Premenstrual syndrome (PMS)

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Symptoms

By Mayo Clinic staff

The most common signs and symptoms associated with premenstrual syndrome include:

Emotional and behavioral symptoms

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration

Physical signs and symptoms

  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea

Although the list of potential signs and symptoms is long, most women with premenstrual syndrome experience only a few of these problems.

For some women, the physical pain and emotional stress are severe enough to affect their daily routines and activities. Regardless of their severity, though, the signs and symptoms disappear, for most women, as the menstrual period begins.

But a few women with premenstrual syndrome have disabling symptoms every month. This form of PMS has its own designation — premenstrual dysphoric disorder (PMDD). PMDD is a severe form of premenstrual syndrome with signs and symptoms including severe depression, feelings of hopelessness, anger, anxiety, low self-esteem, difficulty concentrating, irritability and tension. A number of women with severe PMS may have an underlying psychiatric disorder.

When to see a doctor
If you've had no luck managing your premenstrual syndrome with lifestyle changes, and signs and symptoms of PMS are seriously affecting your health and daily activities, see your doctor.

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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