Premenstrual Syndrome (PMS)
Guide To Period Pains, PMS Symptoms And Causes

Time of the month


Premenstrual Syndrome (PMS)


What Is PMS?
What Are The Symptoms?
What Causes It?
Is Stress a Factor?
Who Is Most Likely To Suffer From PMS?
How Is It Diagnosed?

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Guide to Menstruation

What Is PMS?

Medical experts define premenstrual syndrome (PMS) as a combination of mood, physical and behavioral changes which occur predictably before each menstruation and which are severe enough to interfere with a woman's everyday life. These changes typically occur 5 days before a period is due, but can start up to 15 days before. It is commonly referred to as 'time of the month' or TOM. Isolated symptoms such as craving chocolate or feeling tired are not quite the same as PMS. Scientists have identified over 150 symptoms of PMS, and the most common include food cravings, bloating, tiredness, breast soreness, mood swings, backache and headaches. For PMS to truly exist, the combination of symptoms must interfere with normal activity - e.g. you feel too tired to do something, you can't concentrate as normal or you feel so irritable that you shout at people. It is suggested that PMS occurs in 75 percent of all women of child-bearing age.

What Are The Symptoms?

As is the case with SAD (seasonal affective disorder), premenstrual syndrome is characterized by the timing of symptoms. Given that so many symptoms have been identified, what makes PMS distinctive is WHEN they occur: that is 5 to 15 days before menstruation. In fact, there is very little difference between PMS and the early signs of pregnancy. The most common symptoms of PMS include:

• Headaches
• Bloating
• Acne flair ups
• Fatigue
• Mood swings & weeping
• Anger
• Depression
• Joint swelling
• Nausea
• Vomiting
• Nervousness
• Pelvic Pain
• Sleep disorders such as insomnia
• Weight gain from fluid retention (edema)
Bowel disorders - constipation and diarrhea
• Poor concentration
• Food Cravings
• Dizzy spells
• Sweating
• Reduced libido

Approximately 3 to 9 percent of women experience PMS symptoms so severe that they cannot function normally. The American Psychiatric Association named this condition Premenstrual Dysphoric Disorder (PMDD) and has set out criteria for its diagnosis which includes anger, feeling of hopelessness, lethargy, hypersomnia or insomnia. In other words, PMS on acid!

What Causes It?


Given the enormous hormonal changes that a woman experiences during a regular menstrual cycle, it is no wonder that there are side effects. The real mystery however is why some women experience worse PMS symptoms than others despite there being no discernible difference in hormone levels between them. There is some evidence that different hormone fluctuations may contribute to certain symptoms. For example, reduced serotonin levels (the so-called happy hormones) may contribute to depression, anxiety and sleep problems, as well as triggering food cravings and tiredness. One study showed that an obesity drug that affects the neurotransmitter linked to serotonin may relieve symptoms. A decrease in endorphins levels (nature’s natural painkillers) during the menstrual cycle may lead to increased sensitivity to pain. Still, precisely why PMS occurs is not yet known. In fact it may turn out there is more than one form of PMS, each with its own cause and symptoms.

Diet & Nutrition

There is some evidence that a bad diet, lacking in certain minerals and vitamins can exacerbate the symptoms of PMS. Some research shows that an imbalance of calcium and magnesium and insufficient amounts of B6 and vitamin E can make symptoms worse. Eating salty foods like chips can cause fluid retention and bloating. Coffee and alcohol can contribute towards mood swings around time of the month (TOM). Whether a poor diet can aggravate those who suffer from heavy periods or painful periods is still not clear.

Is Stress a Factor?

No, stress does not cause PMS, but it can certainly make symptoms worse. Excessive stress can also cause irregular periods (oligomenorrhea) and missed periods (amenorrhea).

Who Is Most Likely To Suffer From PMS?

Women who are approaching menopause, in the perimenopause phase, appear to suffer most from PMS (Menopause Guide). However studies show that the most severe forms of PMS are more likely to affect women between the ages of 26 and 35 who have a menstrual cycle of 25 to 28 days and who have a stressful life (which frankly describes the average working mom!). Other factors associated with severe PMS include a family history of depression and migraines. Obesity, bad diet and excessive alcohol are also factors. Women with underlying psychiatric illnesses such as panic attacks may find that their symptoms are also worse.

How Is It Diagnosed?

Before any treatment for PMS can be recommended, your doctor will require a history of your menstrual cycle. He will also discuss any environmental factors such as stress at home or work, diet, nutrition and exercise. A pelvic and physical exam may also be carried out as well as blood tests to rule out any underlying disorders such as polycystic ovary syndrome, anemia, uterine fibroids, and endometriosis or thyroid problems. See also, how can I relieve period cramps?


For more female conditions, see the following:

Functional Ovarian Cysts

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