Center for Young Women's Health

Premenstrual Syndrome (PMS)

 

Remember

  • PMS symptoms usually begin the week before a menstrual period.
  • Common symptoms of PMS: mood swings, breast soreness, bloating, acne, cravings for certain foods, and fatigue.
  • PMS is treated with lifestyle changes and sometimes medication.
Getting Treatment:
The Reproductive Endocrine Practice at Boston Children's Hospital offers special services in the diagnosis and treatment of Premenstrual Syndrome (PMS).

PMS stands for Premenstrual Syndrome; "pre" means "before" and "menstrual" refers to the "menstrual cycle" or periods. Not all girls will get PMS, but the physical and emotional symptoms are common. Most girls and women with PMS have symptoms the week before their period. Symptoms can usually be treated with lifestyle changes and over-the-counter medicine. If these are not effective, prescription medicines can help.

 

How do I know if I have PMS symptoms?

PMS occurs one week or sometimes up to 2 weeks before your period. There are actually a total of 150 known symptoms of PMS. The most common symptoms include: mood swings, breast soreness, bloating, acne, cravings for certain foods, increased hunger and thirst, and fatigue. Other symptoms may include constipation or diarrhea, irritability, and feeling blue or down in the dumps. If you have any of these symptoms and they happen during the week before your period starts and go away when your period arrives or a few days later, you may have PMS. If you feel blue or down in the dumps and these feelings last longer than the week before your period, it’s probably not related to PMS. In this situation, it's particularly important to ask your primary care provider if you should talk to a counselor or therapist.

 

Since there are so many possible symptoms of PMS, it's a good idea to keep track of them. Remember to note if the symptoms are mild, moderate, or severe. Use a period and symptom tracker for 2-3 months and then bring it to your next medical appointment. A record of your symptoms can help your health care provider figure out the best treatment choices for you.

 

My Monthly Period & Symptom Tracker

My Monthly Period & Symptom Tracker is an easy way to keep track of your menstrual flow, and it’s also a way to keep track of cramps, and/or PMS and period symptoms (if you have them) each month.

Sample Monthly Period & Symptom Tracker

 

My Monthly Period & Symptom Tracker

 

 

What causes PMS?

Scientists are still trying to figure out what causes PMS. We know that during the second half of the menstrual cycle, progesterone (female hormone) levels increase. Then, just before the period comes, progesterone and estrogen (another female hormone) levels drop. It is believed that changes in hormone levels result in PMS symptoms. Other factors may have an effect on PMS symptoms; for example, you may notice that your symptoms are better if you get plenty of sleep and exercise regularly. Although PMS can be frustrating, there are things you can do to make your symptoms better.

 

Is there anything I can do to treat my PMS symptoms?

Nutrition and lifestyle changes are a first step. The following suggestions are healthy recommendations for everyone and are particularly helpful for young women with PMS symptoms.

 

Nutrition Changes:

 

Lifestyle Changes:

Are there medications that might help?

If your symptoms do not improve with a few nutrition and lifestyle changes, talk with your healthcare provider. He/she may be able to prescribe medication that will help relieve your discomforts. There are several medicines that are currently used to treat PMS symptoms. The most commonly prescribed are oral contraceptives (birth control pills) which prevent ovulation and keep hormone levels even. Most pills (particularly those that are low in progestin or contain drospirenone) can improve symptoms. Sometimes symptoms can improve even more if the pill is taken continuously (one active pill every day and no placebo pills). Other medications include ibuprofen or naproxen sodium that can help to relieve lower back discomfort and headaches and mild diuretics such as Spironolactone to lessen bloating and mood changes. If depression is a significant issue, your health care provider may prescribe antidepressants such as Prozac® (Fluoxetine) or Zoloft® (Sertraline).

 

Are there vitamins or minerals that will improve my symptoms?

Although more research studies are needed, there are certain vitamins and minerals that may help PMS symptoms. Several research studies show that calcium can significantly decrease many of the symptoms associated with PMS. Make sure that you are getting the recommended 1300 mg/day from calcium-rich foods or drinks or from supplements. Other supplements that could help with PMS symptoms are magnesium (400 mg/day), vitamin B6 (100 mg/day), and vitamin E (400 IU/day), but more research needs to be done. Check with your health care provider about whether you should try them and how much you should take because taking high doses of supplements can have unpleasant or dangerous side effects. For example, high doses of magnesium may cause diarrhea in some people.

 

Sometimes other medical conditions can mimic PMS symptoms, so it's important to keep your health care provider up-to-date with any health issues you are having. If your PMS symptoms are so severe that you feel very depressed, talk with a parent, guardian, or trusted adult, and consult your health care provider as soon as possible.

 

Written and reviewed by the CYWH Staff at Boston Children's Hospital

 

Updated: 10/31/2013

 

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Menstrual Cramps

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Painful Periods (Dysmenorrhea)

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