. Available at: https://www.acog.org/~/media/For%20Patients/faq057.pdf?dmc=1&ts=20120824T1006488269. Accessed September 25, 2014.
Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2014. Accessed September 25, 2014.
Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.html. Updated July 16, 2012. Accessed September 25, 2014.
4/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Brown J, Shaughn O'Brien PM, Marjoribanks J, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. 2009;(1):CD001396.
- Reviewer: Andrea Chisholm, MD
- Review Date: 08/2014
- Update Date: 09/30/2013
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