Pre-menstrual syndrome
Pre-menstrual syndrome involves physical changes and mood changes related to menstruation.
It usually starts during the 2 weeks leading up your period and stops within 3 days of your period starting. The cause is unknown but there may be a number of different factors involved as different symptoms respond to different treatments.
Pre-menstrual syndrome is common and affects around 75 per cent of menstruating women, although the symptoms are usually mild. Fewer than 15 per cent of these women have severe symptoms and need to seek medical advice from their doctor.
Symptoms of pre-menstrual syndrome include mood swings (including anxiety, depression, irritability or aggression), fatigue, difficulty concentrating, food cravings, changes in libido (sex drive), fluid retention, bloating (such as ankle swelling or a feeling of weight gain), skin changes, breast swelling or tenderness and headache.
When mood symptoms are particularly bad you may be experiencing a more severe form of PMS called premenstrual dysphoric disorder, or PMDD.
When should you seek medical advice?
You should see your doctor if:
- your symptoms are moderate to severe and interfere significantly with your normal lifestyle;
- you experience significant alterations in mood, particularly if mood changes are severe enough to be noticed by others (possible PMDD);
- you have breast tenderness that is particularly painful;
- you have bloating and fluid retention that is severe and uncomfortable; or
- you have abnormal vaginal bleeding or discharge.
What can you do?
You can help reduce pre-menstrual symptoms by:
- practising relaxation techniques;
- doing regular aerobic exercise;
- eating more complex carbohydrates;
- cutting down on salt to help reduce bloating; and
- avoiding caffeine and alcohol.
Keeping a diary of your menstrual cycle, symptoms and treatments may also help you detect any changes and patterns.
You may wish to try supplements, available from pharmacists, to help relieve your pre-menstrual tension. Some women find that vitamin B6 (pyridoxine) or evening primrose oil supplements, for example, help relieve their symptoms.
Because the symptoms are so variable you may find it necessary to try different products. Each product should be tried for about 3-4 months to determine its effectiveness.
Your doctor or pharmacist should be able to advise you about which treatments may work best for you. For severe symptoms, prescription-only treatments may be recommended.
Women with PMDD may be prescribed selective serotonin reuptake inhibitor (SSRI) antidepressants such as fluoxetine or sertraline.
Last Reviewed: 10 April 2009
- 1. eMIMS Prescribing Information, May 2009
2. MayoClinic.com. Premenstrual syndrome (PMS) [updated 2007, Dec 7; accessed 2009, Apr 27]. Available at: http://www.mayoclinic.com/health/premenstrual-syndrome/DS00134
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