Condition Center: PMS

Photo Illustration by Aly Lim
Photo Illustration by Aly Lim

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Premenstrual syndrome, or PMS, as it's more widely known, describes a cluster of symptoms that happen before menstruation. PMS is extremely common, and for the majority of people, symptoms may be uncomfortable but are largely manageable. In some cases, however, symptoms are severe enough to interfere with one's quality of life and relationships, which may indicate PMDD, or premenstrual dysphoric disorder.

However, "if symptoms are disruptive to life in any way (not just severely), there are steps that can be taken to make those symptoms better," says Wendy Goodall McDonald, MD, an ob-gyn and author of the Stethoscope Dreams series for children. "We as humans with uteruses shouldn't be expected to just live with symptoms that interfere with our life and happiness."

The symptoms of PMS aren't always predictable and can encompass both emotional and physical traits. Here's what you need to know about this common condition.

Understanding PMS

PMS encompasses symptoms that are both physical and emotional. They occur in the time leading up to menstruation. Symptoms depend on the individual but can range from mood changes and sleep disturbances to bloating and headaches.

Shannon Corbett, MD, an ob-gyn with a subspecialty in gynecologic reproductive endocrinology and infertility, says symptoms can be understood in a few broad categories:

  • Psychological, such as irritability, nervousness, insomnia, fatigue, depression, anxiety, anger, and decreased libido
  • Neurologic/vascular, which may include headaches, muscle spasms, heart palpitations, and hot flashes
  • Gastrointestinal symptoms, which may include bloating, constipation, abdominal cramping, and appetite changes
  • Fluid retention, which may lead to weight gain, breast fullness and pain, and swelling of the hands, ankles, or feet
  • Skin changes, such as acne or the worsening of preexisting skin conditions

PMS symptoms can last anywhere from a couple of days to two weeks before your menstrual cycle, Dr. Goodall McDonald says. But on a larger scale, a person can experience PMS until menopause — the body's process of permanently stopping menstruation, usually happening in someone's 40s or 50s, per the Mayo Clinic.

Causes of PMS

PMS is caused by hormonal fluctuations that happen during the body's menstrual phases. Dr. Corbett says a decline in progesterone before menstruation is the likely cause. Progesterone is a hormone produced by the ovaries and helps prepare the body for pregnancy, in addition to regulating blood pressure, mood, and sleep.

"PMS is hormonally driven. As long as a person is ovulating and producing progesterone, they will be susceptible to PMS," Dr. Corbett says.

The severity of an individual's PMS depends on many factors, including their hormonal sensitivities and preexisting factors like weight and age. Additionally, lifestyle factors such as smoking or a personal or family history of mental health issues (such as anxiety, depression, postpartum depression, or PTSD) can increase the likelihood of PMS symptoms, Dr. Corbett says.

The Most Effective PMS Treatments

If you experience PMS, the good news is that there are a range of treatment options to help manage symptoms.

Lifestyle changes — including regular exercise, drinking water, and reducing your consumption of processed sugars, alcohol, and caffeine — may make a difference. Dr. Goodall McDonald says in some cases and depending on severity, your doctor may prescribe a medication, including certain antidepressants (which your doctor may suggest taking intermittently, during just your luteal phase of the menstrual cycle, or for everyday use) or hormonal birth control.

Dr. Corbett says beyond birth control or antidepressants, your doctor may also prescribe other gonadotropin-releasing hormone agonists or antagonists supplements, which studies have shown to reduce symptoms of PMS.

Both doctors agree that if PMS symptoms are bothering you and getting in the way of your life, you should absolutely consult a medical professional. "PMS is real, it is not a made-up phenomenon, and severe symptoms should be treated by a doctor," Dr. Corbett says.