Premenstrual Syndrome

What Is Premenstrual Syndrome (PMS)?

Premenstrual Syndrome (sometimes called Premenstrual Tension or PMT) are symptoms that some women experience in the second half of their menstrual cycle before their period begins. Most women will get some of these symptoms, even if they are only mild. Other women have such severe symptoms that their lives are disrupted for a week or two every month. The most common symptoms of PMS include:
• tiredness
• mood changes - feeling down, tearful, irritable, anxious, angry
• nausea
• food cravings
• aches and pains
• sore breasts
• abdominal bloating and constipation
• headaches (or even migraines)
• difficulty concentrating
• acne
• fluid retention

PMS settles completely once the period is over, so there is always a time in the cycle when a woman has no symptoms at all. If a woman’s symptoms continue after her period, then the cause may be something other than PMS, like depression, approaching menopause or thyroid problems. PMS symptoms can often get worse when a woman is in her thirties and may continue to be a problem until menopause.

What Causes PMS?

The exact cause of PMS is not known but it seems to have something to do with the way hormonal changes in the last part of the menstrual cycle affect a woman’s body.

What Can I Do To Help Reduce PMS?

It may be useful to keep a calendar record of your menstrual cycle. This will help you to know when your symptoms usually start, so you can try to manage them or avoid the things that cause you stress around that time.
Try explaining the situation to the person or people you live with. This will help them to be more understanding of you at this time.

Lifestyle changes

A healthy lifestyle seems to help with PMS symptoms. Eat plenty of fruit, vegetables and whole grains and cut down on salt, coffee, alcohol, sugar and cigarettes. Some women find that eating smaller meals more frequently helps as well. Get some regular aerobic exercise - aim for half an hour every day. Get plenty of sleep. Try to lower your general stress level. Consider learning relaxation techniques, yoga, meditation or tai chi, or have a regular massage.

Management options

Many women don’t need medication once they recognise their PMS and make some lifestyle changes. However, some women can find medications are helpful.
• Calcium supplements (600mgs twice daily): some evidence that this reduces PMS.
• Vitex Agnus Castus (Chasteberry extract): some evidence that this therapy, which has been used by women for many years, is effective at reducing PMS symptoms.
• The combined oral contraceptive pill:  may help relieve symptoms for some women. This might be a good option if you need contraception as well. Because the Pill stops ovulation and tends to make periods lighter and less painful many women find that it improves their symptoms of PMS. Some of the newer pills can reduce fluid retention as well, so if this is a problem for you, the doctor may suggest one of these pills. Other hormonal contraceptive methods such as the contraceptive injection or implant may also work to reduce PMS in some women.
• Selective Serotonin Reuptake Inhibitors (SSRIs): used for many years to treat depression. We now know that when they are taken in low doses in the last half of the cycle, they can be very effective at treating the mood disturbance symptoms of PMS in some women. These medications can have side-effects and some women complain of sleeplessness, nausea and dizziness while using them.

In the past, high doses of Vitamin B, Evening Primrose Oil, and progesterone creams and tablets have all been suggested as treatments for PMS. There is very little evidence that any of these are effective.

If your symptoms are very severe, you should discuss this with your doctor. Some women can have very severe symptoms that may require specialist help.

If you would like to talk with someone, contact your local doctor, or Family Planning clinic. You can also phone the Family Planning NSW Healthline on 1300 658 886.

For More Information

Contact the Healthline on 1300 658 886
Or email: healthline@fpnsw.org.au
NRS (for deaf) 133 677
Or your nearest Family Planning clinic

The information in this Factsheet has been provided for educational purposes only. FPNSW has taken every care to ensure that the information is accurate and up-to-date at the time of publication. Individuals concerned about any personal reproductive or sexual health issue are encouraged to seek advice and assistance from their health care provider or visit a Family Planning clinic.

Reviewed: March 2012   |   03/12