Dealing With Premenstrual Syndrome


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Dr. Purnima Rani Dutta
Dr. Purnima Rani Dutta
MD GynecologyDealing With Premenstrual Syndrome

Premenstrual syndrome (PMS) refers to the emotional and physical changes that occur in the one to two weeks prior to a woman’s period. More than 75 percent of menstruating women have gone through some premenstrual syndrome. Symptoms tend to reappear in a certain pattern. But the changes, both physical and emotional may vary from just slightly prominent to highly intense.

The symptoms of PMS varies from person to person, most common of which are:

Emotional and behavioral changes

  • Mood swings
  • Anxiety
  • Irritability
  • Depressed mood
  • Insomnia
  • Poor concentration
  • Appetite changes
  • Craving for food
  • Social withdrawal

Physical symptoms

  • Joint aches and muscle pain
  • Headache
  • Fatigue
  • Breast tenderness
  • Constipation or diarrhea
  • bdominal bloating

Regardless of the severity, the symptoms usually disappear within three to four days of the start of the menstrual period. But for a few women with premenstrual syndrome, the symptoms can be disabling. This kind of PMS is called premenstrual dysphoric disorder (PMDD).


The exact cause of premenstrual syndrome is unclear, but the existing theories include the following:

Cyclic changes in hormones: Symptoms of PMS change with fluctuations in the hormone levels and disappear when a woman gets pregnant or undergoes menopause.

Chemical changes in the brain: Fluctuations in the levels of serotonin, a neurotransmitter that plays a crucial role in mood states, could trigger symptoms associated with PMS. Insufficient serotonin levels may contribute to premenstrual depression and few other symptoms associated with PMS.

Depression: Some women with premenstrual syndrome suffer from depression that is undiagnosed. But depression isn’t responsible for all the symptoms.


For most women, lifestyle modifications can help with the symptoms of PMS. But depending on its severity, the doctor may prescribe medications for premenstrual syndrome. The commonly prescribed medications for premenstrual syndrome includes:

Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) have proven useful in reducing the mood symptoms. SSRIs are usually the first line treatment for both PMS and PMDD.

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications are taken before the onset of a period, NSAIDs such as ibuprofen can ease the cramping and breast discomfort.

Diuretics: These medications help the body to shed excess fluid through the kidneys. Spironolactone is a diuretic that can contribute to reducing some of the symptoms of PMS.

Hormonal contraceptives: These medications stop the process of ovulation, which may relieve some of the PMS symptoms.