Premenstrual syndrome (PMS)

What is PMS?

PMS, meaning premenstrual syndrome, is a common condition. It describes a range of symptoms many women experience in the lead-up to their period. 

Most women experience PMS to some degree throughout their lives. In most cases, it’s manageable, but if it starts to interfere with your daily life, there’s help available.

What are the symptoms of PMS?

Women experience different symptoms, and they can vary from month to month too. Some of the most common signs of PMS include:

Mental symptoms of PMS

• Crying 

• Mood swings

• Tiredness (fatigue)

• Feeling upset, sad, or irritable

• Easily overwhelmed 

• Angry outbursts

• Forgetfulness 

• Less concentration

• Lower sex drive 

• Anxiety

• Depression 

Physical symptoms of PMS

• Headaches

• Lower back pain

• Cramps

• PMS bloating (bloated tummy)

• Sore, tender breasts

• Spots or acne flare-ups

• Hunger and cravings (especially for sweet things) 

Muscle aches

• Constipation or diarrhoea

• Changes in sleep patterns 

• Sensitivity to light or sound 

What causes PMS?

It’s not known why some women get PMS. Several factors may affect PMS, including:

• Hormonal changes – The symptoms of PMS are affected by the monthly hormonal fluctuations you experience 

• Brain chemistry – Changes in serotonin, a brain chemical responsible for mood, may result in PMS

• Depression – It’s thought that women with PMDD may have undiagnosed depression. Though not all of the symptoms mean you have depression. If there are no symptoms once the period arrives, it indicates it isn’t depression

What are the risk factors of PMS?

While any woman can experience PMS, some may be more at risk, including those who: 

• Have a family history of PMS

• Have a history of depression or mental health issues like postpartum depression

• Experience weight issues – Women who are overweight or obese are more likely to get PMS

• Smoke – Smoking cigarettes increases PMS risk

• Have experienced physical, sexual or emotional trauma 

• Have a history of substance abuse

Premenstrual dysphoric disorder (PMDD) symptoms 

Premenstrual dysphoric disorder, called PMDD, is a cluster of more severe symptoms some women experience before their period. 

PMDD is like extreme PMS and it can have a much bigger negative impact on your quality of life. 

PMDD symptoms can include:

• Uncontrollable crying 

• Feeling anger and rage

• Feeling hopeless, anxious, or doomed 

• Less interest in activities you normally enjoy 

• Binge eating

• Problems sleeping (insomnia)

• Depression 

• Suicidal feelings

It isn’t fully understood why some women get PMDD, but it’s linked with sensitivity to changes in hormones and differences in genes. 

If you need urgent advice because you are worried you might harm yourself, call the GP for an urgent appointment or go straight to A&E at the hospital. 

How can PMS be treated? 

If PMS is getting in the way of your life, visit a GP to discuss your treatment options. Depending on your symptoms these may include:

• Hormonal medicine 

• Talking therapy 

• Antidepressants 

• Dietary supplements 

If your symptoms don’t get better with treatment, a GP may refer you to a specialist. Depending on your symptoms this could be a gynaecologist or a psychiatrist. 

Complementary therapies and dietary supplements

There’s limited evidence that complementary therapies and supplements help, but it might be an area you want to explore. Popular options include:

• Acupuncture 

• Reflexology 

• Supplements like vitamin B6, magnesium and vitamin D 

How can I manage PMS?

There are several actions you can take to help manage your PMS without treatment. These include:

• Doing regular exercise 

• Eating a healthy diet 

• Getting adequate sleep 

• Reducing stress through things like meditation, mindfulness or yoga 

• Stop smoking

• Don’t drink too much alcohol

If you plan to see a GP about your symptoms, it’s a good idea to keep a diary of them for a few cycles.

When should I speak to a doctor?

You should see a GP if lifestyle changes haven’t helped and your PMS symptoms are affecting your health and quality of life. 

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.