What Is Premenstrual Syndrome?

Premenstrual Syndrome, commonly referred to as PMS, is a term used to describe the symptoms many women experience one to two weeks before the beginning of their period. Physical symptoms, accompanied by mood swings and depression, are the classic signs. Thirty to forty percent of American women have symptoms severe enough to interfere with their daily lives, while three to five percent have symptoms severe enough to be incapacitating.

PMS symptoms can occur any time after ovulation, approximately two weeks after the beginning of your period.

What Are the Symptoms of Premenstrual Syndrome?

The following is a list of both behavioral and physical symptoms commonly associated with PMS. All PMS symptoms should disappear rapidly once menstruation begins.


  • Increased irritability
  • Feeling anxious
  • Crying spells
  • Cyclic depressive symptoms
  • Forgetfulness
  • Difficulty concentrating


  • Breast swelling or tenderness
  • Headaches
  • A “bloated” feeling or temporary weight gain of a few pounds
  • Nausea or constipation followed by diarrhea at the start of menstruation
  • Acne
  • Swelling of hands or feet
  • Increased appetite or thirst
  • Food cravings
  • Fatigue or insomnia

What Causes Premenstrual Syndrome?

PMS has been described as far back as Hippocrates. Modern investigation of PMS began in the early 1930’s when it was called “premenstrual tension”. For many years, research has focused on two hormones produced by the ovaries, estrogen and progesterone. Other investigations have centered on serotonin levels (a neurotransmitter in the brain,) deficiencies of endorphins, defects in the metabolism of glucose or B6, low concentrations of zinc, magnesium or calcium, and an imbalance in the body’s level of acidity.

No conclusive evidence has been found to support any of these theories. Research has found though, that PMS responds to a variety of treatments.

How Is Premenstrual Syndrome Diagnosed?

There are no diagnostic tests for PMS. It is generally diagnosed through a process of elimination. To aid in diagnosis, you should keep a diary for several months of symptoms; when they appear, their severity, and when they subside. You and your physician can review your record in order to determine a treatment plan.

How Is Premenstrual Syndrome Treated?

Premenstrual Syndrome may be treated through a modification of lifestyle and change in diet, or through medications.

Lifestyle and Dietary Changes

  • Decrease Caffeine – Caffeine can exaggerate certain PMS symptoms, such as irritability, anxiety, insomnia, and nervousness.
  • Avoid salt – Many women gain a few pounds in the second half of the menstrual cycle due to water retention. Avoiding salty foods can help decrease the bloating. Since brain cells can also retain fluid, decreasing salt may also help relieve headaches and aid in concentration. Along with the sodium reduction it is important to drink at least 8 to 10 glasses of water a day. Water acts as a natural diuretic, along with its normal role in cellular function.
  • Avoid sugar – Eating sugary foods can set off a vicious cycle of sugar cravings. Blood sugar swings can cause a disruption in hormonal production and distribution.
  • Stop smoking – Nicotine can exaggerate PMS symptoms much the same as caffeine.
  • Decrease alcohol intake – Alcohol can intensify PMS symptoms because it depletes the body of B vitamins, disrupts the metabolism of carbohydrates, and affects the liver’s ability to process hormones.
  • Add Calcium – Taking 1200 mg of chewable calcium carbonate a day can decrease PMS symptoms by as much as 50%. Improvements may not be apparent until the third cycle of treatment.
  • Exercise – Women who exercise regularly have milder PMS symptoms. You should participate in some type of aerobic exercise for 20 to 30 minutes at least 3 times a week.
  • Add Magnesium – The intake of 200 mg of Magnesium a day may reduce fluid retention, breast tenderness and bloating by 40%. Improvements may not be realized until completing the second cycle of treatment.


  • Over the counter PMS preparations – There are a number of over the counter PMS medicines available which contain a medication for headaches and pain along with a mild diuretic.
  • Oral Contraceptives (Birth Control Pills) – Taking birth control pills, or changing prescriptions if already on the pill can decrease PMS symptoms for many women.
  • Spironolactone – This is a diuretic that has been shown in some studies to decrease bloating and mood-related symptoms.
  • NSAIDs (Examples of NSAIDs available over the counter are Advil, Motrin, Aleve, and Nuprin) – NSAIDs are prostaglandin inhibitors. They work best if taken before the onset of PMS symptoms. They work on headaches, cramping, and may reduce the amount of blood loss.