Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

brand logo

Am Fam Physician. 1998;58(1):197-198

See related article on premenstrual syndrome.

What are the symptoms of premenstrual syndrome?

Premenstrual syndrome (called PMS for short), has many symptoms. The symptoms can occur a week or so before the menstrual period starts.

The main symptoms of PMS are feeling irritable, anxious and short-tempered. You may also feel sad or cry easily. Also, you may have headaches, back pain, breast pain and cramps. Your hands and feet may swell. You may feel bloated (fullness in the stomach). You may have muscle aches and pain. You may feel tired. Some women with PMS crave salty foods or sweet foods during the week before their period.

How common is PMS?

If you have PMS, you're not alone. Up to 40 percent of women of child-bearing age have symptoms of PMS for a week or two before their period starts. Some women have only mild discomfort, but a few women have symptoms bad enough to make them stay home from work or school.

What causes PMS?

The causes of PMS aren't known. Some women with PMS have chemical changes in the brain that are like the changes in people with depression. This suggests that in some women with PMS, brain chemistry changes that happen during the menstrual cycle may cause mood changes in the week or two before the period starts.

Changing levels in a woman's hormones during her menstrual cycle might play a role in PMS. PMS only occurs in women whose ovaries release an egg during a menstrual cycle. The release of an egg is called ovulation (pronounced “ah-view-lay-shun”). Women using birth control pills don't ovulate, so they usually don't have PMS.

Low levels of vitamins and minerals may cause some symptoms of PMS. In some studies, low levels of magnesium, manganese and vitamin E have been found in women who have PMS. Studies have also shown that eating a lot of salty foods may cause fluid retention. This can make your feet and hands swell. In addition, eating a lot of simple sugars (cookies, candy, sweet drinks) may cause mood changes and tiredness before a woman's period. Some women drink a lot of caffeinated beverages, like coffee and colas. The caffeine might make them feel more irritable.

How will my doctor find out if I have PMS?

Your doctor can find out if you have PMS from your symptoms. Your doctor will ask how bad your symptoms are and at what time of the month you get them. Your doctor may ask you which symptoms bother you the most.

Your doctor may want you to keep a monthly symptom diary. You would write down the different symptoms you have and the days you have them. You would also write down how bad each symptom is on each day. You can rate each of your symptoms as mild, moderate or severe. Your diary should include all of the symptoms you notice, like increased irritability or sadness, breast pain, headaches, muscle aches, bloating, swelling of your hands and feet, and food cravings. On some days of the month, you probably won't have any symptoms. Looking at your symptom diary can help your doctor tell if you have PMS.

Are there any treatments for PMS?

Yes. PMS can be treated. After your doctor knows about your symptoms, he or she can suggest ways to treat them. A combination of treatments usually helps.

Your doctor may suggest changes in your diet, with less caffeine, salt and sugar. A healthy diet may help you feel better. Taking vitamins and minerals may help. Regular exercise may also help your symptoms. If your symptoms are very bad, your doctor may prescribe medicine for you.

Learning how to cope with problems that come up in your life may help relieve the stress and irritability you feel before your period. The more you understand your PMS symptoms and how they affect your life, the better you'll be at dealing with the things that make your symptoms worse.

Be sure to talk with your doctor before treating yourself for PMS. If you've read about some nutritional supplement for PMS, talk with your doctor before you start taking it. Together, you and your doctor can decide what's safe and what might work.

Continue Reading

More in AFP

Copyright © 1998 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.