Find PMS Specialists near you

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FAQs:

What is PMS?

Premenstrual syndrome, or PMS is a combination of physical and emotional symptoms that many women get after ovulation and before the start of their menstrual period. Researchers think that PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant. PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin rising again.

When Does PMS Start?

On average, the menstrual cycle lasts about 28 days. If you have an average-length cycle:

- Ovulation, or the egg’s release from the ovaries, will occur around day 14, or the midpoint of the cycle.

- PMS symptoms can begin any time after ovulation (though they typically begin in the week before your period) and last until 5 or so days after menstruation begins.

- Menstruation, or bleeding, will begin on day 28 of the cycle.

Who Gets PMS?

As many as three in four women say they get PMS symptoms at some point in their lifetime. For most women, PMS symptoms are mild. Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD).

PMS may happen more often in women who:

- Have high levels of stress

- Have a family history of depression

- Have a personal history of either postpartum depression or depression

How Do I Know If I Am in PMS?

Most women, over 90%, say they get some premenstrual symptoms, such as bloating, headaches, and moodiness.3 For some women, these symptoms may be so severe that they miss work or school, but other women are not bothered by milder symptoms. On average, women in their 30s are most likely to have PMS.

What is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder, or PMDD, is the name for severe PMS that disrupts your daily life. It is related to hormonal symptoms but can lead to reduced serotonin levels, which causes intense emotional symptoms. Besides typical PMS symptoms, PMDD can cause panic attacks, difficulty focusing on tasks, serious fatigue, irritability, and even paranoia. PMDD only affects about 5% of women.

What is Dysmenorrhea?

Dysmenorrhea is a technical term for extremely painful menstrual cramps. This is the most common cause of menstrual nausea. It can present as a primary or secondary condition. Primary dysmenorrhea is the result of uterine contractions caused by increased prostaglandins. Secondary dysmenorrhea is the result of another condition.

Is Nausea a Symptom of PMS?

Many women experience nausea during menstruation. This is common and can be due to hormonal changes during the menstrual cycle. Many women experience additional symptoms such as menstrual cramps, headaches, and other symptoms that can make the nausea even worse. The body also releases chemicals called prostaglandins during this time that can create these hormonal changes, and some women are more sensitive than others.

How Long Does PMS Last Before You Get Your Period?

The onset of PMS symptoms varies. For a PMS diagnosis, you should notice symptoms within five days before starting your period. But the timing isn’t always exact. You may start to notice symptoms two weeks before your period or two days before your period. Pay attention to your patterns.

Can PMS Be Prevented?

For some women, making lifestyle changes helps to reduce the occurrence of PMS symptoms. These changes may include:

1. Get regular exercise 3 to 5 times each week

2. Eat a well-balanced diet. You should eat more whole grains, vegetables, and fruits, while eat less salt, sugar, caffeine, and alcohol.

3. Get enough sleep and rest

4. Don’t smoke

Does PMS Change with Age?

Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse. PMS stops after menopause when you no longer get a period.

Is There a Cure for Premenstrual Syndrome?

No. But your symptoms will eventually go away once you experience menopause and no longer have periods. Until then, there’s plenty you can do to manage your symptoms so that they don’t disrupt your life. Keep tabs on when you tend to notice symptoms, and take note of the treatments that relieve them. Put them to use each month when your symptoms usually begin.

How Common is PMS?

Although it’s common to have one or a few premenstrual symptoms, clinically significant PMS occurs in only 3% to 8% percent of people who menstruate.

Symptoms of Premenstrual Syndrome

The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.

Emotional and behavioral signs and 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

- Change in libido

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

- Alcohol intolerance

For some, the physical pain and emotional stress are severe enough to affect their daily lives. Regardless of symptom severity, the signs and symptoms generally disappear within four days after the start of the menstrual period for most women.

But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of premenstrual syndrome (PMS) is called premenstrual dysphoric disorder (PMDD).

Premenstrual dysphoric disorder (PMDD) signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.

Causes of PMS

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

1. Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.

2. Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that's thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.

3. Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms

Foods to Eat During Your Period

When the PMS hits, try one of these healthy options to help ease your symptoms: 

Salmon

Rich in omega-3 fatty acids, this fish is known for its antioxidant and anti-inflammatory properties, which relax the uterus and fight cramps. Consider making a meal of grilled salmon or salmon sushi for a dose of high-quality protein and plenty of B vitamins.

Dark Chocolate

You probably don’t need another excuse to eat some chocolate. It’s undoubtedly one of the most popular foods to eat during your period for numerous reasons. Loaded with antioxidants and magnesium, dark chocolate is a great comfort food. 

