Premenstrual Syndrome (PMS) affects millions of women worldwide, bringing both physical discomfort and emotional challenges before menstruation.
While it’s a normal hormonal process, understanding its causes, symptoms, and
treatments can help you regain control and feel balanced each month 🌷
 |
| PMS _Everything You Need to Know About Premenstrual Syndrome (PMS) |
This guide covers everything about PMS — from causes and diagnosis to
supplements, treatment, and even professional medical guidelines (RCOG GTG).
What Is PMS?
Premenstrual Syndrome (PMS) refers to a set of emotional, behavioral, and physical symptoms that
occur 1–2 weeks before menstruation and usually fade once bleeding starts.
It’s caused by hormonal fluctuations, particularly the drop in estrogen
and progesterone levels after ovulation.
🔄 How PMS Fits Into the Menstrual Cycle
To understand PMS, it helps to know your menstrual cycle:
|
Phase |
Days |
What Happens |
PMS Connection |
|
Follicular phase |
1–14 |
Estrogen rises, mood and energy
improve. |
Usually symptom-free. |
|
Ovulation |
~Day 14 |
Estrogen peaks, progesterone begins
to rise. |
Feeling confident and energetic. |
|
Luteal phase |
15–28 |
Progesterone dominates, then drops
before period. |
PMS symptoms appear. |
|
Menstruation |
1–5 |
Hormones reset as bleeding starts. |
Symptoms ease. |
✨ Hormonal fluctuations — especially the drop in progesterone — trigger
PMS-related changes in mood, energy, and body.
🌿 How Common Is PMS?
- Around 75% of menstruating
women experience PMS symptoms.
- 20–40% have moderate symptoms affecting
daily life.
- 3–8% develop Premenstrual
Dysphoric Disorder (PMDD), a severe form of PMS.
🔍 Causes and Risk Factors
The exact cause is complex and multifactorial, but these factors play key
roles:
🧬 Hormonal Changes
Cyclical changes in estrogen and progesterone affect brain chemicals,
metabolism, and water balance.
🧠 Neurotransmitter Fluctuations
Low levels of serotonin — the “happiness hormone” — can trigger
depression, fatigue, and cravings.
🍫 Lifestyle Triggers
- High caffeine, sugar, or salt
intake
- Stress, anxiety, or lack of sleep
- Poor diet or low physical
activity
🩺 Underlying Conditions
Women with depression, anxiety, or thyroid disorders often
experience more intense PMS.
💕 Common PMS Symptoms
PMS can include more than 150 possible symptoms, but these are the
most common:
🩷 Physical Symptoms
- Bloating and abdominal cramps
- Breast tenderness
- Headaches or migraines
- Muscle or joint pain
- Weight gain (fluid retention)
- Fatigue and sleep changes
💛 Emotional &
Behavioral Symptoms
- Mood swings and irritability
- Anxiety or tension
- Sadness or crying easily
- Food cravings
- Trouble focusing
- Feeling overwhelmed or low in
confidence
Every woman’s experience is unique — and tracking your cycle helps you
understand your personal PMS pattern.
🧩 Diagnosis of PMS
There’s no specific test for PMS.
Diagnosis is based on symptom tracking and ruling out other medical
conditions.
Your doctor may ask you to:
- Keep a symptom diary for
at least 2–3 cycles.
- Note the timing and severity
of symptoms.
- Exclude causes like thyroid
issues, depression, or anemia.
💊 Treatment of Premenstrual Syndrome
Managing PMS depends on symptom severity.
Treatment often includes a mix of lifestyle changes, supplements, and medical
therapy.
🌿 1. Lifestyle
Adjustments
- Eat balanced meals with
plenty of fruits, vegetables, and whole grains.
- Limit salt, caffeine, and
alcohol.
- Exercise regularly to release
endorphins.
- Practice sports, meditation, or
journaling to reduce stress.
- Maintain a consistent sleep
schedule.
💊 2. Medical
Treatments
Doctors may recommend:
- NSAIDs (e.g., ibuprofen) for pain and headaches.
- SSRIs (e.g., fluoxetine,
sertraline) for mood-related PMS or PMDD.
- Hormonal contraceptives to stabilize hormones.
- Diuretics for fluid retention.
- Cognitive Behavioral Therapy
(CBT) for emotional regulation.
🧴 Best Supplements for PMS Relief
Certain vitamins and minerals can ease PMS symptoms naturally 🌼
|
Supplement |
Benefit |
|
Calcium (1000–1200 mg/day) |
Reduces mood swings and bloating. |
|
Vitamin B6 (50–100 mg/day) |
Supports serotonin production and
reduces fatigue. |
|
Magnesium (200–400 mg/day) |
Relieves cramps, anxiety, and
headaches. |
|
Vitamin E (400 IU/day) |
Decreases breast tenderness. |
|
Omega-3 Fatty Acids |
Anti-inflammatory, improves mood and
pain. |
|
Zinc |
Helps regulate hormones and reduces
acne. |
⚠️ Always consult your healthcare provider before
starting supplements.
📘 Premenstrual Syndrome GTG (RCOG Green-top Guideline)
The Royal College of Obstetricians and Gynaecologists (RCOG)
issued Green-top Guideline No. 48, offering evidence-based
recommendations for PMS management.
Key Takeaways:
- Diagnosis: Requires prospective daily symptom charting for 2+ cycles.
- First-line treatment: Lifestyle changes and CBT.
- Moderate to severe PMS: Treat with SSRIs.
- Hormonal treatments: Combined oral contraceptives or GnRH analogues may help
resistant cases.
- Surgery: Considered only for severe, treatment-resistant PMS after
medical options fail.
👉 Following GTG ensures treatment is
evidence-based and patient-centered.
🌧️ Premenstrual Dysphoric Disorder (PMDD)
PMDD is a severe, disabling form of PMS that causes intense emotional
and physical symptoms.
Symptoms Include:
- Severe depression, irritability,
or anger
- Panic attacks or anxiety
- Extreme fatigue or hopelessness
- Trouble sleeping or concentrating
Diagnosis:
According to DSM-5 criteria, symptoms must:
- Occur during the luteal phase,
- Improve after menstruation
starts, and
- Significantly impact daily life.
Treatment:
- SSRIs (fluoxetine, sertraline,
paroxetine) are first-line.
- CBT to manage emotional responses.
- Hormonal suppression using birth control or GnRH
analogues.
- Lifestyle and diet modifications as supportive care.
🧘♀️
Emotional Coping Tips
- Track your emotions and energy
daily.
- Communicate with loved ones about
your needs.
- Prioritize rest and self-care.
- Avoid guilt — PMS isn’t weakness;
it’s biology 💖
- Seek help if emotions feel
uncontrollable or distressing.
🩷 Real Women’s
Stories
“Tracking my symptoms changed everything. I finally realized it wasn’t me
— it was PMS. Now I rest, hydrate, and move gently.”
— Hala, 28
“Sports, magnesium, and cutting caffeine helped me balance my moods. PMS
no longer ruins my week.”
— Nour, 33
🌼 Final Thoughts
PMS isn’t “all in your head” — it’s a biological and hormonal rhythm your
body follows every month.
By learning your cycle, nourishing your body, and seeking support when needed,
you can transform PMS from a struggle into a period of mindful self-care 🌷
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