Skip to main content
Mother Nature AI
ReproductiveICD-10: N94.3Up to 75% of menstruating women have some PMS; 3–8% have severe PMDD

Premenstrual Syndrome

Also known as: PMS, Premenstrual Tension

Premenstrual syndrome (PMS) encompasses a wide range of physical, emotional, and behavioral symptoms that occur during the luteal phase of the menstrual cycle (1–2 weeks before menstruation) and resolve shortly after the period begins. Up to 75% of menstruating women experience some PMS symptoms, with about 3–8% meeting criteria for the more severe form, premenstrual dysphoric disorder (PMDD). Symptoms can significantly impair daily functioning in moderate to severe cases.

Symptoms

Mood swings and irritability
Depressed mood or tearfulness
Anxiety or tension
Bloating and water retention
Breast tenderness and swelling
Headaches
Food cravings, especially for carbohydrates and sweets
Fatigue and sleep changes
Acne flare-ups
Constipation or diarrhea

Causes

  • Cyclical changes in estrogen and progesterone levels
  • Altered sensitivity to hormonal fluctuations in the brain
  • Changes in serotonin levels during the luteal phase
  • Possible role of GABA and allopregnanolone (progesterone metabolite)

Risk Factors

  • History of depression or mood disorders
  • Family history of PMS or PMDD
  • Age (symptoms often worsen in the late 20s to 40s)
  • Stress
  • Smoking
  • Low physical activity levels

Diagnosis

  • Symptom diary tracking over at least 2 menstrual cycles
  • Symptoms must be present in the luteal phase and resolve within a few days of menstruation
  • Exclusion of other conditions (thyroid disease, depression, perimenopause)
  • PMDD requires ≥5 symptoms with significant functional impairment (DSM-5 criteria)

Treatment

  • Regular aerobic exercise (30 minutes most days)
  • Calcium supplementation (1,200 mg/day has evidence for symptom reduction)
  • SSRIs (fluoxetine, sertraline) for severe PMS or PMDD — can be used continuously or only during the luteal phase
  • Combined oral contraceptive pills (especially drospirenone-containing formulations)
  • Cognitive-behavioral therapy
  • NSAIDs for cramps and headaches

Prevention

  • Regular exercise throughout the menstrual cycle
  • Balanced diet rich in complex carbohydrates, calcium, and magnesium
  • Limiting salt, caffeine, and alcohol in the luteal phase
  • Stress reduction techniques
  • Adequate sleep

When to See a Doctor

  • PMS symptoms that significantly interfere with work, relationships, or daily life
  • Symptoms of PMDD (severe depression, anxiety, or rage premenstrually)
  • Suicidal thoughts related to the menstrual cycle
  • Symptoms that do not improve with lifestyle modifications

Frequently Asked Questions

Related Conditions

Menopause

Reproductive

Depression

Mental Health

Migraine

Neurological

Endometriosis

Reproductive

Have questions about Premenstrual Syndrome?

Ask Mother Nature AI for personalized, evidence-based guidance.

Ask about Premenstrual Syndrome

Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.