Summary
Read the full fact sheet- Premenstrual syndrome (PMS) refers to the physical and emotional symptoms that some women experience in the lead up to menstruation.
- PMS symptoms can impact on quality of life.
- Symptoms usually stop during or at the beginning of the menstrual period. There is at least one symptom-free week before symptoms start returning.
- Keep a detailed diary for at least two menstrual cycles to work out if your symptoms are caused by PMS.
On this page
What is premenstrual syndrome (PMS)?
Some women can experience physical and emotional symptoms one or two weeks before their period. This is called ‘premenstrual syndrome’ or ‘PMS’. Most of the time PMS can be easily managed.
About two-thirds of women who have periods experience some breast pain during their menstrual cycle, and most have one or two premenstrual symptoms. These symptoms usually ease when your period starts.
Symptoms can be worse in teenage years and as you approach menopause, possibly due to changes in hormone levels.
Sometimes symptoms can be more severe. This is called ‘premenstrual dysphoric disorder’ (PMDD). PMDD affects about 3% to 8% of women.
Symptoms of PMS
Everyone experiences PMS differently. And symptoms can change from cycle to cycle.
Symptoms can be physical, for example, you may have:
- breast tenderness or swelling
- abdominal bloating
- acne
- constipation and diarrhoea
- fluid retention
- weight gain.
You may also experience:
- joint or muscle pain
- poor sleep and tiredness
- food cravings or increased appetite
- headaches and migraines
- hot flushes and sweats.
Symptoms can also be emotional, for example:
- irritability
- anxiety
- low mood
- trouble with concentration and memory.
What causes PMS?
It’s not clear why some women have PMS, but it may be associated with how certain chemicals in the brain interact with the hormone progesterone.
Different factors can influence PMS, for example, your:
- mental health
- stress levels
- physical health
- weight
- medical history.
Getting a diagnosis
There are no tests for PMS. Your doctor may diagnose PMS based on your symptoms and medical history.
You can record your symptoms over at least two menstrual cycles and discuss any patterns with your doctor.
Managing PMS
There are many things you can do to manage PMS.
Lifestyle changes
A healthy lifestyle can help reduce PMS symptoms, for example:
- increase your physical activity - 30 minutes of moderate physical activity on most days will increase your ‘feel-good’ hormones (endorphins)
- eat healthy food (e.g. lean protein, vegetables, fruit and wholegrains)
- drink lots of water and reduce caffeine and alcohol, especially two weeks before your period
- reduce stress – take time out do things you enjoy
- try relaxation techniques such as yoga and meditation
- get enough sleep and rest.
Medicine and hormone treatments
Your doctor may recommend different medicines, for example:
- hormonal treatments, such as the oral contraceptive pill, may help by suppressing ovulation
- certain antidepressants can help with complex mood symptoms.
Natural therapies
Natural therapies are part of a broad range of complementary medicine and therapies (CMT).
Sometimes herbs, vitamins and minerals are used to manage PMS symptoms. While the evidence is not strong, some supplements may help. For example:
- chaste tree (also called ‘chaste berry’)
- vitamin B6
- magnesium
- calcium
- evening primrose oil.
Make sure you get advice from a qualified and experienced health practitioner, such as a herbalist, naturopath or Chinese medicine practitioner, before using complementary therapies. And always tell your GP (doctor) if you are taking any complementary medicines.
Other therapies
Many women feel they benefit from other therapies, such as cognitive behavioural therapy (CBT), acupuncture and massage.
When to see your doctor
See your doctor if:
- PMS symptoms are bothering you
- symptoms persist despite lifestyle changes
- medicine or hormonal treatments don’t improve your symptoms
- symptoms stop you from doing things you want to do.
More information
For more detailed information, related resources, articles and podcasts, visit: jeanhailes.org.au/health-a-z/periods.
Where to get help
- Your GP (doctor)
- Jean Hailes for Women’s Health
- Women’s health clinic
- Sexual Health Victoria (SHV). To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
- Premenstrual syndrome (PMS), 2018, Mayo Clinic, USA.
- Hofmeister S, Bodden S, 2016, Premenstrual syndrome and premenstrual dysphoric disorder. American Family Physician, vol. 94, no. 3, pp. 236-40.
- Brown J, O' Brien PM, Marjoribanks J, Wyatt K 2009, ‘Selective serotonin reuptake inhibitors for premenstrual syndrome’, Cochrane Database of Systemic Reviews, no. 2, CD001396.
- Lopez LM, Kaptein AA, Helmerhorst FM, 2012, ‘Oral contraceptives containing drospirenone for premenstrual syndrome’, Cochrane Database of Systemic Reviews, no. 2, CD006586.
- Yonkers KA, O’Brien PM, Eriksson E 2008, ‘Premenstrual syndrome’, The Lancet, vol. 371, no. 9619, pp. 1200–1210.
- Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists, 2017, ‘Management of premenstrual syndrome’, British Journal of Obstetrics and Gynaecology, 127, e73–e105.
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