Oatmeal

Oats are a whole grain rich in calcium and vitamins A and B, and they’re also a great source of iron. One cup contains about 14 of your daily recommended 18 milligrams of iron. One study found that a higher intake of the type of iron found in oatmeal was associated with a lower risk of PMS symptoms. Oatmeal is also a great option if you have an upset stomach.

Watermelons, Figs, and Plums

The natural sugars found in these foods may satisfy cravings for something sweet. Additionally, these fruits are rich in vitamins that can help with bloating. Watermelon also has a high water content and can help keep your body hydrated, which will reduce swelling and bloating.

Citrus

A smart alternative to sugary treats, oranges, lemons, and limes are packed with fiber and vitamin C and can provide relief from mood swings and bloating. Meanwhile, their high water content also keeps you hydrated. Combat PMS-related nausea and fatigue with a glass of lemon water or a (lightly sweetened or unsweetened) citrus smoothie. Moderation is key for getting a dose of feel-good energy without irritating your stomach.

Eggs

The iron, fat-soluble nutrients, B vitamins, essential fatty acids, and protein in egg yolks do wonders for PMS. But if you have a sensitive stomach, avoid hard-boiled eggs, which can cause gas, bloating, and heartburn.

Chamomile

Last on the list of foods to eat while on your period: chamomile tea. This soothing beverage can help relax your nerves and your uterus. It reduces the severity of cramps, squashes stress and anxiety, and even promotes better sleep.

Foods to Avoid During Your Period

During menstruation, you’re simultaneously losing blood and undergoing rapid hormonal shifts. Opt for foods with ample nutrients like vitamins, minerals, water, protein, iron, and fiber. At the same time, try your best to avoid the following:

Processed Foods

Canned foods, heavily processed meat, and other items made with chemicals and preservatives can make bloating and water retention worse. High levels of sodium are unhealthy at any time of the month, but they do even more damage during your period.

Candy and Snacks

Satisfy your sweet tooth by choosing juicy fruit, and try to avoid sweet snacks. They contribute to bloating and gas, while delivering a short-term spike in blood sugar. A brief sugar high inevitably leads to a major crash, leaving you feeling worse than before.

Alcohol

When you’re on your period, reduce or eliminate consumption of alcoholic beverages. Why is this important? The loss of blood at this time lowers your blood pressure, making you more vulnerable to alcohol’s side effects. It also aggravates fatigue and boosts menstrual flow.

Spicy Foods

Eating spicy dishes may add gas and bloating to your list of ailments. If you can’t bring yourself to give up spicy food, you might be better off opting for healthy options like fresh chilis. Furthermore, some studies suggest that cinnamon, turmeric, and fennel could help battle common PMS symptoms, but more research is required to determine if this is true. These spices and herbs may contain anti-inflammatory, anti-cancer, and anti-hypertensive properties. Just practice portion control to prevent an upset stomach. Always talk to your health care provider before taking any herbs or supplements for your symptoms.

Vitamins and Minerals Help with PMS Symptoms

Some evidence indicates that calcium, and other minerals and vitamins, may help with PMS symptoms.

Calcium

Calcium has the most evidence as an effective dietary treatment for PMS. The recommended dietary intake for women is 1,000 mg/day ages 19 to 50 years and 1,200 mg/day after age 50. Calcium-rich foods include dairy products, dark green vegetables, nuts, grains, beans, and canned salmon and sardines. Food sources provide the most nutritional value, but supplements may be helpful for certain women.

Vitamin B6

Limited clinical evidence suggests that vitamin B6 may help reduce PMS symptoms. The recommended daily intake for adult women before age 50 is 1.3 mg/day and after age 50 is 1.5 mg/day. Very high doses over long periods can cause nerve damage with symptoms of numbness in the feet and hands. Food sources of B6 include meats, oily fish, poultry, whole grains, dried fortified cereals, soybeans, avocados, baked potatoes with skins, watermelon, plantains, bananas, peanuts, and brewer's yeast.

Other B Vitamins

Other B vitamins that may play a role in PMS include riboflavin (B2), niacin (B3), and folate (folic acid). Food sources for these vitamins include:

1. Riboflavin. Dairy products, leafy green vegetables, liver, tomatoes, mushrooms, almonds.

2. Niacin. Dairy products, chicken, beef (especially liver), tuna, salmon, nuts, mushrooms, leafy vegetables, whole grain cereals, avocados, tomatoes, broccoli, asparagus.

