Making Sense of PMS

Premenstrual syndrome (PMS) is a set of physical and emotional symptoms that can happen to women during certain parts of their menstrual cycle due to hormonal changes. PMS symptoms usually occur 1 to 2 weeks before a period or shortly after ovulation. The symptoms can come and go and change during life. The good news is that many of the symptoms can be managed with home remedies or over-the-counter (OTC) medications. If PMS symptoms are really severe or disruptive to your daily life, you may have Premenstrual Dysphoric Disorder (PMDD).

What are the symptoms of PMS?

Symptoms of PMS can look and feel different for each woman but may include any of the symptoms present in the table below:

When the emotional symptoms are more severe, like difficulty sleeping, severe depression or irritability, panic attacks, difficulty focusing, or nothing seems to relieve your symptoms, you may have PMDD.

What if I have PMS symptoms?

Symptoms of PMS can be managed with home remedies or OTC medications. Regular exercise, a healthy diet, and a regular sleep schedule can help with mood and combat fatigue. Consider:

• Stress relievers like yoga or meditation
• Heat, or warm baths to help with cramping or bloating
• OTC anti-inflammatories and pain relievers such as ibuprofen or naproxen to help with cramping, headaches, or back pain. Some women find it helps to start taking these medications regularly 2-3 days before their period starts.

Some vitamins, minerals, and herbal supplements have also been found to help potentially with PMS symptoms.

• Calcium has been shown to help with fatigue, cravings, and mood changes. You can take calcium through your diet (such as dairy foods) or supplements.
• Vitamin B6 has been shown to help with fatigue, mood changes, memory, and bloating. Foods rich in Vitamin B6 include fish, chicken, potatoes, fruit, and some cereals. You can also take a supplement.
• Supplements such as black cohosh and evening primrose oil have also been tried, but studies aren't clear as to whether they actually help.

If symptoms are severe and disrupt daily life, or are consistent with PMDD, you can talk to your healthcare provider about using prescription medicines such as hormonal birth control, which can help regulate hormones and alleviate most of the symptoms. Some hormonal birth control pills contain a type of progesterone that also acts as a diuretic which can help with bloating. If you are not a candidate for hormones, your doctor may prescribe other medications such as a diuretic to help with bloating or an antidepressant or anti-anxiety medication to help with some mood disturbances.

Related questions

• Can you take Ibuprofen if you have COVID-19 (coronavirus)?
• Naproxen vs ibuprofen: What's the difference?
• Can you take ibuprofen on an empty stomach?

When should I see my doctor?

PMS symptoms last a few days and can usually be treated with home remedies and OTC medications as described above. However, if you think you have PMDD or your symptoms are severe and do not improve with the suggested remedies, you may want to talk to your doctor about other management and treatment options.

Pharmacist Tips:

• Be sure to drink plenty of water, get plenty of sleep, and eat a healthy well-balanced diet.
• Try heating pads or soaking in a bath to help with cramping, bloating, and backaches.
• Take ibuprofen or naproxen with food to keep it from upsetting your stomach.

Sometimes it can help to chart your symptoms and menstrual cycle during the month to share with your healthcare provider so they can help you manage your symptoms. Many free apps can help you do this, such as Clue, Flo, and Eve by Glow.

Summary

PMS symptoms are very common. Most symptoms can be relieved by OTC medications, home remedies, or lifestyle changes. Talk to your doctor or pharmacist if your symptoms are severe.