Got PMS? The Infamous Premenstrual Syndrome, Explained

It’s that time of the month again… almost. Even before your period starts, you might already be experiencing a group of symptoms called premenstrual syndrome (PMS), signaling your monthly meeting with Aunt Flo soon.

Research shows that PMS affects 75% of menstruating women on some level. For most women, the symptoms are pretty manageable. For others, they can be so crippling that they disrupt their everyday activities. 

That’s why if you’re one of the women who have to go through PMS every month, it helps to have information on your side.

Keep reading if you want to learn more about PMS and better understand your personal experience. This post will cover a quick intro to PMS, its symptoms, and your treatment options.

What is PMS?

Premenstrual syndrome is the collective term for a group of signs and symptoms experienced by menstruating women just before they have their menses.

No one knows why PMS happens and why the symptoms vary greatly. But according to medically-informed speculations, it might have something to do with the hormone fluctuation during your menstrual cycle.

Every menstrual cycle has four phases: menstruation, follicular phase, ovulation, and luteal phase. PMS is associated with the luteal phase, which happens just before another cycle begins.

During this last phase of the menstrual cycle, you experience an increase in hormone levels—particularly estrogen and progesterone. These are associated with irritability, mood swings, and other symptoms.

But many researchers believe that hormones aren’t the only ones to blame. Serotonin also increases around this time, causing changes in your mood and thoughts. 

Other factors also increase your risk of premenstrual syndrome, including:

• physical and emotional trauma
• substance abuse
• family and personal history of depression and PMS
• domestic violence

For something to be diagnosed as PMS, you must experience symptoms for at least three menstrual cycles in a row.

What Are the Symptoms of PMS?

Premenstrual symptoms come in many forms. For some, they only experience physical ones. But for most women, it’s a combination of physical and emotional symptoms.

Unfortunately, the symptoms women report and experience vary so widely that it’s hard to create a definitive list of all PMS symptoms.

Still, here are the most common symptoms that you should know about:

Physical Symptoms

• Tender breasts
• Abdominal pain due to bloating, constipation, and diarrhea
• Fatigue
• Acne
• Headaches
• Physical pain
• Fluid retention
• Decreased alcohol tolerance

Behavioral and Emotional Symptoms

• Difficulty concentrating
• Mood swings
• Sleep problems
• Crying spells
• Food cravings and appetite changes
• Anxiety
• Decreased libido

If you’re one of the unlucky few, you may be suffering severe PMS symptoms every month that affect your daily life. This is called premenstrual dysphoric disorder (PMDD), and the symptoms are very similar to your average PMS—except they’re more alarming.

PMS vs. PMDD: What’s the Difference?

While three in four women experience PMS, PMDD is much less common. It happens to only 3-8% of women.

But the thing is, women experiencing PMS can manage their symptoms on their own. PMDD symptoms, while similar to PMS, are so severe they need the help of healthcare professionals to manage them.

Some of the more serious symptoms of PMDD include:

• Mood swings. During PMS, you might feel like you’re so happy one moment, then about to cry the next. But in PMDD, the mood swings are so extreme you don’t feel in control of them. You might get angry at things that generally don’t bother you or cry over stuff that doesn’t usually upset you.
• Anxiety. Women with PMDD describe their anxiety as feeling extremely tense or on edge all the time.
• Depression. For women with PMDD, depression may be so extreme that they feel hopeless and suicidal. They might even stop caring about their hobbies, jobs, friends, and family.

Regardless of how it feels for you, the most important thing is awareness. Knowing that it’s part of the experience helps you anticipate and prepare for it every month.

When Does PMS Start?

You’ll usually see your PMS symptoms start within 5-11 days before your menstrual period. 

Going beyond that normal range isn’t something to worry about unless you have other health issues. Taking good care of your health and keeping an eye out for any symptoms out of the blue would help a lot.

How Long Does PMS Last?

PMS lasting for 14 days into your menstrual cycle up to seven days after your period starts is considered normal. Still, experiencing PMS for a full 21 days is rare.

But even at their most severe, your symptoms shouldn’t last an entire month. If they last longer, you may have to visit your doctor to ensure that undiagnosed health problems aren’t to blame.

Managing Your Symptoms

Although there’s no cure for it, there are things you can do to manage your symptoms better. 

You can try to ease PMS symptoms on your own by following these few tips:

• Incorporate complex carbohydrates into your diet. Adding whole grains, rice, or lentils can reduce mood swings and food cravings.
• Modify your diet. If you’re experiencing bloating and weight gain during PMS, you can reduce the amount of salt in your diet to combat these symptoms. You might also want to have smaller but more frequent meals to reduce the sensation of fullness. Avoid caffeine and alcohol as well.
• Find ways to relax. There’s a lot of things you can do about this! A more active social life helps, while others prefer meditation, yoga, deep breathing exercises, and progressive muscle relaxation.
• Don’t skimp on sleep. Not having enough sleep is linked to fatigue, depression, and anxiety. PMS symptoms are already a big hassle as they are. Lack of sleep only makes things worse.
• Get regular exercise. You should get moving even when you’re not experiencing symptoms yet. Working out isn’t just good for your cardiovascular health. It also helps fight depression and fatigue, improving your mood.
• Try over-the-counter medicine. You don’t have to endure physical pain. OTC medication like aspirin, ibuprofen, and naproxen may address any mild to moderate discomfort. If you’re not sure whether or not it’s safe to take something, consult a health professional.
• Explore alternative medicine. Some women report herbal remedies like ginkgo, ginger, and St. John’s wort help relieve PMS symptoms. Others swear by vitamin supplements, like calcium, magnesium, vitamin B6, and vitamin E. Keep in mind that the FDA doesn’t regulate these, so there’s no record of product safety or effectiveness. Before taking any of these remedies, make sure to talk to your doctor first.

Be warned: no single PMS treatment works for every woman. You can only know what works best for you through trial and error. 

That’s why it’s essential to keep track of your symptoms so you can identify triggers and plan strategies to lessen them.

If you’re experiencing severe PMS, your doctor will want to rule out other potential causes. They may order a physical exam, complete blood count, gynecological exam, liver function tests, and psychiatric evaluation to nail down the actual cause.

The results of the exams will determine your doctor’s treatment approach. 

Here are some things they may recommend:

• Stress management
• Stopping caffeine consumption
• Counseling
• Medications
• Antidepressants like selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatments for both PMS and PMDD. Taken daily two weeks before menstruation begins, they’ve successfully reduced mood symptoms. 
• NSAIDs (non-steroidal anti-inflammatory drugs) can help with physical symptoms, like cramps and breast tenderness.  They are usually taken before the onset of your period.
• Diuretics can help your body get rid of excess fluid contributing to PMS symptoms like weight gain, swelling, and bloating.
• Hormonal contraceptives will stop ovulation, thus bringing relief to your PMS symptoms.
• Psychiatric evaluation (mainly applicable to women with any history of depression and trauma to address potential psychiatric triggers)

Be completely honest during your evaluation to make sure your doctor can help you overcome your symptoms. This will ensure your best chances of eventually going back to your normal life.

Conclusion

Like with anything involving the human body, PMS is very complicated. Medical researchers are constantly trying to understand this phenomenon better. 

But even though your experience can be different from another woman’s, know that you’re not alone. Plus, you’ll always have us to give you accurate and up-to-date information on various women’s health issues.

We hope this helps you improve your understanding of PMS and how you’ll approach treatment. You’ve got this!