3. Folate. Leafy green vegetables, citrus fruits, dried beans, and folate-enriched cereals, breads, and pastas.

Magnesium

The effects of magnesium are not as well established as with calcium, but some evidence suggests that it may be helpful in reducing fluid retention in women with mild PMS. Causes of magnesium deficiencies include excessive alcohol, salt, soda, and coffee intake, as well as profuse sweating, intense stress, and heavy menstrual bleeding. Magnesium can be toxic in high amounts and can interact with certain drugs. Discuss with your doctor whether you should take a magnesium supplement.

Iron

Some research suggests that women who consume a diet high in plant-based (non-heme) iron have a lower risk for PMS symptoms. Dietary sources of plant-based iron include lentils, beans, spinach, and iron-fortified cereal. Plant-based iron is also available in supplement form, but it is important for women not to consume more than 45 mg/day. The recommended dietary allowance for iron in adult women is 18 mg/day under the age of 50 and 8 mg/day after that age.

Medications to Help Treat PMS Symptoms

Over-the-counter and prescription medicines can help treat some PMS symptoms.

Over-the-counter pain relievers you can buy in most stores may help lessen physical symptoms, such as cramps, headaches, backaches, and breast tenderness. These include:

- Ibuprofen

- Naproxen

- Aspirin

Some women find that taking an over-the-counter pain reliever right before their period starts lessens the amount of pain and bleeding they have during their period.

Prescription medicines may help if over-the-counter pain medicines don’t work:

1. Hormonal birth control may help with the physical symptoms of PMS,12 but it may make other symptoms worse. You may need to try several different types of birth control before you find one that helps your symptoms.

2. Antidepressants can help relieve emotional symptoms of PMS for some women when other medicines don’t help. Selective serotonin reuptake inhibitors, or SSRIs, are the most common type of antidepressant used to treat PMS.

3. Diuretics (“water pills”) may reduce symptoms of bloating and breast tenderness.

4. Anti-anxiety medicine may help reduce feelings of anxiousness.

All medicines have risks. Talk to your doctor or nurse about the benefits and risks.

What Not to Do During PMS

There are, however, a couple of things you should avoid doing in order to make those few days in the month a little more bearable. Periods may cause some pain and discomfort but you can take specific steps to ease the symptoms

Here are 10 things you should not be doing during your periods:

1. Giving in to salt cravings

Foods with a high salt content are not good for you when you’re menstruating because they can worsen your cramps. What’s more, it can cause severe bloating and add to the discomfort.

2. Drinking a lot of coffee

This is one of the worst things you can do when you’re menstruating! High caffeine content can exacerbate your pain and also contribute to breast tenderness. You might crave caffeine but you will definitely need to reduce the intake of coffee.

3. Using a douche

Douching to clean yourself down there can prove to be very harmful. It can cause several health issues like infections and an increased risk of developing STDs by interfering with the vagina’s natural barriers against bacteria.

4. Wearing the same sanitary product all day long

It doesn’t matter if you’re using a sanitary pad or a tampon, wearing the same product for more than 4 to 6 hours will prove to be a breeding ground for bacteria and will lead to the development of bad odour. In addition, doing so can also cause skin rashes and TSS (Toxic Shock Syndrome).

5. Waxing or shaving

When you’re on your period, avoid hair removal. The area is sensitive and the pull of the wax strips can hurt, adding to your discomfort. Shaving can prove to be an extremely messy affair due to the period flow. In case you end up with a cut due to the shaving, it might lead to infection. So, plan it after a week of your period to reduce the risk of pain and discomfort.

6. Having unprotected sex

First of all, it’s absolutely normal to have sex when you are menstruating but having sex without protection during periods is a bad idea! If you’re not looking at starting a family just yet, you should avoid taking the chance. Plus, protected sex is also a way of avoiding STDs. Period, or no period, always practice safe sex in order to steer clear of infections and STDs.

7. Smoking

We all know smoking is dangerous for our health but women who smoke during their period are more likely to experience severe pain. So, it’s better to kick the butt.

8. Going to bed without a pad

You might think sleeping without a pad can be comforting but it is a bad idea! If you’re worried about the rashes and discomfort it might cause, you can switch to another brand or start wearing a menstrual cup but don’t go to bed without wearing a sanitary product to handle the flow.

9. Going for a breast exam

When you’re menstruating, your hormone level fluctuations can make it difficult to detect abnormalities in your breasts. Hence, it is best to avoid a breast exam in the middle of your periods.

