Premenstrual syndrome (PMS) is a collection of physical and psychological symptoms that can occur in a cyclical pattern in people who menstruate. The start of symptoms coincides with the second half of the menstrual cycle, called the luteal phase.

Symptoms typically resolve within a few days after the period begins. However, they can sometimes last for 2 weeks.

While doctors are unsure why some people experience PMS symptoms, contributing factors may include certain lifestyle factors and fluctuations in the levels of sex hormones and serotonin.

Here, learn more about PMS symptoms and how to treat and prevent them.

A woman eating food from a jar who may be experiencing PMS symptoms.Share on Pinterest
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PMS refers to clinically significant physical and psychological symptoms that occur during the second half of the menstrual cycle.

Experts suggest that PMS affects 47.8% of people of reproductive age who menstruate. Among this population, 20% experience severe symptoms.

Some people may experience mild-to-moderate symptoms, whereas others may report symptoms that are severe enough to affect their normal daily functions.

Physical symptoms may include:

Emotional symptoms can include:

  • appetite changes
  • food cravings
  • sleep difficulties
  • difficulty with memory or concentration
  • less interest in sex

PMS symptoms may worsen a week before menstruation, with a peak often occurring 2 days before bleeding begins.

Premenstrual symptoms occur before a person starts their period.

The menstrual cycle consists of two phases: the follicular phase, which starts on the first day of bleeding, and the luteal phase, starting after ovulation.

PMS symptoms occur during the luteal phase.

A 2020 article notes that the duration of symptoms also differs from person to person. Some individuals may only experience symptoms for a few days, but they can persist for 2 weeks for others.

Pregnancy symptoms may sometimes resemble PMS because they are typically nonspecific.

In general, one of the most noticeable signs of pregnancy is a missed period. However, some birth control methods can cause a person to stop having periods altogether.

Additionally, some pregnant people experience implantation bleeding, which is a bleed that may be similar to a very light period.

The National Institute of Child Health and Human Development (NICHD) note that 25% of pregnant people experience implantation bleeding. It can occur approximately 6–12 days after conception.

In a study in the Journal of Clinical Nursing, the top three first trimester pregnancy symptoms that healthy pregnant women in Turkey reported were:

  • Nausea or vomiting: This can begin from 2–8 weeks after conception.
  • Fatigue: People who are pregnant may notice this 1 week after conception.
  • Breast pain or tenderness: This can begin as early as 1–2 weeks after conception.

Other early symptoms of pregnancy include:

  • headaches
  • mood swings
  • frequent urination
  • food cravings and aversions

Doctors recommend that people who are sexually active track their menstrual cycle and symptoms. This information can help people evaluate whether their symptoms are due to PMS or pregnancy.

To check for pregnancy, people can purchase at-home urine pregnancy tests from a pharmacy.

It is important to follow the instructions for the specific pregnancy test as some can detect pregnancy earlier than others.

The best time for people to check for pregnancy is on the day of their missed period or approximately 19 days after the suspected conception.

According to Planned Parenthood, home pregnancy tests are 97.4% accurate when a healthcare professional uses them. When a person self-administers a home pregnancy test, the accuracy rate can drop to 75%.

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. It can cause severe anxiety, depression, and irritability in the 1–2 weeks before a period begins.

People experiencing severe PMS symptoms that significantly affect their quality of life and daily functioning may have PMDD and may need to seek treatment.

According to Johns Hopkins Medicine, symptoms of PMDD include:

  • irritability and anger that can affect others
  • tension
  • anxiety
  • panic attacks
  • feelings of despair or sadness
  • mood swings
  • fatigue
  • lack of interest in relationships or activities
  • food cravings
  • binge eating
  • difficulty sleeping
  • feeling out of control

It can also include the same physical symptoms as PMS.

Learn more about PMDD here.

To diagnose PMS, doctors may need to rule out other possible causes of the symptoms, such as:

The Office on Women’s Health (OWH) note that doctors are unsure why some people develop PMS symptoms while others do not.

However, the authors of a 2020 article suggest that the hormonal fluctuations that occur during the menstrual cycle may be a contributing factor.

Lowered estrogen levels trigger the release of norepinephrine from the hypothalamus. Norepinephrine is a chemical in the brain that works as a hormone and neurotransmitter.

Norepinephrine then causes the levels of acetylcholine, dopamine, and serotonin in the brain to decrease. The change in the levels of these chemical substances may lead to many of the psychological and neurological symptoms of PMS, such as depression, insomnia, and fatigue.

Lifestyle factors may also contribute to PMS symptoms, including:

  • sugary foods
  • deep fried foods
  • lack of exercise
  • poor quality sleep
  • caffeine
  • alcohol
  • smoking

The goal of treating PMS is to relieve the symptoms and to reduce their effects on activities of daily living.

Depending on the symptoms, the doctor may choose from a variety of medications.

Different treatments for PMS include:

Other nondrug interventions that may help treat certain PMS symptoms include:

Although people cannot prevent PMS symptoms, certain lifestyle factors can potentially worsen them.

Therefore, doctors may suggest:

  • reducing stress
  • getting regular exercise
  • eating healthful foods
  • reducing fat, salt, and sugar intake
  • consuming foods that contain complex carbohydrates
  • avoiding smoking

The American College of Obstetricians and Gynecologists note that eating six smaller meals per day instead of three larger ones can help keep a person’s blood sugar level stable, which may help reduce symptoms.

A study featuring in Nutrients found that fruits are protective against the psychological and physical symptoms of PMS.

While many treatment and prevention strategies may help people experiencing PMS symptoms, symptoms typically recur after stopping treatment.

Researchers have noted that untreated PMS symptoms can sometimes affect a person’s sex life, which may lead to sexual distress and other psychological symptoms. PMS may also increase suicidal risk in hormone-sensitive individuals.

People experiencing severe PMS symptoms that affect their daily functions or quality of life should speak with a doctor.

Doctors may suggest certain preventive measures and treatment options for particular symptoms.

Almost half of those who menstruate experience PMS symptoms. Most often, PMS symptoms are mild to moderate, but severe symptoms are possible.

Sometimes, people may require treatment if their symptoms affect their quality of life or activities of daily living.

Doctors can suggest several treatment and preventive measures for people with bothersome PMS symptoms.

Lifestyle and dietary factors may contribute to PMS symptoms. Reducing stress, quitting cigarette smoking, exercising regularly, and consuming a healthful diet may help reduce the severity of PMS symptoms.