Premenstrual Syndrome

Premenstrual syndrome (PMS) or premenstrual disphoric disorder (PMDD) is a mix of emotional and clinical symptoms. PMS occurs 10 to 14 days before the start of a menstrual period. Common symptoms include pelvic pain, headache and mood changes. Most women have PMS to some degree.


The cause is unknown. There is evidence that it is related to the female hormones during the second half of the menstrual cycle. These hormones fluctuate and are thought to affect chemicals in the brain (serotonin) that can influence a person's mood.


Symptoms may include any of the following:

  • Headache.

  • Swelling of hands and feet.

  • Abdominal bloating.

  • Tiredness.

  • Breast tenderness.

  • Depression.

  • Crying spells.

  • Anxiety.

  • Irritability.

  • Confusion.

  • Joint and muscle pains.

  • Forgetfulness.

  • Withdrawal from family, friends and activities.


Diagnosis is made by your caregiver who will ask you questions about the kind of symptoms you are having, when they occur and what may bring them on. If your are having any of the symptoms listed above that occur 10 to 14 days before your menstrual period, it is strong evidence you have PMS.


  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Oral contraceptives.

  • Hormone therapy.

  • Medications that slow down the production of serotonin in the brain (fluoxetine, sertraline and others).

  • Diuretics. These get rid of extra fluid from your body.

  • Anti-depression medication when necessary.

  • Surgery to remove both ovaries. This is a last resort and if no further pregnancies are wanted.

  • Consider counseling or joining a PMS therapy support group.


  • Exercise regularly as suggested by your caregiver. Exercise especially before your menstrual period.

  • Eat a regular, well-balanced diet rich in carbohydrates.

  • Restrict or eliminate caffeine, alcohol and tobacco consumption.

  • Be sure to get enough sleep. Practice relaxation techniques.

  • Drink 64 oz. fluids per day. This is 8 glasses, 8 oz. each. It is best to drink water.

  • Eliminate known stressors in your life.

  • Attend relationship or parenting counseling, if needed.

  • Take a multi-vitamin in the recommended daily dosages.

  • Calcium, magnesium, vitamin B6 and vitamin E are some times helpful for PMS symptoms.

  • Take medications as suggested by your caregiver.


  • You need medication for excessive swelling, depression, severe headaches, or because you cannot sleep.

  • You need help from your caregiver to help you decide if you need to have your ovaries removed because none of your treatment is helping you.