Premenstrual syndrome (PMS): Causes, Symptoms and Treatments

This article is medically reviewed by Dr Priya Jain, MBBS

Have you ever felt irritated and frustrated without any reason before your periods?

When everybody around you bothers you?

Does nothing interest you?

And you feel miserable due to these sudden changes in your moods which is sometimes hard to handle for people around you?


Well yeah, that’s premenstrual syndrome (PMS)…

I am sure some people didn’t even know that they go through PMS every month.

If you are also one of those who find this time difficult, 

Keep reading till the end 

You will get to know everything about PMS.

PMS premenstrual syndrome

What is premenstrual syndrome?

As the name suggests ‘premenstrual syndrome’ is something that occurs before menstruation.

PMS is a very common condition that affects a woman’s behaviour and emotions before their period and once their periods start the symptoms automatically go away.

Almost every woman at some point in their life goes through this

And more than 90% of menstruating women are suffering from PMS.

The symptoms may vary from woman to woman but this is something that needs assistance in the initial days.

For some, the symptoms may occur 5-11 days before their periods while for some it may start during ovulation which is somewhere in the middle of the menstrual cycle. (14th day of the cycle).

Causes of PMS

Being so common also the exact cause of PMS is not known. Some factors may trigger PMS but they are not the main root cause behind it.

However, some researchers believe that it is caused by cyclic changes in female hormones.

Estrogen and progesterone levels when spikes up during certain times of the month result in mood swings, irritation, and anxiety.

Another factor is the change in serotonin level, it is a chemical present in your brain and gut that affects the moods, emotions, and thoughts of a woman.

An article published on a leading health website ‘Harvard Health Publishing’ says that there is some evidence that shows that deficiency of magnesium could also be one of the reasons behind PMS. Lifestyle also tends to play a very important role in PMS.

Symptoms of PMS

The symptoms of PMS are usually mild but its severity can vary from person to person.

The symptoms fall under two main categories which are listed below

  • Bloating
  • Breast tenderness
  • Backaches or muscle pain
  • Dizziness
  • Palpitations
  • Constipation
  • Swelling of feet and ankles
  • Fluid retention and weight gain
  • Painful uterine cramps just before and during the first few days of menstruation
  • Headaches
  • Food cravings (especially for salty or sweet foods)
  • Acne breakout
  • Low energy or fatigue


  • Mood swings
  • Irritability
  • Depression
  • Aggressiveness 
  • Increased appetite
  • Forgetfulness
  • Changes in sexual desires
  • Tense or anxious
  • Emotional outbursts 
  • Insomnia
  • Sleeping for 15 or more hours per day
  • Feeling of loneliness
  • Overwhelmed
  • Forget things
  • Less concentration

Can PMS be avoided?

PMS is very common and it cannot be avoided, but it can be cured to a great extent by doing some small changes here and there in lifestyle.

Regular exercise and a balanced diet can help a lot in controlling PMS.

Yoga and meditation along with mind relaxations techniques should be practised, it will calm your mind and take away those negative feelings.

I know some people don’t feel like talking but talking to your near and dear ones can help a lot in relieving stress caused by PMS.

Moderate symptoms can be controlled at home without medical assistance. 

And the symptoms which are of severe intensity may need a medical assistant.

Treament of PMS

  • Exercise for 30 minutes at least 3 times a week.
  • Take a good night’s sleep of at least 7-8 hours.
  • Don’t watch or listen to depressing stuff either on your phone or television.
  • Cut on to caffeine and alcohol.
  • Eat home-cooked food, less salty, and less spicy.
  • Practice yoga and meditation techniques that calm the mind.
  • Do not skip meals, especially breakfast. Try to have a high protein breakfast.
  • You can also take supplements of folic acid, calcium, magnesium to combat PMS symptoms.
  • Don’t worry too much about little things and work in a low-stress environment.
  • Quit smoking…NOW.

What to eat and avoid to control PMS

Small changes in your diet can create big differences in your PMS journey.

According to a detailed study, It is seen that there is a significant association between the severity of PMS and dietary habits.

But you should keep in mind that eating healthy only when you start seeing the symptoms will not help.

Be consistent with your diet. Maintain a healthy diet throughout the month for better and long-lasting results.


Do you know what is the best thing you can do for your body?

Cut down the intake of packaged and processed food.

These contain a lot of salts and sugars in almost everything which so unhealthy 


Instead of eating this try to eat home-cooked food.


 Increase the intake of calcium in your diet.

A study suggests that calcium supplements are effective in reducing mood disorders during PMS.

Milk, cheese, yoghurt, etc are good sources of calcium.


A study suggests that high dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents.

If at all you don’t want to consume supplements, some foods are rich in vitamin D.

For vegetarians : 

  • Spinach
  • Kale
  • Okra
  • Collards
  • Soybeans
  • White beans

For non-vegetarians :

  • Oily fish – such as salmon, sardines, and mackerel
  • Red meat
  • Liver
  • Egg yolks

Leafy vegetables are rich in iron and vitamin B and it helps us in feeling fresh. 

If you feel sweet cravings munch onto seasonal fruits.

Fruits contain a lot of water content so it helps us to stay hydrated.


