What causes PMS?

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PMS- symptoms, causes & treatment

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Authored by Dr Aifric Boylan on 09.04.2019
Medically Reviewed by Dr Davinder Nagah
Last updated on 11.06.2024

What is PMS?

  • Premenstrual Syndrome is also known as:
    • Premenstrual Tension (PMT)
    • Premenstrual Disorder (PMD)
    • Premenstrual Dysphoric Disorder (PMDD) if it’s severe
  • Premenstrual syndrome is defined as:
  1. Distressing physical or emotional symptoms
  2. Occurring regularly in the 2 weeks before your period
  3. Not occuring at other times in your menstrual cycle
  • It’s only diagnosed after other medical conditions are excluded

premenstrual syndrome PMS

What conditions can be assessed by our doctors?

How common is PMS?

  • It’s really common. About 40% of women have PMS
  • Only half of women with PMS seek medical help
  • Over 10% of women need time off work for PMS

What are the symptoms of PMS?

  • Symptoms of PMS commonly include:
    • Bloated tummy
    • Irritability or anger
    • Pain in the breasts
    • Pain in the joints and muscles
  • Less common symptoms of PMS include:
    • Headaches
    • Weight gain
    • Swelling of the hands or feet
    • Excessive hunger, cravings
    • Tiredness
    • Tearfulness
    • Disrupted sleep
    • Loss of concentration
    • Anxiety or depression
    • Confusion

What causes PMS?

  • Nobody is certain
  • It doesn’t occur before puberty (when periods start), during pregnancy, or after the menopause (when periods stop)

Who gets PMS?

  • PMS runs in families – there’s a strong genetic link
  • It’s more common in:
    • Overweight women
    • Women who don’t exercise much
    • Younger women
    • Women with longer periods
    • Women who are victims of domestic violence

What is the treatment for PMS?

  • If you think you have PMS, you should start by keeping a diary of your symptoms
    • This will help your doctor to understand the problem
  • Your doctor should:
    • Have a discussion with you about your symptoms
    • Examine you
    • Possibly perform some blood tests and/or imaging tests such as an ultrasound
  • Increasing your exercise has been shown to help
  • You may be offered a referral to a psychologist
  • Prescription medications which may help
    • Vitamin B6 
    • The combined oral contraceptive pill, taken either with or without breaks
    • Certain antidepressant medication
    • Diuretics (water tablets) may help with swelling
  • If none of the above works, you may be offered a hormone patch to stick on your skin or other forms of hormone tablets
  • If your doctor isn’t managing to help with your symptoms, you could ask to be referred to a gynaecologist
  • Sometimes, if things are really bad, people have their uterus and ovaries removed (total abdominal hysterectomy & bilateral oophorectomy)
  • If you think you may have PMS you should consult with your doctor

What is Premenstrual Dysphoric Disorder or PMDD?

  • PMDD is severe PMS
    • The symptoms of PMS are listed above
  • It affects about 5% of women during their fertile years
  • More than half of women with PMDD suffer from mental illness at some point in their lives
  • It is a significant cause of sick leave
  • Diagnosing PMDD involves completing a diary of ratings for certain symptoms
  • If you think you may have PMDD you should consult with your doctor
  • Management of PMDD mirrors the management of PMS (as described above)

Article Resources

Royal College of Obstetricians and Gynaecologists

Liisa Hantsoo.  Premenstrual Dysphoric Disorder: Epidemiology and Treatment

what causes PMS?
What conditions can be assessed by our doctors?

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