If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is PMS?

Premenstrual syndrome (PMS) is the name for a group of symptoms that you may experience up to 14 days before your period (menstruation). The symptoms usually stop soon after your period starts.

About half of people who experience PMS also have another health problem, which may get worse in the time before their menstrual period. These health problems share many symptoms with PMS, including:

• Depression and anxiety disorders
• Myaligic encephalomyelitis/chronic fatigue syndrome
• Irritable bowel syndrome (IBS)
• Bladder pain syndrome
• PMS may also worsen other health problems, such as asthma, allergies, and migraines

SYMPTOMS

What are the symptoms of PMS?

Most people feel some mild discomfort before their periods. But if you have PMS, you may feel so anxious, depressed or uncomfortable that you can’t cope at home or at work. Some of the symptoms of PMS are listed below. Your symptoms may be worse some months and better others.

It is common for you to have some of these symptoms:

• Acne
• Back pain
• Bloated abdomen
• Changes in appetite, including cravings for certain foods
• Constipation
• Crying spells
• Diarrhea
• Depression
• Fast heartbeat
• Feeling irritable, tense or anxious
• Feeling tired
• Headache
• Hot flashes
• Joint pain
• Mood swings
• Not feeling as interested in sex
• Tender and swollen breasts
• Trouble concentrating
• Trouble sleeping
• Swollen hands or feet
• Wanting to be alone
• Weight gain

If your PMS symptoms are severe, you may have a condition called premenstrual dysphoric disorder (PMDD). This is especially true if your anxiety and depression feelings are extreme.

CAUSES & RISK FACTORS

What causes PMS?

No one knows for sure what causes PMS. It seems to be linked in part to changes in hormone levels during the menstrual cycle. PMS is not caused by stress or psychological problems, although these may make the symptoms of PMS worse.

DIAGNOSIS & TESTS

How is PMS diagnosed?

Your healthcare provider will ask you to keep track of your symptoms on a calendar. If your symptoms follow the same pattern each month, you may have PMS.

Your healthcare provider may want to examine you and do some tests to rule out other possible problems. They may also want to talk about your eating habits, exercise habits, your work and your family.

PREVENTION

Can PMS be prevented or avoided?

PMS can sometimes be prevented by controlling hormone fluctuations with hormone-containing contraceptives, for example. For some, eating a healthy diet and exercising regularly may ease PMS symptoms.

TREATMENT

How is PMS treated?

There is no cure for PMS, but eating a healthy diet, exercising regularly and taking medicine may help. Your healthcare provider will talk to you about whether you need to change your diet and exercise habits. They may also prescribe medicine for you, depending on what your symptoms are and how severe they are.

You may need to try more than one medicine to find the treatment that works best for you. Many medicines are available over-the-counter, but others require a healthcare provider’s prescription. Medicines that can be prescribed include diuretics, antidepressants and birth control pills.

What are diuretics?

Diuretics help your body get rid of extra sodium and fluid. They can ease bloating, weight gain, breast pain and abdominal pain. Diuretics usually are taken just before you would normally experience these symptoms in your menstrual cycle and can be stopped when they are no longer needed.

Do antidepressants help?

Antidepressants can help with the severe irritability, depression and anxiety that some people experience. These medicines are usually taken every day even when you feel fine.

What about birth control pills?

Your healthcare provider may talk to you about taking birth control pills (often just called “the pill”) to help ease some of your PMS symptoms. Birth control pills help by evening out your hormone levels throughout your cycle. Some women’s PMS symptoms get a lot better when they take birth control pills. However, the pill can also cause side effects of its own, and it doesn’t help everyone.

What about medicines I can buy without a prescription?

You can buy medicines without a prescription to help with the symptoms of PMS. These medicines usually combine aspirin or acetaminophen with caffeine, antihistamines, or diuretics. One brand name is Midol.

These medicines can work quite well for mild or moderate PMS. Contact your healthcare provider or pharmacist before you try one of these drugs.

 Living with PMS

Managing your PMS begins with knowing what your PMS symptoms are and when they happen. Then you can change your diet, exercise and schedule to get through each month as smoothly as possible.

Try not to get discouraged if it takes some time to find tips or medicine that help you. Treatment varies from one person to another. Your healthcare provider can help you find the right treatment.

What about vitamins and other home remedies?

You may have read that some vitamins and other supplements, such as vitamin B6, vitamin E, magnesium, manganese and tryptophan, can help relieve PMS. There haven’t been many studies about these treatments, and it’s possible that they could do more harm than good. For example, vitamin B6 and vitamin E can cause side effects if you take too much. Contact your healthcare provider if you’re thinking of trying any of these vitamins or supplements.

On the other hand, taking calcium pills may reduce symptoms of water retention, cramps and back pain. Taking about 1,000 mg of calcium a day probably won’t be harmful, especially because calcium has so many other benefits, such as being good for your bones.

Tips on controlling PMS

• Eat complex carbohydrates (such as whole grains and whole-grain breads, pasta and cereals), fibre and protein. Cut back on sugar and fat.
• Avoid salt for the last few days before your period to reduce bloating and fluid retention.
• Cut back on caffeine to feel less tense and irritable and to ease breast soreness.
• Avoid alcohol. Drinking it before your period can make you feel more depressed.
• Try eating up to 6 small meals a day instead of 3 larger ones.
• Get aerobic exercise. Work up to 30 minutes, 4 to 6 times a week.
• Get plenty of sleep–about 8 hours a night.
• Keep to a regular schedule of meals, bedtime and exercise.
• Try to schedule stressful events for the week after your period.