10. Skipping meals and eating junk food

Skipping meals during your periods isn’t a good idea because it can severely affect your energy levels, making you feel lethargic and irritable. This, however, doesn’t mean you replace actual meals with junk food. Junk food contains high amounts of salt and sugar, contributing to issues like bloating and discomfort.

How to Ease Symptoms of PMS

While there’s no cure for PMS, you can take steps to ease your symptoms.

To get relief from mild or moderate symptoms, it may help to give the following strategies a try:

1. Drink plenty of fluids to ease abdominal bloating. This includes herbal teas, like red raspberry leaf or chamomile, which may ease cramping.

2. Eat a balanced diet that includes plenty of fruits, vegetables, and whole grains.

3. Consider cutting back on sugar, salt, caffeine, and alcohol, especially if you’re particularly sensitive to their effects.

4. Ask a healthcare professional about trying supplements like folic acid, vitamin B-6, calcium, and magnesium to help reduce cramps and mood symptoms.

5. Try getting more vitamin D via natural light, food, or supplements.

6. Aim to get 7 to 9 hours of sleep each night to help relieve fatigue and improve overall well-being.

7. Try to get at least half an hour of physical activity each day, if you’re able. Exercise can not only help relieve bloating and cramping, but it can also help ease anxiety and depression symptoms.

8. Set aside time each day for self-care, which might include exercise, relaxation, time to yourself for hobbies, or time for social interaction.

Over-the-counter medications and treatments can also help reduce physical PMS symptoms. Options include:

1. pain relievers, like ibuprofen, aspirin, or acetaminophen, for head and muscle aches or stomach cramping

2. diuretics to help relieve bloating and sore or tender breasts

3. heat wraps or heating pads on your abdomen to relieve cramps

If you have severe mood symptoms that create complications in your daily life, cognitive behavioral therapy (CBT) or other therapy approaches can help you learn new ways to reframe and cope with distressing thoughts and emotions.

How to Stop PMS Mood Swings

In order to reduce and manage mood swings before your period and during it, there are a number of simple lifestyle changes you can make. Without further ado, here is a list of natural remedies for PMS mood swings:

1. First, exercise! Exercise releases endorphins. Endorphins are your brain’s very own feel-good chemicals that boost your mood. You know that rush you get after running around or playing football with friends? That’s from endorphins.

2. Next, try avoiding caffeine and sugary foods. These spike your mood, only to set you up for a crash later. If you’re already facing mood swings before your period, the ups and downs caused by sugar and caffeine can be particularly devastating.

3. Eat a balanced diet and prefer food rich in fibre like fruits, vegetables and beans.

4. Drink water to stay hydrated.

5. Try avoiding stress. While stress doesn’t directly cause PMS mood swings, it can certainly make them feel worse. In order to help stop PMS mood swings, do your best to avoid stressful activities and events before and during your period in order to give yourself a break.

6. Get some extra sleep. Sleep is always great for calming your nerves and helping your body relax. Try not to push yourself too hard and stay up too late for some extra help with PMS mood swings.

7. Invest in some TLC and “me time”. Do some extra pampering activities for yourself during your period. Anything that will help you relax and slow down the onslaught of thoughts in your head is a good start. Try a good face mask or a warm bath. A warm bath can also help ease period cramps, so that’s an extra bonus.

8. Get out and about. It’s easy to obsessively worry or rage when you’re in a closed, familiar space. Instead, try taking a walk. Breathe some fresh air. A change in scenery can create a change in mood. Plus, it’s a great natural remedy for PMS mood swings.

9. Relax. Try practising deep breathing exercises to calm your nerves and feel good.

10. Listen to how you feel – don’t feel bad if you want to curl up on the sofa instead of going out with your friends.

When to See a PMS Specialist

If you’ve tried different things but still have bad PMS, it’s probably time to get help. Make an appointment with your doctor or gynecologist. They’ll ask about your symptoms, your health, and medicines you take. They may take some blood tests to make sure the problem is PMS and not something else.

If you have notes about your symptoms, bring them to the appointment. Plan ahead about the questions you want to ask. That way, you’ll get the best help from your doctor.

Your doctor may suggest a treatment plan including:

- Talk therapy, a way to feel better and learn new skills to overcome challenges by talking with a mental health counselor.

- Over-the-counter (OTC) medicines

- Prescription medications

Sources:

OASH

Mayo Clinic

Cleveland Clinic

Healthline

Mount Sinai

Johns Hopkins

WebMD

Tidewater Physicians for Women

Always

Health Shots

FLO

 

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.