What is Premenstrual Syndrome?

Premenstrual syndrome (PMS) refers to the emotional and physical symptoms that up to 30 per cent of women experience leading up to their period (menstruation). Most women experience premenstrual symptoms that can be managed. However, for women who experience PMS, severe symptoms start about 4 to 10 days before a period and usually stop after bleeding begins.

What are the symptoms of PMS?

Symptoms of PMS vary in intensity from woman to woman and can vary from one cycle to the next. The most common symptoms include: 

What causes PMS?

The exact cause and varying severity of PMS symptoms, is not properly understood. PMS is a complex condition involving emotional, physical, hormonal and environmental factors. Stress levels, psychological state, poor physical health, cultural and social environment, and changes in neurotransmitters (brain chemicals) like serotonin, may all influence the development of PMS symptoms.

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a seriously debilitating form of PMS that affects about three to eight per cent of menstruating women. Women who have this condition experience severe symptoms that interfere with daily life. If you are experiencing severe and debilitating PMS symptoms, speak to your general practitioner (GP).

How can I manage PMS symptoms?

There are a number of things you can do yourself to manage and reduce your PMS symptoms.

Be physically active

Regular physical activity is important, particularly during the premenstrual phase. Physical activity increases endorphins (one of the brain's neurotransmitters) that can reduce symptoms. Endorphins also act as natural painkillers and help you feel more relaxed and in control. Choose a form or variety of physical activity you enjoy, and aim for 30 minutes of moderate intensity activity on most, if not all days, especially when symptoms are at their worse.
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Reduce stress levels

Make an effort to reduce or avoid extra stressors as stress can exacerbate PMS symptoms. Talk to your family about your PMS and help them develop strategies to be supportive during this time and take time out to relax and enjoy your own interests. If you feel your levels of stress are increasing, consider professional counselling. Cognitive behavioural therapy (CBT) can assist the management of stress, as can relaxation therapies. See your GP for more information.

Maintain good physical health

Try to improve your health and wellbeing, as maximising your health will help to reduce your PMS. If you feel unwell or are sick, see your GP.

Maintain a healthy lifestyle

• eat regular, healthy meals including plenty of vegetables, fruit, mixed grains and cereals.
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• eat small meals to maintain stable energy levels, this will also significantly reduce food cravings
• drink less caffeine – particularly if you are suffering breast tenderness. Try drinking 6-8 glasses (1.5-2 litres) of water each day instead
• cut down salt and salty foods to help reduce fluid retention
• get enough rest, sleep and exercise
• don't smoke. Need help quitting smoking? Call the Quitline on 13 7848 or visit www.quit.org.au 
• wear a well fitting cotton bra if you suffer tender, painful breasts
• write down your symptoms – this will help you identify a pattern with your symptoms

How is PMS treated?

If PMS symptoms persist and the above does not help, see your GP. It's important that other possible causes of the symptoms are excluded. Although no 'cure' can be offered, there are many treatments that can help manage, reduce and for some women, completely alleviate PMS symptoms. The different types of treatment for PMS include the following:

Vitamins, minerals and herbs

Some supplements that may be effective in treating PMS include vitamin E (400iu per day), magnesium pyrrolidone (250mg twice a day), vitamin B6, and chaste tree. However, the evidence on their effectiveness is not strong. Calcium has been shown to improve symptoms in the dose of about 600mg twice a day. Always consult your health practitioner before taking any supplement, as they may have unwanted effects or interact with other medications.

Complimentary therapies

Complimentary therapies such as acupuncture or naturopathy may be helpful in relieving psychological and/or physical symptoms for some women. However, a lack of controlled studies means there is no clear evidence of their benefits.

Medications

There are a range of medications available that have been proven to help, such as the antidepressants known as selective serotonin reuptake inhibitors (SSRIs), anti-prostaglandin (for pain/cramps), anti-inflammatories, and spironolactone diuretic (for bloating).

Hormonal treatments

These treatments can suppress ovulation and reduce the hormones of the premenstrual phase. Hormone therapies can include contraceptive therapies such as the oral contraceptive pill. Consult your GP for further information regarding hormone treatment options.

Things to keep in mind

• Premenstrual syndrome (PMS) refers to the range of emotional and physical symptoms that some women experience in the lead-up to their period, which may interfere with their quality of life.
• Most PMS symptoms can be managed with lifestyle modifications, such as exercise, diet and supplements. However, if symptoms persist and interfere with daily activities, see your GP or seek referral to a gynaecologist with expertise in PMS.
• It may be useful to keep a detailed diary of at least two menstrual cycles to see if there is a pattern with your symptoms. This allows you and your health practitioner to talk about the best treatment options for you.

Where can I get more information? 

www.jeanhailes.org.au 

www.healthforwomen.org.au 

www.betterhealth.vic.gov.au – Better Health Channel

www.healthinsite.gov.au – HealthInsite

Content updated April 2012