Premenstrual syndrome quiz
Take a quiz to find out if you have premenstrual syndrome.
Premenstrual syndrome (PMS) causes a range of symptoms including bloating, cramping, headaches, irritability, fatigue, and sleep and appetite changes. Find out how to treat them.
What is premenstrual syndrome?
Premenstrual syndrome (PMS) can cause physical and emotional symptoms in the days leading up to your menstrual cycle.
Common symptoms include bloating, cramping, headaches, irritability, fatigue, and sleep and appetite changes. These symptoms usually improve within a few days of getting your period.
Depending on how severe your symptoms are, treatment options may include medications such as birth control pills and antidepressants like selective serotonin reuptake inhibitors (SSRIs).
Treatment may also include at-home approaches like decreasing caffeine, salt, and refined sugar, increasing exercise, and reducing stress.
Symptoms of premenstrual syndrome
PMS can cause both emotional or physical symptoms that can often impact school and work performance or home life. These symptoms include:
- Mood swings
- Sad or depressed mood
- Increased appetite or food cravings
- Decreased interest in normal activities
- Abdominal bloating
- Breast tenderness
- Hot flashes
- Decreased interest in sex
- Difficulty with concentration
- Changes in sleep
There are diagnositic criteria that can determine if you have PMS or if you have a more serious but less common disorder called premenstrual dysphoric disorder (PMDD).
PMS is usually diagnosed if you have symptoms in the 5 days before your period for 3 months in a row. Symptoms usually stop within 3 or 4 days of getting your period.
The American Psychiatric Association defines PMDD as having at least 5 of the symptoms listed above, including one symptom that affects your mood, like depression or irritability. PMDD is much less common and is estimated to affect 2—5% of the population.
The menstrual cycle is divided into two distinct phases—the follicular phase and the luteal phase. The luteal phase starts after ovulation. If the egg that was released during ovulation is not fertilized, levels of the hormones estrogen and progesterone begin to drop rapidly toward the end of the luteal phase (the days leading up to your period).
While the exact mechanism is not yet clear, it is thought that these decreasing levels of estrogen and progesterone lead to changes in the neurotransmitters GABA and serotonin, which lead to PMS symptoms.
Treatment is generally based on how severe your symptoms are and how much they affect your daily life.
Mild PMS treatment
If you have mild PMS, it means your symptoms do not cause significant distress or disrupt your life. For mild PMS, studies have shown that regular exercise and relaxation techniques can help relieve symptoms. Try to exercise daily throughout the month, not just when you have symptoms.
Moderate or severe PMS treatment
Women with moderate or severe PMS (also known as PMDD) are generally treated with medication. Before starting any medications, it's important to rule out other psychiatric conditions, substance use, or thyroid problems.
Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are often recommended for moderate to severe PMS. SSRIs should take effect within the first menstrual cycle after starting therapy. If not, the dose can be increased.
Depending on how long you usually have symptoms, your doctor may recommend you take an SSRI every day or that you only take it during the luteal phase of your menstrual cycle.
About 15% of people taking SSRIs experience side effects. These may include insomnia, headache, nausea, and decreased sex drive.
Birth control pills
If SSRIs are not helpful enough or you cannot tolerate the side effects, you can consider taking birth control pills to reduce your PMS symptoms.
Lifestyle choices can help reduce PMS symptoms. These include:
- Eating a healthy diet, low in sugar, salt, and fats
- Reducing caffeine, alcohol, and nicotine
- Exercising at least 30 minutes a day on most days
- Managing stress with relaxation techniques like deep breathing, meditation, and yoga
See all treatment optionsBuoy's medical team has found the best treatments for your condition and symptoms. While it starts with home treatments, you may also need to have a virtual or in-person visit with a healthcare provider, get a prescription, or consider other treatment options.
When to see a healthcare provider
You should see your healthcare provider if your PMS symptoms lower your quality of life or day-to-day functioning. While PMS and PMDD are rarely a medical emergency, getting the right treatment can improe your physical and mental health.
Questions your doctor may ask to determine premenstrual syndrome
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Do you have trouble sleeping?
- Do you currently smoke?
- Are your symptoms causing difficulty at work, socializing, or spending time with friends & family?
- Have you lost your appetite recently?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Premenstrual syndrome (PMS). Office on Women’s Health. OWH Link
- Premenstrual syndrome (PMS). American College of Obstetrics and Gynecology. Published May 2015. ACOG Link
- Epperson CN, Steiner M, Hartlage SA, et al. Premenstrual dysphoric disorder: Evidence for a new category for DSM-5. Am J Psychiatry. 2012;169(5):465-475. NCBI Link
- Potter J, Bouyer J, Trussell J, Moreau C. Premenstrual syndrome prevalence and fluctuation over time: Results from a French population-based survey. J Women’s Health (Larchmt). 2009;18(1):31–9. PubMed Link
- Deuster PA, Adera T, South-Paul J. Biological, social, and behavioral factors associated with premenstrual syndrome. Arch Fam Med. 1999;8(2):122-8. PubMed Link
- Aganoff JA, Boyle GJ. Aerobic exercise, mood states and menstrual cycle symptoms. J Psychosom Res. 1994;38(3):183-192. PubMed Link
- Marjoribanks J, Brown J, O'Brien PM, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. 2013;(6):CD001396. PubMed Link
- Endicott J, Nee J, Harrison W. Daily record of severity of problems (DRSP): Reliability and validity. Arch Womens Ment Health. 2006;9(1):41-9. PubMed Link