Premenstrual syndrome (PMS)

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Causes

By Mayo Clinic staff

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

  • Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
  • Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.
  • Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.
  • Stress. Stress can aggravate some of your PMS symptoms.
  • Poor eating habits. Some PMS symptoms have been linked to low levels of vitamins and minerals. Other possible contributors to PMS include eating a lot of salty foods, which may cause fluid retention, and drinking alcohol and caffeinated beverages, which may cause mood and energy level disturbances.
Preparing for your appointment Symptoms
References
  1. Yonkers KA, et al. Premenstrual syndrome. The Lancet. 2008;371:1200.
  2. Colin CM, et al. Complications of menstruation; abnormal uterine bleeding. In: DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=2388399. Accessed Nov. 22, 2011.
  3. Casper RF, et al. Treatment of premenstrual syndrome and premenstrual dysphoric disorder. http://www.uptodate.com/home/index.html. Accessed Nov. 23, 2011.
  4. Frequently asked questions. Gynecologic problems FAQ057. Premenstrual syndrome. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq057.cfm. Accessed Nov. 23, 2011.
  5. Dog TL. Premenstrual syndrome. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed Nov. 23, 2011.
  6. Borenstein JE, et al. Using the daily record of severity of problems as a screening instrument for premenstrual syndrome. Obstetrics & Gynecology. 2007;109:1068.
  7. Johnson SR. Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: A clinical primer for practitioners. Obstetrics & Gynecology. 2004;104:845.
  8. Jing Z, et al. Chinese herbal medicine for premenstrual syndrome (review). Cochrane Database of Systematic Reviews. 2009:CD006414. http://www2.cochrane.org/reviews. Accessed Dec. 6, 2011.
  9. Panay N. Management of premenstrual syndrome: Evidence-based guidelines. Obstetrics, Gynaecology and Reproductive Medicine. 2011;21:221.
  10. Shulman LP. Gynecological management of premenstrual symptoms. Current Pain and Headache Reports. 2010;14:367.
DS00134 Jan. 18, 2012

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