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Premenstrual Syndrome
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Women

Premenstrual Syndrome

Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms occurring one to two weeks before a period, ranging from mild to severe.

What is premenstrual syndrome (PMS)?

Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The symptoms may range from mild to severe.

What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a severe type of PMS. With PMDD, the symptoms are severe enough to interfere with your life. PMDD is much less common than PMS.

What causes premenstrual syndrome (PMS)?

Researchers don't know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others.

What are the symptoms of premenstrual syndrome (PMS)?

PMS symptoms are different for everyone. You may get physical symptoms, emotional symptoms, or both. Your symptoms may also change throughout your life.

Physical symptoms may include:

  • Breast swelling and tenderness
  • Acne
  • Bloating and weight gain
  • Headache
  • Joint pain
  • Backache
  • Constipation or diarrhea
  • Food cravings

Emotional symptoms may include:

  • Irritability
  • Mood swings
  • Crying spells
  • Depression
  • Anxiety
  • Sleeping too much or too little
  • Trouble with concentration and memory
  • Less interest in sex

How is premenstrual syndrome (PMS) diagnosed?

You may wish to see your health care provider if your symptoms bother you or affect your daily life. There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed with PMS, your symptoms must:

  • Happen in the five days before your period for at least three menstrual cycles in a row
  • End within four days after your period starts
  • Keep you from enjoying or doing some of your normal activities

Your provider may wish to do tests to rule out other conditions which may cause similar symptoms.

What are the treatments for premenstrual syndrome (PMS)?

No single PMS treatment works for everyone. If your symptoms are not severe, you may be able to manage them with:

  • Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen, to help ease cramps, headaches, backaches, and breast tenderness
  • Getting regular exercise
  • Getting enough sleep
  • Eating healthy foods
  • Avoiding salt, caffeine, sugar, and alcohol in the two weeks before your period

Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.

Some women take certain herbal supplements for PMS symptoms. But there is not enough evidence to prove that supplements are effective for PMS. Check with your provider before taking any vitamins or supplements.

If you are not able to manage your PMS symptoms, your provider may suggest prescription medicines. These medicines may also be used to treat PMDD. They include:

  • Hormonal birth control, which may help with the physical symptoms of PMS. But sometimes they may make the emotional symptoms worse. You may need to try several different types of birth control before you find the right one.
  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which may help with emotional symptoms.
  • Diuretics ("water pills") to reduce symptoms of bloating and breast tenderness.
  • Anti-anxiety medicine to ease symptoms of anxiety.

Frequently Asked Questions

Yes. Hormonal shifts during perimenopause, weight changes, and the hormonal reset that occurs after pregnancy can alter the type, intensity, or timing of PMS symptoms. If you notice a sudden increase in severity or new symptoms (e.g., severe depression, suicidal thoughts), seek evaluation promptly, as this may indicate premenstrual dysphoric disorder (PMDD) or another medical condition.
Track your cycle for at least three months, noting when symptoms start and stop. PMS symptoms appear consistently 5‑14 days before menses and resolve after bleeding begins. If symptoms occur at other times, are severe, or are accompanied by weight change, heat intolerance, or persistent fatigue, ask your provider to check thyroid function and screen for depression or anxiety disorders.
Regular aerobic exercise (30 minutes most days), a low‑salt, high‑fiber diet, and limiting caffeine and alcohol can lessen bloating, breast tenderness, and mood swings. Calcium (1,200 mg/day) and vitamin D (800‑1,000 IU/day) supplementation have also shown modest benefit. Keeping a symptom diary helps you identify personal triggers such as specific foods or stressors.
If symptoms interfere with work, school, or relationships despite lifestyle modifications, discuss medication with your clinician. First‑line options include a short course of NSAIDs for pain, oral contraceptives to stabilize hormone fluctuations, or selective serotonin reuptake inhibitors (SSRIs) taken continuously or only during the luteal phase. Your provider will weigh benefits against side‑effects and personal health history.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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