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Premenstrual syndromePublished by BUPA's health information team, healthinfo@bupa.com, August 2007. This factsheet is for women who have premenstrual syndrome (PMS) or anyone who would like information about it. Premenstrual syndrome (PMS) is a mixture of physical and emotional symptoms that some women experience during the days, or sometimes weeks, leading up to their menstrual period. What is PMS?PMS can start up to two weeks before your period and usually goes away when your period starts. It most commonly affects teenagers and women in their early 20s. Some women have symptoms of PMS each month before their period starts. Nearly all women get some mild symptoms before their period. However, around one in 20 women have symptoms that interfere with their quality of life. SymptomsMore than 100 symptoms have been associated with PMS. Common symptoms can be grouped into emotional, behavioural and physical categories. Emotional and behavioural symptoms can include:
Physical symptoms can include:
These symptoms are common and are not unique to PMS. So it's the timing of the symptoms that are the telltale signs of PMS. With PMS, the symptoms will:
A small number of women with PMS may be diagnosed with premenstrual dysphoric disorder (PMDD). This is a more severe form of the syndrome characterised by mood swings, depression, anxiety and irritability that interferes substantially with everyday life. CausesNo one knows the exact cause of PMS, but one theory is that women with PMS are particularly sensitive to the varying levels of hormones in the body at certain times of the month. It's possible that these hormones also interact with the body's mood-controlling chemicals (such as serotonin) in the brain. DiagnosisThere are no specific tests that can diagnose PMS. Your doctor will usually make a diagnosis based on a description of your symptoms and when they occur. If you suspect you have PMS, keep a diary of your symptoms for two or three menstrual cycles before you visit your GP. This will help you and your doctor to see if the symptoms are related to your menstrual cycle. The National Association for Premenstrual Syndrome has an online diary that you can fill in to create a personalised chart of your symptoms. It's very important to distinguish between PMS and other problems that could be causing similar physical or emotional symptoms, because the treatment will be different. TreatmentMany women put up with PMS, believing it to be a normal part of being female. However, there is a great deal that you can do to help reduce mild to moderate symptoms. Self-helpIf, by keeping a symptom diary, you think that your physical or emotional symptoms are linked with your period, then you may have already crossed the first hurdle. Now you can predict more accurately how you will feel at certain times of the month, this may help you to:
Some women find that PMS symptoms improve if they take regular exercise and eat a healthy, balanced diet rich in fruit, vegetables and wholegrain carbohydrates, with limited caffeine, alcohol and salt. There is no evidence to back this up, but these lifestyle habits promote good health and a sense of wellbeing. It's reasonable to try some painkillers if you experience premenstrual headaches, backache or other aches and pains. Over-the-counter painkillers, such as those you would normally take for a headache, may help. Get advice from your GP or pharmacist before using over-the-counter medicines, and always follow the instructions on the packet. Some women have found that taking vitamin B6 supplements is helpful. There is some limited scientific evidence that this works, but high doses can damage the nervous system. Don't take more than 50 or 100mg of vitamin B6 supplements each day and if you have any questions or concerns, talk to your GP or pharmacist. You may have to try several self-help measures before you find something that is effective for you. MedicinesIf you have symptoms that are disrupting your life, and these don't improve with self-help measures, consider seeing your GP for advice. He or she may do tests to rule out other illnesses that could be causing your symptoms. If PMS is diagnosed, your GP may prescribe medicines, depending on the type of symptoms you have. If you are one of the small proportion of women who has PMDD, prescription medicines called selective serotonin reuptake inhibitors (SSRIs) can be effective, such as fluoxetine (Prozac). Despite being an antidepressant medicine, fluoxetine appears to have a positive effect on both the physical and behavioural symptoms of PMS. You may have side-effects from the medicine, such as:
If self-help measures and treatment with SSRI medicines don't relieve your symptoms, your doctor may prescribe different types of medicines. These may be hormonal treatments, or medicines to target specific symptoms. Some options are listed below.
Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007. Expected review date: August 2009.
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