Most women of reproductive age experience mild behavioral or physical symptoms a few days before their period. These combined symptoms are considered premenstrual syndrome (PMS). PMS can start as early as within one year after a girl’s first menstrual period (menses).
What Causes PMS?
Hormonal changes during a menstrual cycle and chemical changes in the brain can contribute to PMS.
What Are PMS Signs and Symptoms?
PMS causes many different behavioral and physical signs and symptoms and typically occur in a predictable pattern. A small number of women experience symptoms that are so severe they may be diagnosed with premenstrual dysphoric disorder (PMDD). Regardless of severity, PMS symptoms generally disappear with the onset of menses or several days after the start of menses.
Common behavioral changes may include: mood swings, depressed mood, irritability, anxiety, sadness, crying spells, food cravings, social withdrawal and poor concentration.
Common physical changes may include: abdominal bloating, extreme sense of fatigue, breast tenderness, headaches and dizziness.
How Is PMS Diagnosed?
There aren’t any laboratory tests or images needed to diagnose PMS, rather it is a collection of signs and symptoms. There are some conditions that share similar signs or symptoms of PMS such as thyroid disorders and other mood disorders such as depression or anxiety. It is important to discuss concerns with a provider.
A provider will obtain a detailed menstrual history, because the relationship between symptoms and the menstrual cycle is important. To confirm a diagnosis of PMS, a woman must have at least one symptom that is physical or behavioral in at least three consecutive menses, and must impair functioning in some way in the days leading up to the menses and disappear once menses begins, or shortly after the onset of menses.
Is Medication Needed to Treat PMS?
PMS symptoms should not cause a woman to miss school or activities or ruin relationships. A woman can reduce their symptoms of PMS first by lifestyle changes such as a healthy diet (decreasing salt and caffeine intake and increasing fruits, vegetables, whole grains and calcium), decreasing stress, incorporating exercise in their routine and getting plenty of rest.
If symptoms are challenging to manage a woman should schedule an appointment with a provider. Commonly prescribed medications to help relieve PMS symptoms are nonsteroidal anti-inflammatories, hormonal contraceptives and antidepressants.
To learn more about frequently asked gynecologic questions, or to request an appointment with our pediatric and adolescent gynecology team, click here.
Dana Lenobel, FNP, is a board-certified family nurse practitioner. She is a member of the Section of Pediatric and Adolescent Gynecology at Nationwide Children’s Hospital. Dana received her Master’s Degree at the University of Cincinnati.
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