Premenstrual syndrome (PMS)

Premenstrual syndrome (PMS)

Overview

Premenstrual syndrome, commonly known as PMS is characterized by a set of physical, emotional, and behavioural symptoms that usually occurs a week or two before the menses.

The physical symptoms of PMS may include breast tenderness, bloating or heaviness in the abdomen, headache, constipation or diarrhea, acne, and muscle pains, while the emotional symptoms may present in the form of restlessness, anxiety, anger, irritability, cravings and mood swings.

While a combination of many factors like hormonal changes, chemical changes in the brain and lifestyle factors are considered to cause PMS, some factors that can increase the risk of PMS symptoms include being overweight or obese, smoking, personal or family history of depression or certain nutritional deficiency of vitamins and minerals.

Dr Aman Aditya Pandey Says

Lifestyle adjustments can help you reduce or manage the signs and symptoms of PMS. The conservative approaches such as exercise, yoga, and meditation, help in alleviating depressive symptoms. Also, your doctor can help you find ways to relieve your symptoms with the help of certain drugs.

Key Facts

Usually seen in

  • Women between 20 to 30 years of age

Gender affected

  • Women

Body part(s) involved

  • Uterus

Prevalence

  • Worldwide: 47.8% (2020)

Mimicking Conditions

  • Depression
  • Anxiety
  • Perimenopause
  • Chronic fatigue syndrome
  • Irritable bowel syndrome (IBS)
  • Thyroid disease

Necessary health tests/imaging

  • Pelvic exam test
  • Patient record

Treatment

  • Painkillers: Ibuprofen, Naproxen & Aspirin
  • Antidepressants: Fluoxetine, Sertraline, Paroxetine &  Escitalopram
  • Birth control pills (oral contraceptives): Drospirenone &  Ethinyl estradiol
  • Gonadotropin-releasing hormone (GnRh) agonists: Leuprolide & Goserelin acetate
  • Diuretics: Spironolactone

Specialists to consult

  • General physician
  • Gynecologist
  • Psychiatrist 
  • Counselor

Symptoms Of PMS


There are various physical and emotional symptoms associated with PMS. They can also vary from month to month and are sometimes so severe that they affect the daily lives of women. Symptoms usually peak two days before menstruation and disappear within four days of menstruation. Symptoms might include:

Physical symptoms

  • Change in appetite
  • Weight gain
  • Back pain
  • Headache
  • Swelling and tenderness of breasts
  • Constipation
  • Tiredness
  • Pain in the genital area (dyspareunia)
  • Nausea
  • Diarrhea
  • Bloating
  • Migraine
  • Drowsiness
  • Poor concentration
  • Insomnia
  • Increased nap-taking
  • Swelling of the hands and feet
  • Bodyache
  • Joint pain 
  • Lower tolerance for noise or light
  • Abdominal pain
  • Menstrual cramps

Worried about what’s to come after PMS? Here are 6 effective ways to manage period pain. Emotional symptoms

    Crying

    Mood swings

    Irritability

    Anger

    Feelings of tension

    Disinterest in daily activities

    Fatigue

    Feeling overwhelmed or out of control

In some women with PMS, severe, debilitating symptoms occur which can affect the daily routine activities of women, known as premenstrual dysphoric disorder (PMDD). It causes extreme mood shifts such as:

    Severe depression

    Panic attacks

    Feelings of hopelessness

    Low self-esteem

    Anger and irritability

    Crying spells

    Suicidal thoughts

Did you know?

Symptoms of PMS are very similar to the symptoms of early pregnancy. Listen to our experts explain PMS better.

Causes Of PMS

The exact cause of PMS is not known. The hormone fluctuations may play a role in developing symptoms of PMS. Some women react more to these fluctuations than others, which can be linked to genetic factors or chemicals released in the brain. The following changes in the hormones that may cause PMS include:

1. Estrogen

The fluctuations in estrogen levels cause mood swings. Studies also suggest that a decreased amount of estrogen stimulates common symptoms of PMS such as insomnia, fatigue, and depression.

2. Progesterone

PMS is also influenced by the hormone progesterone. Low progesterone levels or progesterone levels falling too rapidly during the second half of the menstrual cycle can lead to PMS symptoms.

3. Serotonin

There is an increase in serotonin precursors between days 7 to 11 and 17 to 19 of the menstrual cycle. This rise in serotonin causes mood swings which is a significant symptom of PMS.

4. Prolactin

Women with PMS symptoms have high levels of prolactin, especially in the premenstrual time. Studies suggest that high prolactin levels clubbed with low levels of progesterone can lead to anxiety and depression.

Most of the women have a lot of questions about periods. And one of the most common ones is: Are my periods normal? Have a question about periods?

