Premenstrual Syndrome (PMS)

PMS stands for Premenstrual Syndrome; "pre" means "before" and "menstrual" refers to the "menstrual cycle" or periods. Not all girls will get PMS, but the physical and emotional symptoms are common. Most girls and women with PMS have symptoms the week before their period. Symptoms can usually be treated with lifestyle changes and over-the-counter medicine. If these are not effective, prescription medicines can help.

How do I know if I have PMS?

PMS occurs one week or sometimes up to 2 weeks before your period. There are actually a total of 150 known symptoms of PMS. The most common symptoms include: mood swings, breast soreness, bloating, acne, cravings for certain foods, increased hunger and thirst, and fatigue. Other symptoms may include constipation or diarrhea, irritability, and feeling blue or down in the dumps. If you have any of these symptoms and they happen during the week before your period starts and go away when your period arrives or a few days later, you may have PMS. If you feel blue or down in the dumps and these feelings last longer than the week before your period, it’s probably not related to PMS. In this situation, it is important to make an appointment to talk to a counselor or therapist.

Since there are so many possible symptoms of PMS, it is a good idea to keep track of them. Remember to note if the symptoms are mild, moderate, or severe. Use a period and symptom tracker for 2-3 months and then bring it to your next medical appointment. A record of your symptoms can help your healthcare provider figure out the best treatment choices for you.

My Monthly Period & Symptom Tracker

My Monthly Period & Symptom Tracker is an easy way to keep track of your menstrual flow, and it’s also a way to keep track of cramps, and/or PMS and period symptoms (if you have them) each month.

• Review the sample Monthly Period & Symptom Tracker.
• Print out copies of My Monthly Period & Symptom Tracker.
• Simply make a check mark in the appropriate box (or boxes) for each day of the month. If you don't have any flow or any symptoms on any given day, leave the box empty. Refer to the Blood Flow Key at the bottom for "Flow" definitions.
• The dates at the top are the same as the dates in one month. Some months have 28 days, others have 30 or 31.
• Remember to bring My Monthly Period & Symptom Tracker with you to your medical appointments

What causes PMS?

Scientists are still trying to figure out what causes PMS. We know that during the second half of the menstrual cycle, progesterone (female hormone) levels increase. Then, just before the period comes, progesterone and estrogen (another female hormone) levels drop. It is believed that changes in hormone levels result in PMS symptoms. Other factors may have an effect on PMS symptoms; for example, you may notice that your symptoms are better if you get plenty of sleep and exercise regularly. Although PMS can be frustrating, there are things you can do to make your symptoms better.

What should I do if I have PMS?

Nutrition and lifestyle changes are a first step. The following suggestions are healthy recommendations for everyone and are particularly helpful for young women with PMS symptoms.

Nutrition Changes:

• Eat complex carbohydrates that are high in fiber (such as whole grain breads, whole wheat pasta, and high fiber cereals instead of white bread, white pasta, and sugary cereals).
• Cut back on sugar and fat. Even though your body may be craving sweets or fast foods that are high in fat, try to limit these foods since they may add to your PMS symptoms.
• Don't eat foods high in salt (sodium) for the few days before your period. For example: avoid canned soups, Chinese food, hotdogs, and pizza which are very high in sodium. Cutting down on sodium may help to control bloating by lowering the amount of fluid your body retains.
• Keep Hydrated. Drink plenty of water.
• Cut back on caffeine. Reducing the amount of caffeine you eat and drink (soda, coffee drinks, and chocolate) may help you feel less tense and can ease irritability and breast soreness.
• Try eating up to 6 small meals a day instead of 3 large ones and include a balance of foods and nutrients (protein, carbohydrates, fruits/veggies, and healthy fats) at each small meal. This will help keep your blood sugar levels even, which will give you energy that lasts.
• Don’t forget dairy and calcium! Research studies have shown that getting 1300 mg of calcium helps with PMS symptoms. This means you should eat or drink 4 servings of high calcium foods (such as milk, fortified OJ, or soy milk) each day or take calcium supplements.

Lifestyle Changes:

• Fit in exercise. Do aerobic exercise (such as running, dancing, or jump roping) for 30 minutes a day, 4 to 6 times a week.
• Catch your ZZZ’s. If you’re a teen, you need about 9 hours of sleep each night.
• Try to maintain a regular schedule of meals, exercise, and bedtime.
• Keep stress to a minimum. If possible, try to schedule events that you think could be stressful during the week after your period.
• Avoid alcohol. Drinking alcohol before your period can make you feel more depressed.

Are there medications that might help?

If your symptoms do not improve with a few nutrition and lifestyle changes, talk with your healthcare provider. He/she may be able to prescribe medication that will help relieve your discomforts. There are several medicines that are currently used to treat PMS symptoms. The most commonly prescribed are oral contraceptives (birth control pills) which prevent ovulation and keep hormone levels even. Most pills (particularly those that are low in progestin or contain drospirenone) can improve symptoms. Sometimes symptoms can improve even more if the pill is taken continuously (one active pill every day and no placebo pills). Other medications include ibuprofen or naproxen sodium that can help to relieve lower back discomfort and headaches and mild diuretics such as Spironolactone to lessen bloating and mood changes. If depression is a significant issue, your health care provider may prescribe antidepressants such as Prozac or Zoloft (Sertraline).

Are there vitamins or minerals that will improve my symptoms?

Although more research studies are needed, there are certain vitamins and minerals that may help PMS symptoms. Check with your healthcare provider about whether you should try them and how much you should take.

Calcium	Several studies show that calcium can significantly decrease many of the symptoms associated with PMS. Make sure that you are getting the recommended 1300 mg/day.
Magnesium	Magnesium supplements (dose of 200-400 mg/day) may help reduce PMS symptoms. This dose may cause diarrhea in some people.
Vitamin B6	Studies of vitamin B6 are mixed and generally don’t show a helpful effect. The amount of vitamin B6 should be limited to no more than 100 mg/day. Check with your healthcare provider before taking vitamin B6 for more than a few months.
Vitamin E	One study suggests that vitamin E may decrease PMS symptoms at a dose of 400 IU/day.

Sometimes other medical conditions can mimic PMS symptoms, so it's important to keep your healthcare provider up-to-date with any health issues you are having. If your PMS is so severe that you feel very depressed, talk with a parent, guardian, or trusted adult, and consult your healthcare provider immediately.