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Premenstrual Syndrome


Premenstrual syndrome (PMS)

is a group of physical, emotional, and mental changes that begin 1 to 2 weeks before your monthly periods. Hormone or brain chemical changes, a family history of PMS, stress, or depression may cause PMS. A lack of healthy foods, too much caffeine, or not enough exercise can cause PMS or make it worse.

Common signs and symptoms

may range from mild to severe. They usually go away within hours to days after your monthly period starts. You may have any of the following:

  • Irritability, depression, crying spells, or decreased interest in daily activities
  • Trouble thinking, focusing on tasks, or remembering things
  • Weight gain or swelling in your abdomen, ankles, hands, or face
  • Acne
  • Headaches, backaches, or swollen, tender, painful breasts
  • Constipation or diarrhea
  • Increased hunger or food cravings
  • More tired than usual or trouble sleeping

Call your local emergency number (911 in the US) if:

  • You feel that you may hurt yourself or someone else.

Call your doctor or gynecologist if:

  • You feel pain in your abdomen and shaking or have chills and a fever.
  • You have symptoms that last longer than 2 weeks each month.
  • You feel very depressed most or all of the time.
  • Your PMS symptoms cause problems in your life or relationships.
  • You have questions or concerns about your condition or care.


may not be needed. The following can help relieve your symptoms:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Diuretics help your body get rid of extra fluid. You may urinate more than usual while you are taking this medicine.
  • Antidepressants may be given to help improve your mood or behavior. Sometimes it is given only during the last 2 weeks of the menstrual cycle. Some vitamins, herbal supplements, or food supplements may interact with this medicine. Ask your healthcare provider before you take any supplements.
  • Birth control pills may be given if your PMS is severe. Birth control pills contain hormones that can help to improve PMS symptoms.
  • Nutrition supplements may be recommended, such as calcium, magnesium, or vitamins. These supplements may help to relieve your PMS symptoms. Talk to your healthcare provider before you take any supplements for PMS.

Lifestyle changes that may help PMS symptoms:

  • Exercise as directed. Exercise may decrease stress and PMS symptoms and help you feel better. Get at least 150 minutes (2 hours and 30 minutes) of physical activity each week, such as walking. Do muscle strengthening activities at least 2 days a week. Spread physical activity throughout the week. Talk to your healthcare provider about the best exercise plan for you.
    Diverse Family Walking for Exercise
  • Get enough sleep. Most people need 6 to 8 hours of sleep each night. Ask your healthcare provider how many hours of sleep you should have. To help you sleep better, avoid drinks that contain alcohol or caffeine in the late afternoon or evening. Avoid nicotine (tobacco products). Do not exercise within 3 hours of going to bed.
  • Do not drink alcohol. Do not have drinks that contain alcohol for 1 week before your period.
  • Eat a variety of healthy foods. Healthy foods may help you feel better and have more energy. Include fruits, vegetables, whole grains, low-fat dairy products, and lean protein foods (meat, beans, and fish).
    Healthy Foods
  • Limit sodium. Too much sodium (salt) can cause you to retain water and increase swelling. Read labels on food and drink packages to find out how much sodium is in the food or drink. Do not eat or drink more than 2,300 milligrams (mg) of sodium each day.

  • Limit caffeine. Too much caffeine can make you feel nervous or moody. Foods and drinks such as chocolate, coffee, some teas, and soda have caffeine.
  • Eat less sugar. Read package labels to find out how much carbohydrates (sugars) are in the foods you eat. Sugar may be called sucrose, fructose, corn syrup, or high fructose corn syrup.

Follow up with your doctor or gynecologist as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Premenstrual Syndrome (Ambulatory Care)

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.