Is it PMS?
It may be, if your symptoms come in the 2 weeks before your period and ease once it starts. Doctors check it fits that pattern with one simple record you can start tonight.
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What is premenstrual syndrome?
PMS is the name for symptoms that come in the 2 weeks before your period. They usually get better once your period starts, and often go by the end of it. The NHS says symptoms can intensify in those 2 weeks.
It’s very common. The RCOG, the UK body for doctors who treat women’s health, says nearly all women have some premenstrual symptoms. The NHS says it can affect anyone who has periods.
| Where you feel it | Common symptoms |
|---|---|
| Mood | Mood swings. Feeling depressed, irritable, upset, anxious or emotional. |
| Body | Tiredness or trouble sleeping. Bloating or cramping. Sore breasts. Headaches. |
| Skin, hair and appetite | Spotty skin. Greasy hair. Changes in appetite or food cravings. |
Your mix can change from month to month. But the RCOG says symptoms tend to form a pattern over time.
No one fully knows the cause. It may be changes in your hormone levels through the cycle. Some women may be more affected by these changes than others.
So the timing is your first clue. Next, write it down.
How do I know it’s PMS?
That simple record is a symptom diary. The RCOG says to keep one for at least two cycles in a row. Your doctor then checks if your symptoms fit the pattern of PMS.
One bad day is a photo. Two months of notes is the film. It shows when symptoms start, and if they ease once your period does.
How a symptom diary leads to a diagnosis
- 1
Note it daily
Each symptom, how bad it is, and the day your period starts.
- 2
Two cycles
Keep going for at least 2 cycles in a row.
- 3
GP review
Take it to your GP to check it fits the PMS pattern.
- 4
Keep tracking
On a treatment, carry on for at least 2 to 3 more months.
That last step matters. The diary shows whether a treatment is working.
If the diary isn’t enough, you may be offered 3 months of medicine that briefly stops your ovaries making hormones. It may help with the diagnosis.
Cramps the main problem? See is my period pain normal.
PMS or PMDD: what’s the difference?
PMDD, or premenstrual dysphoric disorder, is a more severe form of PMS. The symptoms are similar but much more intense.
| How many | What it’s like | |
|---|---|---|
| Some PMS | Nearly all women | Symptoms in the 2 weeks before a period. |
| Severe PMS | 2 to 4 in 100 women | Bad enough to stop you getting on with daily life. |
| PMDD | A small number of women | Much more intense. Can include feeling very anxious, angry, depressed or suicidal. |
PMDD can also bring headaches, joint and muscle pain, overeating and problems sleeping.
Think it’s PMDD? Read PMDD symptoms and the blood tests that rule out look-alikes. If you have ADHD, see PMDD and ADHD.
What helps PMS at home?
Six NHS steps to try this cycle
- Exercise regularly.
- Eat a healthy, balanced diet. You may find small meals every 2 to 3 hours better.
- Get plenty of sleep.
- Try yoga or meditation to cut stress.
- Take painkillers such as ibuprofen or paracetamol to ease the pain.
- Don’t smoke, and don’t drink too much alcohol.
Source: NHS: PMS
What about supplements? The NHS says vitamin B6, calcium, vitamin D and magnesium may help. But there’s not much evidence that they work.
Sore breasts? The RCOG says evening primrose oil can ease breast tenderness.
On other medicines? Check with a GP or pharmacist before you start regular supplements. Then read calcium supplements or which magnesium to take.
What are the treatments for PMS?
If home steps aren’t enough, a GP may suggest other treatments as well.
| Treatment | What the RCOG says |
|---|---|
| Talking therapy (CBT) | Known to help. Should be offered. |
| Combined pill with drospirenone | A first-choice treatment. You may take it with no break. |
| Antidepressants (SSRIs or SNRIs) | A first choice for severe PMS. Taken daily, either the 2 weeks before a period or all month. |
| Medicines that pause your cycle (GnRH analogues) | For severe PMS, if others haven’t worked or don’t suit you. They cause a short, reversible menopause. |
CBT, or cognitive behavioural therapy, means talking with a therapist. It helps you learn new ways to manage symptoms.
A review of 31 trials in women with PMS or PMDD found SSRIs eased symptoms more than a dummy pill. That held whether women took them only before a period or every day. The evidence was of low to moderate quality.
Side effects were fairly common, most often feeling sick and low energy. Your GP can talk you through them.
Never stop or change a prescribed medicine without your prescriber. The RCOG says to stop antidepressants gradually, with your care team’s advice.
When to speak to a GP
Bring your diary. See a GP if:
- You have PMS symptoms and lifestyle changes haven’t helped.
- Your symptoms are affecting your daily life.
- You still get symptoms after treatment. You may be referred to a gynaecologist, psychiatrist or counsellor.
- You need urgent help for your mental health. Call NHS 111 and select the mental health option, or call Samaritans on 116 123.
Call 999 or go to A&E if you have PMDD symptoms and are feeling suicidal. Don’t drive yourself there.