Premenstrual Syndrome (PMS): Symptoms, Causes & Treatment

Premenstrual Syndrome (PMS): Symptoms, Causes & Treatment

Premenstrual syndrome (PMS) affects many women of childbearing age and results in mood swings, muscle pain and cramps. Mild to moderate PMS can be effectively treated with simple lifestyle and dietary changes, while severe PMS often requires medical advice.

What Is Premenstrual Syndrome?

Premenstrual syndrome (PMS) is a range of symptoms caused by a woman’s monthly menstrual cycle. It can also be referred to as premenstrual tension (PMT). These symptoms affect around 75% of women of child bearing age in some way and are often more severe during the twenties and thirties.

What Causes PMS?

While the exact cause of PMS is not known, there are several factors that are thought to contribute to the severity of symptoms. Hormone levels fluctuate during the monthly menstrual cycle, particularly the two main female hormones oestrogen and progesterone. These fluctuations cause certain chemical changes to serotonin levels in the brain, which has a strong effect on mood. PMS can be aggravated by low dietary levels of certain vitamins and minerals or diets that are high in salt.

Common PMS Symptoms

Although it’s not clear why some women suffer from PMS while others don’t, it may be due to varying imbalances in hormones levels from woman to woman. During the menstrual cycle, women can experience many different physical and psychological symptoms, some of which can be so severe that they seriously impact on the quality of day to day life. Symptoms often begin to appear 1 to 2 weeks before the period starts and disappear soon afterwards.

The most common PMS symptoms include:

Physical Symptoms

  • painful period cramps
  • breast tenderness and swelling
  • joint or muscle pain
  • acne
  • weight gain
  • water retention and bloating
  • headaches or migraines
  • trouble sleeping

Psychological Symptoms

  • depression or low mood
  • mood swings
  • irritability

Severe forms of PMS can cause feelings of depression, hopelessness and even thoughts about suicide. This is called premenstrual dysphoric disorder (PMDD), which is thought to affect around 1 in 20 women. If you are suffering from symptoms which are making life feel unbearable consult with your GP.

How to Treat PMS

Premenstrual syndrome (PMS) can often be managed with simple lifestyle and dietary changes, while more severe PMS may require medical attention. Many treatments seek to rebalance fluctuating hormone levels and mood.

Lifestyle Changes

  • Exercise: Regular aerobic exercise and gentle stretches help to lift your mood and relieve period cramps. Aim for at least 30 minutes of exercise 3 times per week.
  • Diet: Some women find it beneficial to eat 5 to 7 small meals throughout the day to maintain normal blood sugar levels and reduce bloating, and include complex carbohydrates such as whole grains to balance mood. Avoid foods high in fat and salt as these can aggravate symptoms.
  • Stress: High-stress levels can increase susceptibility to the symptoms of PMS. Take action to reduce stress levels by ...
  • Sleep: Hormonal shifts can disrupt sleep and increase irritability. Try to establish a regular sleeping pattern to achieve eight hours of sleep per night. Among other benefits, this will help to reduce stress, tension and anxiety associated with PMS. Even try a nap in the afternoon when experiencing symptoms.
  • Limit alcohol and caffeine: Cravings can be stronger when experiencing PMS. There is some evidence to suggest that caffeine increases PMS related anxiety, irritability and breast tenderness. Try herbal teas or decaffeinated beverages when experiencing symptoms of PMS.
  • Quit smoking: A large scale 10-year study found that women who smoked were more than twice as likely to suffer from moderate to severe PMS symptoms compared to those who didn’t smoke.

PMS Remedies and Supplements

Dietary supplements have long been used to relieve the symptoms of PMS, with varying degree of effectiveness. Those that are effective include:

  • Evening Primrose Oil (EPO): The oil of the evening primrose plant is rich in an omega 6 fatty acid called gamma linolenic acid (GLA). There are several studies supporting the use of evening primrose oil for PMS. Evening primrose oil increases the level of omega 6 in the body so you need to ensure you are consuming omega 3 oils to maintain a healthy balance of 3 to 6.
  • Calcium and Magnesium: Certain vitamins and minerals are also important. Magnesium is often referred to as nature’s tranquilliser for its ability to reduce anxiety and tension, while Calcium has been shown to reduce the severity of PMS symptoms, particularly cramps. A combined calcium and magnesium supplement may help to relieve period cramps and mood swings.
  • Vitamin B6: This essential B vitamin supports mood and behaviour and low levels of B6 may heighten PMS symptoms. Good food sources of vitamin B6 include poultry, fish and bread.

If you are taking any prescription medications, always check with your GP before taking supplements.


Some women find over the counter pain relievers such as ibuprofen or aspirin to be effective at relieving discomfort from period cramps and muscle aches. In severe cases, birth control pills can also be used to stop ovulation completely.

A combination of lifestyle changes, natural remedies and medications (if needed) can be effective in managing many of the symptoms of PMS.