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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
  • Lightheadedness
  • 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-5), 5 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:

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.

Premenstrual syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113966/Premenstrual-syndrome. Updated June 9, 2016. Accessed October 4, 2016.

Premenstrual syndrome (PMS). Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-syndrome-pms.html. Updated April 2014. Accessed August 18, 2016.

Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.html. Updated December 23, 2014. Accessed August 18, 2016.



Last reviewed August 2016 by James Cornell, 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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