Risk Factors Of PMS

Though the exact cause of PMS is still unknown, there are an array of risk factors that are associated with PMS. They include:

1. Age

PMS is a disease that is linked with menstrual cycles, so it affects women after menarche (the first occurrence of menstruation) till menopause. It is mostly seen between mid 20s to late 30s.

There are several changes in the woman’s body as she turns 30. So let’s explore what 30s hav2. Lifestyle factors

There are various lifestyle factors that can increase the chances of PMS.

Diet: Excess intake of sugar, coffee, packaged and processed food is associated with an increased risk of PMS.

Sedentary lifestyle: Some studies also suggest the role of sedentary and inactive lifestyles in PMS.

Poor sleep quality: Inadequate and poor quality sleep predisposes women to PMS.

Trying to get good-quality sleep. Check out our widest range of sleep aid products to help you sleep better.e in store for every woman!

health tips for 2025

Health tips for 2025

health tips for 2025

Clean your hands properly Hand hygiene is critical not only for health workers but for everyone. Clean hands can prevent the spread of infectious illnesses. You should hand wash using soap and water when your hands are visibly soiled or hand rub using an alcohol-based product.

Eat a healthy diet Eat a combination of different foods, including fruit, vegetables, legumes, nuts and whole grains. Adults should eat at least five portions (400g) of fruit and vegetables per day. You can improve your intake of fruits and vegetables by always including veggies in your meal; eating fresh fruit and vegetables as snacks; eating a variety of fruits and vegetables; and eating them in season. By eating healthy, you will reduce your risk of malnutrition and noncommunicable diseases (NCDs) such as diabetes, heart disease, stroke and cancer.

Consume less salt and sugar Filipinos consume twice the recommended amount of sodium, putting them at risk of high blood pressure, which in turn increases the risk of heart disease and stroke. Most people get their sodium through salt. Reduce your salt intake to 5g per day, equivalent to about one teaspoon. It’s easier to do this by limiting the amount of salt, soy sauce, fish sauce and other high-sodium condiments when preparing meals; removing salt, seasonings and condiments from your meal table; avoiding salty snacks; and choosing low-sodium products. On the other hand, consuming excessive amounts of sugars increases the risk of tooth decay and unhealthy weight gain. In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake. This is equivalent to 50g or about 12 teaspoons for an adult. WHO recommends consuming less than 5% of total energy intake for additional health benefits. You can reduce your sugar intake by limiting the consumption of sugary snacks, candies and sugar-sweetened beverages.

Reduce intake of harmful fats Fats consumed should be less than 30% of your total energy intake. This will help prevent unhealthy weight gain and NCDs. There are different types of fats, but unsaturated fats are preferable over saturated fats and trans-fats. WHO recommends reducing saturated fats to less than 10% of total energy intake; reducing trans-fats to less than 1% of total energy intake; and replacing both saturated fats and trans-fats to unsaturated fats.The preferable unsaturated fats are found in fish, avocado and nuts, and in sunflower, soybean, canola and olive oils; saturated fats are found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard; and trans-fats are found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, cookies, biscuits, and cooking oils and spreads.

Avoid harmful use of alcohol There is no safe level for drinking alcohol. Consuming alcohol can lead to health problems such as mental and behavioural disorders, including alcohol dependence, major NCDs such as liver cirrhosis, some cancers and heart diseases, as well as injuries resulting from violence and road clashes and collisions.

Don’t smoke Smoking tobacco causes NCDs such as lung disease, heart disease and stroke. Tobacco kills not only the direct smokers but even non-smokers through second-hand exposure. Currently, there are around 15.9 million Filipino adults who smoke tobacco but 7 in 10 smokers are interested or plan to quit. If you are currently a smoker, it’s not too late to quit. Once you do, you will experience immediate and long-term health benefits. If you are not a smoker, that’s great! Do not start smoking and fight for your right to breathe tobacco-smoke-free air.

Be active Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. This includes exercise and activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits. The amount of physical activity you need depends on your age group but adults aged 18-64 years should do at least 150 minutes of moderate-intensity physical activity throughout the week. Increase moderate-intensity physical activity to 300 minutes per week for additional health benefits.

Check your blood pressure regularly Hypertension, or high blood pressure, is called a “silent killer”. This is because many people who have hypertension may not be aware of the problem as it may not have any symptoms. If left uncontrolled, hypertension can lead to heart, brain, kidney and other diseases. Have your blood pressure checked regularly by a health worker so you know your numbers. If your blood pressure is high, get the advice of a health worker. This is vital in the prevention and control of hypertension.

Get tested Getting yourself tested is an important step in knowing your health status, especially when it comes to HIV, hepatitis B, sexually-transmitted infections (STIs) and tuberculosis (TB). Left untreated, these diseases can lead to serious complications and even death. Knowing your status means you will know how to either continue preventing these diseases or, if you find out that you’re positive, get the care and treatment that you need. Go to a public or private health facility, wherever you are comfortable, to have yourself tested.

