Premenstrual Syndrome (PMS)
Premenstrual Syndrome (PMS) is a common condition that affects many women a few days or weeks before their menstrual period. It involves a combination of physical, emotional, and behavioral symptoms that usually resolve once menstruation begins. PMS can vary from mild discomfort to severe symptoms that interfere with daily life.
PMS is linked to hormonal changes during the menstrual cycle, particularly fluctuations in estrogen and progesterone levels. While PMS is common, proper lifestyle changes and medical care can help manage symptoms effectively.
Causes of Premenstrual Syndrome
The exact cause of PMS is not fully understood, but several factors are believed to contribute to it:
- Hormonal imbalance during the menstrual cycle
- Changes in estrogen and progesterone levels
- Emotional stress and mental health issues
- Genetic predisposition
- Depression or anxiety disorders
- Side effects of birth control pills
- Postpartum hormonal changes
- Thyroid or endocrine disorders
- Poor lifestyle habits such as lack of exercise or unhealthy diet
Hormonal fluctuations affect brain chemicals such as serotonin, which regulate mood, sleep, and emotions. This explains the emotional and psychological symptoms of PMS.
Symptoms of Premenstrual Syndrome
Symptoms usually appear 5–10 days before menstruation and disappear after periods begin.
Physical Symptoms
- Breast tenderness or swelling
- Bloating and fluid retention
- Weight gain
- Headaches
- Back pain
- Joint or muscle pain
- Acne
- Fatigue
Emotional and Behavioral Symptoms
- Irritability
- Mood swings
- Anxiety
- Depression
- Crying spells
- Anger or aggression
- Difficulty sleeping
- Difficulty concentrating
- Food cravings
- Social withdrawal
Severe Symptoms
- Severe depression
- Suicidal thoughts
- Severe breast pain (mastalgia)
- Severe menstrual cramps (dysmenorrhea)
Severe PMS is sometimes called Premenstrual Dysphoric Disorder (PMDD), which requires medical treatment.
Treatment of Premenstrual Syndrome
The main goal of treatment is to reduce symptoms and improve quality of life. Treatment includes lifestyle changes, supplements, and medications depending on severity.
1. Lifestyle Changes (First Line Treatment)
- Regular exercise
- Healthy balanced diet
- Reduce salt intake
- Avoid caffeine and alcohol
- Stress management (yoga, meditation)
- Proper sleep
- Maintain a symptom diary
Lifestyle modification is often sufficient for mild PMS.
2. Supplements for Mild PMS
- Evening Primrose Oil
- Magnesium
- Calcium
- Vitamin E
- Vitamin B6 (up to 100 mg/day)
These supplements help regulate hormones and reduce symptoms.
3. Medications for Moderate PMS
- Fluoxetine 20 mg daily for 10–14 days before menstruation
OR - Fluoxetine 10–20 mg daily continuously
These medications help regulate mood and emotional symptoms.
4. Treatment for Specific Symptoms
PMS with Fluid Retention
- Spironolactone 100 mg daily
- Start 3 days before expected symptoms until menstruation begins
PMS with Severe Breast Pain
- Danazol 200 mg daily (second-line drug, used cautiously)
PMS with Painful Periods (Dysmenorrhea)
- Mefenamic acid 500 mg three times daily
Prevention of PMS
The following measures help prevent or reduce PMS symptoms:
- Regular exercise
- Healthy diet rich in fruits and vegetables
- Reduce caffeine and sugar intake
- Stress management
- Maintain proper sleep routine
- Avoid smoking and alcohol
- Keep track of menstrual cycle
When to See a Doctor
Consult a doctor if:
- Symptoms are severe
- Symptoms interfere with daily activities
- Depression or suicidal thoughts occur
- PMS symptoms worsen over time
- Suspected hormonal or endocrine disorders
- Conditions like PCOS or endometriosis are suspected
Referral to a gynecologist or endocrinologist may be required.
Practice Tips for Managing PMS
- Keep a daily symptom diary
- Allow at least 3 menstrual cycles to evaluate treatment effectiveness
- Avoid high doses of Vitamin B6 (above 100 mg/day)
- Use medications only under medical supervision
- Rule out depression and other mental health conditions
FAQs About Premenstrual Syndrome
PMS is a group of physical and emotional symptoms that occur before menstruation due to hormonal changes.
PMS symptoms usually last 5–10 days before menstruation and disappear after periods begin.
PMS is mainly caused by hormonal imbalance, stress, genetics, and changes in brain chemicals.
PMS cannot be completely cured, but symptoms can be effectively managed with lifestyle changes and treatment.
PMS is considered severe when symptoms interfere with daily life, cause depression, or lead to emotional instability.
Medical Disclaimer
This article is for informational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of Premenstrual Syndrome or any medical condition.