PMS

Understanding Premenstrual Syndrome (PMS)

Recognizing the Physical and Emotional Signs

PMS, or Premenstrual Syndrome, refers to a collection of physical, emotional, and behavioral symptoms that usually begin about 7–10 days before menstruation. Though its exact cause isn’t fully known, researchers attribute PMS to hormonal changes—especially fluctuations in estrogen, progesterone, and serotonin—during the luteal phase of the menstrual cycle. A family history of PMS may also increase your likelihood of experiencing it.

Most people with menstrual cycles encounter PMS at some point, and for many, symptoms recur with each cycle.

Physical and Emotional Symptoms of PMS

Common physical symptoms include:

• Appetite changes
• Difficulty sleeping
• Headaches
• Breast tenderness
• Abdominal cramps or bloating
• Muscle or joint pain

Common emotional symptoms include:

• Mood swings and irritability
• Feelings of sadness or hopelessness
• Heightened anxiety or tension
• Crying spells
• Trouble concentrating

Additional symptoms may include:

• Feeling overwhelmed or emotionally out of control
• Increased sensitivity to perceived rejection
• Social withdrawal
• Forgetfulness or mental fog
• Sudden mood changes and emotional reactivity
• Heightened food cravings
• Restless or disrupted sleep

How is PMS Diagnosed?

There is no specific blood test or scan for PMS. Instead, tracking your symptoms daily for at least two menstrual cycles is the most effective method for diagnosis. A typical indicator is that symptoms fade between days four and twelve of your cycle. Sharing these detailed records with a healthcare provider can help confirm PMS and rule out other possible conditions.

Treating PMS

Lifestyle changes and therapy can significantly ease PMS symptoms. Recommended approaches include:

• Consistent aerobic exercise (e.g., walking, jogging, biking)
• Mind-body practices like meditation, deep breathing, or gentle yoga
• Diet modifications—reducing sugar, caffeine, alcohol, and fatty foods
• Eating small, frequent meals to maintain stable energy levels

Cognitive Behavioral Therapy (CBT) is particularly effective for managing PMS-related emotional stress. CBT sessions focus on identifying and reworking unhelpful thought patterns while helping you track mood shifts throughout your cycle. You’ll likely be encouraged to maintain a journal of symptoms and triggers to support lasting change.

In some cases, healthcare providers may prescribe SSRIs (selective serotonin reuptake inhibitors). These medications can improve mood, concentration, and energy during the luteal phase of your cycle. SSRIs enhance serotonin levels and influence neurosteroids impacted by hormonal fluctuations—offering targeted symptom relief even if no anxiety or depression is present at other times.

Causes of PMS

The severity of PMS can vary over time. Periods of heightened stress or hormonal transitions—such as puberty, post-pregnancy, or menopause—can intensify symptoms. In other seasons of life, symptoms may ease or disappear.

If PMS is disrupting your routines or relationships, consult with your primary care doctor, OB-GYN, or mental health provider. They can help determine whether PMS or another condition (like fibroids or a mood disorder) is responsible and collaborate with you on a treatment plan designed to bring relief.