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Premenstrual syndrome (PMS) is characterized by physical and emotional symptoms that occur in a regular cycle beginning 1-2 weeks before the onset of menstrual flow and improve when menstrual bleeding starts. These symptoms can be extremely distressing and may include:

  • Irritability
  • Mood swings
  • Anxiety
  • Depression
  • Low self-esteem
  • Difficulty concentrating
  • Sleep problems
  • Appetite changes (sugar and/or salt cravings; overeating)
  • Weight gain
  • Fatigue
  • Bloating
  • Headache
  • Breast swelling and tenderness
  • Palpitations
  • Dizziness
  • Gastrointestinal upset
  • Muscle pain

Although the symptoms of PMS may vary, the most common complaints are:

  • Irritability
  • Backache
  • Muscle pain
  • Bloating

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), five or more of the following symptoms must be present for a diagnosis of PMDD:

  • Physical symptoms, such as breast tenderness, bloating, and joint pain
  • Severe depression, possibly with suicidal thoughts
  • Anxiety, tension, or panic attacks
  • Severe irritability and anger
  • Mood swings
  • Difficulty concentrating
  • Fatigue
  • Teariness
  • Difficulty sleeping
  • Feeling out of control
  • Lack of interest in relationships, activities
  • Food cravings or binges

References:

American College of Obstetricians and Gynecologists. Practice bulletin: premenstrual syndrome. ACOG. No. 15. April 2000.

Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Association; 2000.

Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 14, 2012. Accessed August 20, 2012.

Premenstrual syndrome (PMS). Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-syndrome-pms.html. Updated August 2010. Accessed August 20, 2012.

Premenstrual syndrome (PMS) fact sheet. Women's Health.gov website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.cfm. Updated May 18, 2010. Accessed August 20, 2012.



Last reviewed September 2014 by Andrea Chisholm, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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