Get vaccinated Vaccination is one of the most effective ways to prevent diseases. Vaccines work with your body’s natural defences to build protection against diseases like cervical cancer, cholera, diphtheria, hepatitis B, influenza, measles, mumps, pneumonia, polio, rabies, rubella, tetanus, typhoid, and yellow fever. In the Philippines, free vaccines are provided to children 1 year old and below as part of the Department of Health’s routine immunization programme. If you are an adolescent or adult, you may ask your physician if to check your immunization status or if you want to have yourself vaccinated.

Practice safe sex Looking after your sexual health is important for your overall health and well-being. Practice safe sex to prevent HIV and other sexually transmitted infections like gonorrhoea and syphilis. There are available prevention measures such as pre-exposure prophylaxis (PrEP) that will protect you from HIV and condoms that will protect you from HIV and other STIs.

Cover your mouth when coughing or sneezing Diseases such as influenza, pneumonia and tuberculosis are transmitted through the air. When an infected person coughs or sneezes, infectious agents may be passed on to others through airborne droplets. When you feel a cough or sneeze coming on, make sure you have covered your mouth with a face mask or use a tissue then dispose it carefully. If you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook (or the inside) of your elbow.

Prevent mosquito bites Mosquitoes are one of the deadliest animals in the world. Diseases like dengue, chikungunya, malaria and lymphatic filariasis are transmitted by mosquitoes and continue to affect Filipinos. You can take simple measures to protect yourself and your loved ones against mosquito-borne diseases. If you’re traveling to an area with known mosquito-borne diseases, consult a physician for a vaccine to prevent diseases such as Japanese encephalitis and yellow fever or if you need to take antimalarial medicines. Wear light-coloured, long-sleeved shirts and pants and use insect repellent. At home, use window and door screens, use bed nets and clean your surroundings weekly to destroy mosquito breeding sites.

Drink only safe water Drinking unsafe water can lead to water-borne diseases such as cholera, diarrhoea, hepatitis A, typhoid and polio. Globally, at least 2 billion people use a drinking water source contaminated with faeces. Check with your water concessionaire and water refilling station to ensure that the water you’re drinking is safe. In a setting where you are unsure of your water source, boil your water for at least one minute. This will destroy harmful organisms in the water. Let it cool naturally before drinking.

Take antibiotics only as prescribed Antibiotic resistance is one of the biggest public health threats in our generation. When antibiotics lose their power, bacterial infections become harder to treat, leading to higher medical costs, prolonged hospital stays, and increased mortality. Antibiotics are losing their power because of misuse and overuse in humans and animals. Make sure you only take antibiotics if prescribed by a qualified health professional. And once prescribed, complete the treatment days as instructed. Never share antibiotics.

5 lifestyle tips for a healthy tummy

5 lifestyle tips for a healthy tummy

Digestive problems and stomach upsets can be prevented, relieved and even banished by simple lifestyle changes.

Beat stress to ease tummy troubles

You may have noticed a feeling of unease in your stomach during times of stress. That’s because anxiety and worry can upset the delicate balance of digestion.

In some people, stress slows down digestion, causing bloating, pain and constipation, while in others it speeds it up, causing diarrhoea and frequent trips to the loo. Some people lose their appetite completely.

Stress can also worsen digestive conditions like stomach ulcers and irritable bowel syndrome.

Managing and reducing stress can help with your digestion.

Get tips on managing stress

Stop smoking to prevent reflux

Smoking can weaken the muscle that controls the lower end of the food pipe and allow acid from the stomach to travel in the wrong direction back up, a process known as reflux.

Reflux causes the symptoms of heartburn, and can bring on or aggravate stomach ulcers and inflammatory conditions of the bowel.

Smoking is also an important risk factor for stomach cancer.

Find out how to stop smoking

Eat properly to help your digestion

Follow some basic rules for good eating habits to prevent problems:

 Do not rush your food. Take the time to eat slowly and chew each mouthful well.

Do not overeat. Reduce the size of your portions at mealtimes, or try eating 4 to 5 small meals instead of 3 large ones.

Eat regularly and try not to skip meals.

Avoid eating a big meal just before you go to bed. Eat your last meal at least 2 to 3 hours before lying down.

 Make sure you have plenty of water to drink.

Lose excess weight to beat heartburn

If you’re overweight, your tummy fat puts pressure on your stomach and can cause heartburn.

Losing weight may relieve digestive symptoms like heartburn and other acid-related stomach complaints.

Check you’re a healthy weight with the BMI calculator

Get tips on losing weight from the NHS Better Health website

Binge drinking causes acid-related digestive disorders

Moderate drinking will not hurt your digestive system, but binge drinking increases acid production in your stomach, and can cause heartburn and aggravate other digestive disorders.

Binge drinking is defined as drinking too much in a single session.