Please note: This information was current at the time of publication but now may be out of date.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. 

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Am Fam Physician. 2011;84(8):929-930

See related article on premenstrual syndrome.

What is premenstrual syndrome (PMS)?

PMS causes symptoms during the week before your period. You may have physical symptoms (such as cramps or bloating) or mood-related symptoms (such as feeling more tense than usual, having trouble concentrating, or being irritable). You may crave certain foods, have trouble sleeping, or lose interest in your usual activities. These symptoms get better soon after your period starts.

Many women have a few of these symptoms each month, but they are usually mild. Women with PMS have symptoms almost every month that affect what they do or how they feel.

What is premenstrual dysphoric disorder (PMDD)?

PMDD has many of the same symptoms as PMS, but it is more severe. If you have PMDD, you may struggle to do your job or get along with family and friends the week before your period. You may feel very depressed during this time.

How do I know if I have PMS or PMDD?

You may have some of the symptoms described above. If these symptoms happen before your period most months and are severe enough to bother you, tell your doctor.

What can I expect when I see my doctor?

Your doctor will ask you about your menstrual cycles and how you feel at different times during your cycle. Your doctor may have you keep a record of your cycle and symptoms. You may need to have blood tests to look for other causes of your symptoms.

How are PMS and PMDD treated?

Your doctor may talk to you about these options to treat PMS or PMDD:

Antidepressants. Taking certain antidepressant medicines is one of the most effective ways to improve PMS symptoms. Some of these medicines are taken every day, but others can be taken for just part of each month.

Birth control pills. Some types of birth control pills can improve PMS symptoms. These pills are sometimes used to make the time between periods longer, which may help with symptoms.

Vitamin B6. Taking a vitamin B6 supplement (up to 100 mg daily) may help with PMS. However, taking too much does not help and can cause nerve pain or numbness.

Your doctor also may talk with you about other treatments, such as increasing your calcium intake or using certain medicines that improve symptoms of anxiety or bloating and breast tenderness.

What if my symptoms get worse?

Contact your doctor right away if you start feeling more depressed or have thoughts of suicide.

Where can I get more information?

Your doctor

AAFP's Patient Education Resource

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