Understanding PMS: Causes, Symptoms, and Management

Premenstrual Syndrome (PMS) is a common condition that affects many women during their reproductive years. It typically occurs one to two weeks before menstruation and is characterized by a range of physical, emotional, and behavioral symptoms. While most women experience some form of mild discomfort before their period, PMS can be more intense for some, impacting daily activities and quality of life.

What Causes PMS?
The exact cause of PMS isn't fully understood, but it’s believed to be linked to the hormonal fluctuations that occur during a woman’s menstrual cycle. Changes in levels of estrogen and progesterone can affect neurotransmitters in the brain, such as serotonin, which plays a key role in mood regulation.

Other factors that may contribute to PMS include:

Genetics: Women with a family history of PMS are more likely to experience symptoms.
Chemical changes in the brain: As mentioned, serotonin levels may drop during the premenstrual phase, contributing to mood swings, irritability, and depression.
Diet and lifestyle: High salt intake, caffeine, alcohol, lack of physical activity, and stress can all exacerbate PMS symptoms.
Common Symptoms of PMS
PMS affects each woman differently, and the severity of symptoms can vary from cycle to cycle. Symptoms generally start 5-10 days before menstruation and typically subside once the period begins. Common physical and emotional symptoms of PMS include:

Physical Symptoms:

Bloating
Breast tenderness
Headaches
Fatigue
Muscle or joint pain
Acne flare-ups
Digestive issues, such as constipation or diarrhea
Sleep disturbances

Emotional and Behavioral Symptoms:

Mood swings
Irritability
Anxiety
Depression or feelings of sadness
Trouble concentrating
Changes in appetite or food cravings
Low sex drive

Managing PMS Symptoms
Although PMS can be uncomfortable, various ways exist to manage symptoms and reduce their impact on daily life. Here are some practical strategies to help alleviate the effects of PMS:

1. Dietary Changes
Eat a balanced diet: Focus on whole grains, lean proteins, fruits, and vegetables to maintain stable blood sugar levels and reduce mood swings.
Limit salt intake: Reducing sodium can help decrease bloating and fluid retention.
Stay hydrated: Drinking plenty of water can alleviate bloating and help flush excess fluids from your body.
Avoid caffeine and alcohol: These can exacerbate mood swings, anxiety, and sleep disturbances.
Increase calcium intake: Some studies suggest that calcium-rich foods or supplements can help reduce PMS symptoms like mood changes, fatigue, and bloating.
2. Exercise
Regular physical activity can help boost mood, reduce stress, and improve sleep. Aerobic exercises like walking, swimming, or cycling can be particularly beneficial for reducing PMS-related symptoms such as fatigue, depression, and irritability.
3. Stress Management
Stress can intensify PMS symptoms, so finding effective stress-relief strategies is crucial. Yoga, meditation, deep breathing exercises, or spending time in nature can help relax your mind and body.
Cognitive-behavioral therapy (CBT) may be helpful for managing the emotional symptoms of PMS, especially if mood swings, anxiety, or depression are prominent.
4. Medications and Supplements
Over-the-counter pain relievers: NSAIDs like ibuprofen or aspirin can help relieve cramps, headaches, and muscle aches associated with PMS.
Hormonal birth control: Oral contraceptives can regulate hormonal fluctuations, often reducing PMS symptoms.
Antidepressants: For women with severe mood-related symptoms, antidepressants like SSRIs may be prescribed to help regulate serotonin levels.
Supplements: Certain vitamins and minerals, such as calcium, magnesium, vitamin B6, and evening primrose oil, have been shown to help alleviate PMS symptoms in some women. Always consult your healthcare provider before starting any new supplements.
5. Sleep and Rest
Good sleep hygiene is essential to combating the fatigue and sleep disturbances that can accompany PMS. Stick to a regular sleep schedule, create a relaxing bedtime routine, and avoid caffeine or screens before bed.
When to See a Doctor
While most women can manage PMS symptoms with lifestyle changes and over-the-counter treatments, some may experience more severe symptoms that interfere with daily life. In some cases, this may indicate a condition called Premenstrual Dysphoric Disorder (PMDD), a more intense form of PMS characterized by severe mood swings, depression, and irritability. If your symptoms significantly affect your quality of life, talking to your healthcare provider is essential.

They can help determine if PMDD or another underlying condition, such as depression or anxiety, is contributing to your symptoms and can recommend treatments, including medications or therapy, to help manage them.

Conclusion
PMS is a common experience for many women, but it doesn’t have to disrupt your life. By making healthy lifestyle changes, managing stress, and exploring treatment options, you can minimize the impact of PMS and feel more in control of your health. If your symptoms are severe or unmanageable, don’t hesitate to seek guidance from a healthcare provider to find the best treatment plan for your needs.

Complete Healthcare for Women – Obstetrics and Gynecology
509-392-6700
Richard Lorenzo, D.O.
Kortney Jones ARNP

Author

Kortney Jones, ARNP Kortney Jones is board-certified by the American Academy of Nurse Practitioners. She provides OB/GYN services, including birth control, pregnancy and prenatal care, and infertility, as well as gynecological services, such as women’s health and wellness, abnormal uterine bleeding, weight loss, pellet hormone therapy, and menopause.