Premenstrual syndrome (PMS) refers to a wide range of symptoms that:
The exact cause of PMS is not known. Changes in brain hormone levels may play a role, but this has not been proven. Women with premenstrual syndrome may also respond differently to these hormones.
PMS may be related to social, cultural, biological, and psychological factors.
Up to 3 out of every 4 women experience PMS symptoms during their childbearing years. PMS occurs more often in women:
The symptoms often get worse in a woman's late 30s and 40s as she approaches the transition to menopause.
The most common symptoms of PMS include:
Other symptoms include:
There are no specific signs or lab tests that can diagnose PMS. To rule out other possible causes of symptoms, it is important to have a:
A symptom calendar can help women identify the most troublesome symptoms and confirm the diagnosis of PMS.
Keep a daily diary or log for at least 3 months. Record the type of symptoms you have, how severe they are, and how long they last. This symptom diary will help you and your health care provider find the best treatment.
A healthy lifestyle is the first step to managing PMS. For many women, lifestyle approaches are often enough to control symptoms.
Birth control pills may decrease or increase PMS symptoms.
In severe cases, medicines to treat depression may be helpful. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are often tried first, and have been shown to be very helpful. You may also want to seek the advice of a counselor or therapist.
Other medicines that you may use include:
Most women who are treated for PMS symptoms get good relief.
PMS symptoms may become severe enough to prevent you from functioning normally.
The suicide rate in women with depression is much higher during the second half of the menstrual cycle. Mood disorders need to be diagnosed and treated.
Make an appointment with your health care provider if:
PMS; Premenstrual dysphoric disorder; PMDD
Brown I, O'Brien PMS, Marjoribanks I, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. 2009;2:CD001396.
Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012: chap. 36.
Updated by: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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