Women's Health: Premenstrual Syndrome Overview


There are many OTC products to keep women healthy.

Premenstrual syndrome (PMS) is a group of physical, emotional/mood, and/or behavioral symptoms that a woman experiences 1 to 2 weeks before her menstrual cycle begins. An estimated 3 of every 4 menstruating women experience some form of PMS every month; symptoms typically improve significantly or disappear when menses starts. PMS symptoms are likely to peak during your late 20s and early 30s and tend to recur in a predictable pattern every month. For some women, the symptoms are so intense that they negatively impact their overall of quality of life. This type of PMS is known as premenstrual dysphoric disorder (PMDD).

Signs and Symptoms

Signs and symptoms of PMS vary from person to person, but common symptoms include the following:

  • Headache or backache
  • Fatigue
  • Bloating/weight gain
  • Abdominal pain/diarrhea, constipation
  • Joint or muscle pain
  • Breast tenderness
  • Swelling of the ankles, feet, and hands
  • Episodes of fatigue
  • Acne
  • Mood swings/irritability
  • Appetite changes or cravings
  • Difficulty/trouble concentrating or memory issues
  • Depression/anxiety
  • Insomnia

In PMDD, the symptoms are more severe and include at least 1 emotional or behavioral symptom, such as anxiety, depression, extreme mood swings, or irritability.

Cause/Common Triggers

The exact cause of PMS is unknown, but research has identified several factors that may cause or contribute to PMS symptoms:

  • Monthly hormonal changes
  • Chemical changes in the brain
  • Stress
  • Poor eating habits (some PMS symptoms have been linked to low levels of certain vitamins and minerals)

Tests and Diagnosis

To diagnose PMS or PMDD, your doctor will question you about your medical history and your symptoms; to confirm a diagnosis, there must be a pattern to your symptoms. Your doctor may order medical tests to rule out other conditions.

strong>Prevention and Management

The cause of PMS is unknown, so there is no way to prevent it. By incorporating various lifestyle modifications, however, you may be able to alleviate the severity of symptoms you experience:

  • Keep a record of your monthly symptoms to discuss with your doctor.
  • Exercise regularly (3 to 5 times per week if possible).
  • Do not skip meals. Follow a regular meal schedule to maintain a stable
  • blood glucose level.
  • Eat a balanced diet that is low in refined sugars.
  • Try to get a good night’s sleep.
  • If you smoke, quit.
  • Cut down on caffeine, alcohol, red meat, and salty foods.
  • Practice stress reduction techniques.

Treatment and Care

Treatment for PMS is typically tailored to meet your specific needs and may require a combination of therapies. As a first line of therapy, treatment may include implementation of nonpharmacologic measures, including lifestyle and dietary modifications, regular exercise, and stress-reduction techniques. Your doctor may suggest the use of OTC analgesics for headaches, back pain, and cramps. In some cases, your doctor may prescribe medications to manage certain symptoms and will decide the best treatment for you.

Homeopathic and Alternative Remedies

Many individuals elect to use alternative remedies for relief of PMS symptoms, including herbal remedies and homeopathic medicine. Alternative remedies may include the following:

  • Diet modification, including reducing or eliminating the intake of caffeine, salt, and alcoholic beverages, as well as eating foods rich in complex carbohydrates and low in protein, during the PMS phase of the menstrual cycle
  • Vitamin and nutritional supplements, such as calcium, magnesium, vitamin B6, and vitamin E
  • Herbal remedies, such as black cohosh, ginger, raspberry leaf, dandelion, chasteberry, and evening primrose oil
  • Yoga
  • Relaxation techniques

It is important to discuss the use of alternative remedies or supplements with your doctor before using them to ascertain the appropriateness of use.


A variety of OTC products can help manage and treat the common symptoms associated with PMS. These include analgesics, diuretics, vitamins and minerals, and herbal products that contain evening primrose oil, chasteberry, or black cohosh. A pharmacist can guide you in the proper selection of these products. To prevent drug interactions or contraindications, patients should inform the pharmacist of all other medications they are taking.

Resources for Patients

  • Medline Plus; Women’s Health
  • Medline Plus; Female Infertility

Resources for Health Care Professionals

  • National Institute of Mental Health
  • American College of Obstetricians and Gynecologists
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