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Premenstrual Syndrome

Premenstrual Syndrome

Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as premenstrual syndrome or PMS.


Emotional symptoms include depression, angry outbursts, irritability, crying spells, anxiety, confusion, social withdrawal, poor concentration, insomnia, increased nap taking and changes in sexual desire.


Physical symptoms include thirst and appetite changes (food cravings), breast tenderness, bloating and weight gain, headache, swelling of the hands or feet, aches and pains, fatigue, skin problems, gastrointestinal symptoms and abdominal pain.


Symptoms of other conditions can mimic PMS or overlap with PMS. These conditions include depression, anxiety, perimenopause, chronic fatigue syndrome, irritable bowel syndrome and thyroid disease. Depression and anxiety disorders are the most common conditions that overlap with PMS. About one half of women seeking treatment for PMS have one of these disorders. Women with depression, however, often have symptoms that are present all month long. These symptoms may worsen before or during their periods. In addition to depression and anxiety, symptoms of other disorders can get worse right before your period. Examples include seizure disorders, migraines, asthma and allergies.


To diagnose PMS, a woman’s symptoms must be present in the five days before her period for at least three menstrual cycles in a row; end within four days after her period starts; and interfere with some of her normal activities.


If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, we may recommend medication such as hormonal contraceptives and/or antidepressants.


If PMS symptoms are severe and cause problems with work or personal relationships, you may have premenstrual dysphoric disorder (PMDD). PMDD is a severe type of PMS that affects a small percentage of women. Drugs called selective serotonin reuptake inhibitors (SSRIs) — often used to treat depression — can help treat PMDD in some women.