Medically Reviewed by Dr Davinder Nagah
Last updated on 19.06.2023
What is PMS?
- Premenstrual Syndrome is also known as:
- Premenstrual Tension (PMT)
- Premenstrual Disorder (PMD)
- Premenstrual Dysphoric Disorder (PMDD) if it’s severe
- Premenstrual syndrome is defined as:
- Distressing physical or emotional symptoms
- Occurring regularly in the 2 weeks before your period
- Not occuring at other times in your menstrual cycle
- It’s only diagnosed after other medical conditions are excluded
How common is PMS?
- It’s really common. About 40% of women have PMS
- Only half of women with PMS seek medical help
- Over 10% of women need time off work for PMS
What are the symptoms of PMS?
- Symptoms of PMS commonly include:
- Bloated tummy
- Irritability or anger
- Pain in the breasts
- Pain in the joints and muscles
- Less common symptoms of PMS include:
- Headaches
- Weight gain
- Swelling of the hands or feet
- Excessive hunger, cravings
- Tiredness
- Tearfulness
- Disrupted sleep
- Loss of concentration
- Anxiety or depression
- Confusion
What causes PMS?
- Nobody is certain
- It doesn’t occur before puberty (when periods start), during pregnancy, or after the menopause (when periods stop)
Who gets PMS?
- PMS runs in families – there’s a strong genetic link
- It’s more common in:
- Overweight women
- Women who don’t exercise much
- Younger women
- Women with longer periods
- Women who are victims of domestic violence
What is the treatment for PMS?
- If you think you have PMS, you should start by keeping a diary of your symptoms
- This will help your doctor to understand the problem
- Your doctor should:
- Have a discussion with you about your symptoms
- Examine you
- Possibly perform some blood tests and/or imaging tests such as an ultrasound
- Increasing your exercise has been shown to help
- You may be offered a referral to a psychologist
- Prescription medications which may help
- Vitamin B6
- The combined oral contraceptive pill, taken either with or without breaks
- Certain antidepressant medication
- Diuretics (water tablets) may help with swelling
- If none of the above works, you may be offered a hormone patch to stick on your skin or other forms of hormone tablets
- If your doctor isn’t managing to help with your symptoms, you could ask to be referred to a gynaecologist
- Sometimes, if things are really bad, people have their uterus and ovaries removed (total abdominal hysterectomy & bilateral oophorectomy)
- If you think you may have PMS you should consult with your doctor
What is Premenstrual Dysphoric Disorder or PMDD?
- PMDD is severe PMS
- The symptoms of PMS are listed above
- It affects about 5% of women during their fertile years
- More than half of women with PMDD suffer from mental illness at some point in their lives
- It is a significant cause of sick leave
- Diagnosing PMDD involves completing a diary of ratings for certain symptoms
- If you think you may have PMDD you should consult with your doctor
- Management of PMDD mirrors the management of PMS (as described above)
Article Resources
Royal College of Obstetricians and Gynaecologists
O’Brien S et al. Diagnosis and management of premenstrual disorders. BMJ. 2011;342:d2994
Liisa Hantsoo. Premenstrual Dysphoric Disorder: Epidemiology and Treatment
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