Premenstrual syndrome (PMS) is a cyclical worsening of mood and physical health due to hormones released during the menstrual cycle. 40% of all women experience some symptoms of PMS and about 5% of all women will have severe symptoms.
Women normally experience PMS for approximately two weeks, around half of their menstrual cycle. Doctors describe menstrual cycle lengths by calling day 1 the first day of your period, and for women with an average cycle length (around 28 days), PMS tends to start around day 15 which is around the time of egg release (ovulation). The symptoms can last until the end of your period. Often women experiencing an easing of their symptoms once their period begins.
Premenstrual Syndrome includes a large range of both physical and psychological symptoms. These physical and psychological symptoms can be severe enough to affect daily activities. They may impair school performance, interfere with work, affect family life or relationships with others.
Psychological symptoms are common, and can include; anxiety, low mood, irritability, rage, mood swings, restlessness, poor concentration, insomnia, and confusion.
Physical symptoms can occur across all body systems. Common symptoms can include headaches, tiredness, sore breasts, bloating, changes in appetite, muscular pains, backache and skin problems.
Women who have a pre-existing mental health condition may experience a worsening of their usual symptoms for that portion of their menstrual cycle.
Some women will have PMS purely as a result of an external source of hormones, such as the contraceptive pill. They can also occur if you have a coil in place (like the hormone Mirena coil) which can reduce the frequency, heaviness, or even stop you from having periods.
One of the causes of PMS is now thought to be related to a by-product of progesterone, one of the normal female hormones. Alongside this, there are other genetic, environmental, and social factors that can play a part too.
There are some simple steps to help you on the way to getting well. Start monitoring your symptoms alongside tracking your periods, for at least 2 cycles. This will increase self-awareness and be useful should you need to visit your doctor at a later date. Simple over-the-counter painkillers will help with some of the physical pain symptoms of PMS. These include anti-inflammatories such as Ibuprofen, aspirin, and other painkillers like paracetamol.
Exercise has been shown to be beneficial. 30 mins of daily aerobic activity will help release endorphins, increasing your energy and reducing pain levels. Brisk walking, swimming, running, and cycling are all good choices. Combine this with a healthy diet full of fresh fruit and vegetables to maximise your energy.
Complementary therapies can help. There is some evidence for Vitamin B6 and St John’s wort. If trying St John's wort remember that it can interact with some prescribed medications, such as reducing the effectiveness of contraceptive pills. Other herbal options to try are primrose oil and chasteberry.
Talking therapies can be of great help if PMS results in difficult behaviours and situations. These can be done via your phone or online. Your doctor can recommend any available for free, or there are paid options out there.
If you have tried the self-treatment tips but they are not helping, or you have particularly severe symptoms, it is worth speaking to your doctor. Your doctor may offer a blood test to ensure there is no other cause for your symptoms.
They might suggest a referral for talking therapy or counselling for psychological symptoms. Certain hormonal treatments such as the continuous oral contraceptive pill or hormone replacement therapy can help some women with their symptoms.
Some women will have a very severe form of PMS and may have suicidal thoughts – this is called premenstrual dysphoric disorder (PDD). If you feel that your symptoms are severe, are having thoughts of self-harm or suicide, do not delay seeking urgent medical advice.
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