Premenstrual syndrome

Premenstrual syndrome is also known as PMS. PMS is a group of symptoms that some women experience in the days leading up to their period. Symptoms can appear up to 2 weeks before menstruation and stop within a few hours or days after the start of menstruation. Symptoms vary in intensity from one woman to another and from one cycle to another.

The main symptoms are as follows:

• Changes in mood and behaviour:
  • Irritability and anger
  • Anxiety
  • Sadness
  • Decreased concentration
• Physical symptoms:
  • Swollen and tender breasts
  • Water retention (weight gain)
  • Joint and muscle pain
  • Menstrual cramps
  • Diarrhea or constipation
  • Headaches
  • Insomnia
  • Fatigue

Premenstrual dysphoric disorder is the severe form of premenstrual syndrome. It is diagnosed when symptoms are severe enough to interfere with daily activities.

Causes and triggers

The exact cause of PMS is not clearly defined. The most likely cause is the variation of female hormones during the menstrual cycle. Several other factors may also play a role:

• Genetic predisposition
• Lack of serotonin (a messenger in the brain responsible for mood)
• Alcohol and tobacco consumption
• Lack of certain vitamins and minerals

Treatment

Certain lifestyle changes can help reduce the symptoms of PMS.

• Regular exercise
• A healthy diet:
  • Increase your fibre, fruit, and vegetable intake
  • Limit salt and sugar
  • Limit fatty foods
  • Limit alcohol and caffeine
• Manage stress (e.g., practise relaxation techniques)
• Quit smoking

Keeping a symptom log can help in the diagnosis and treatment of PMS. This involves keeping track of when and the time of the day you have symptoms. Track the date that your period starts in the log as well.

If lifestyle changes are not enough to reduce symptoms, you may be prescribed certain medications such as hormones or antidepressants. Certain vitamin or mineral supplements may also help (e.g., calcium and vitamin B6). Speak to your pharmacist before taking a vitamin or mineral supplement.

When should I see a health care professional?

Speak with your health care provider in the following cases:

• Lifestyle changes do not relieve your PMS symptoms
• Your symptoms interfere with your daily activities

Seek immediate help if you are having suicidal thoughts.

For more information:

• Facts on menstruation from the Society of obstetricians and gynaecologists of Canada