I cannot stress this enough. Water works like magic.

I know some of you might find the taste of water boring so you can add some flavours to your water like adding a slice of lime or cucumber or simply having a lemonade. 

Water can help in improving digestion and problems like bloating.


Alcohol and caffeine might tend to relax your mind but do you know it dehydrate your body.

Alcohol and caffeine disrupt our sleep cycle which triggers PMS symptoms a lot.


Say NO to processed food as well as processed grains and go for whole grains. 

For example shift from processed wheat (all-purpose flour) bread to whole wheat bread and likewise for other foods too.


Complex carbohydrates enter the bloodstream slowly so it doesn’t spike up the insulin level. This stabilizes our mood and food cravings whereas if you eat more simple carbs food it enters the bloodstream very fast and spikes the insulin level which ultimately results in more food cravings and an irritated mood.

Complex carbs food includes:

  • Whole wheat bread, pasta, and flour.
  • Brown rice
  • Barley
  • Quinoa
  • Potatoes
  • Corn
  • Legumes, such as black beans, chickpeas, lentils

Intake of iron-rich food is very important to replace what you lose each month during periods.

Foods rich in irons are:

  • Seafood
  • Beans
  • Spinach
  • Dry fruit, such as raisins and apricots
  • Iron-fortified cereals, bread, and pasta
  • Peas

Best exercises to relieve PMS symptoms:

  • Yoga and pilates
  • Low-intensity cardio
  • Low-volume strength training 
  • Light walking and jogging  
  • Include planks and squats
  • Aerobic exercises
  • Cycling
  • Short lap of swimming (with menstrual cup or tampons)
  • Dancing to your favorite music

What makes PMS worst?

If you don’t quit some of your habits right now it is going to give you hard times in the future.

Some of the conditions which may worsen PMS symptoms are:

  • Smoking
  • Drinking too much alcohol or caffeine
  • Inactivity and lethargic routine
  • Binge-watching and not taking enough sleep
  • Depression
  • Intake of processed food 
  • Intake of excess salt and sugar

Premenstrual Dysphoric disorder PMDD: Worst form of PMS


PMDD stands for premenstrual dysphoric disorder.

PMDD is a severe form of PMS.

It can cause severe depression and anxiety attacks.

This is a rare condition and only affects 5% of women most of the childbearing age.

Symptoms of PMDD:

  • Suicidal thoughts 
  • Miserable feeling
  • Uncontrollable anger 
  • Anxiety and tension
  • Panic attacks
  • Mood swings or crying without any reason
  • Lack of interest in daily activities and relationships
  • Trouble thinking or focusing
  • Tiredness or low energy
  • Food cravings 
  • Binge eating or complete loss of appetite
  • Insomnia
  • Feeling out of control
  • Cramps, bloating, breast tenderness, headaches, and joint or muscle pain

Treatment of PMDD 

PMDD needs a medical assistant. If you think you are one of those who are suffering from PMDD you should consult your doctor as soon as possible. 

The treatments for PMDD include:


Don’t be shy to talk to your family and book an appointment with a mental health counsellor.

Thoughts of suicide and anxiety attacks have a very adverse effect on the body. It not only affects the one who is suffering but also the family members. 


Antidepressants are called selective serotonin reuptake inhibitors (SSRIs) which regulate the serotonin level.

This can help in alleviating depression. Your doctor will prescribe your suitable antidepressants.


Over-the-counter pain relievers such as Nonsteroidal anti-inflammatory drugs (NSAIDs) which include ibuprofen(Advil), naproxen(Aleve) can be used as painkillers for relieving severe cramps and body aches. 


Your doctor may advise you to go for some stress management techniques which will help you to combat stress caused by PMDD.

When to see a doctor?

How to know that you need medical assistance?

Ask yourself a simple question: are these symptoms affecting your daily life?

Do they interfere with your routine and disturb you to no end?

Are they going out of control?

Are they interfering with your relationships with others?

If the answer is yes 

That means you need medical assistance.

Your doctor will ask you questions about

  • The symptoms
  • Frequency of symptoms
  • How does it affect you and your family
  • Timings of these symptoms
  • Your family history of PMS 


PMS is common, this is a part of our womanhood.

It can be controlled a lot by simply inculcating some good habits.

Maintaining a healthy and active lifestyle is all you need to fight with PMS.


I would suggest you pamper yourself more during these times

Book yourself a spa, go for a movie or just hangouts with your near and dear ones.

Read good books

Listen to refreshing music

And do watch some comedy videos, I assure you a good laugh is all you need.

Maybe your PMS will completely go away



What food helps with PMS?

Foods rich in calcium, vitamins, iron helps a lot in controlling PMS.
Along with this eat whole grain food and add complex carbohydrates to your diet.
Avoid excessive sugar and salts.
Avoid excess intake of coffee or alcohol.
And the most important yet most undervalued, stay hydrated.

Why do I feel so angry and irritated before my periods?

Estrogen and progesterone levels when spikes up before periods which results in mood swings, irritation, and anxiety.
Another factor is the change in serotonin level, it is a chemical present in your brain and gut that affects the moods, emotions, and thoughts of a woman.

Which exercises helps in relieving PMS?

1. Yoga and pilates
2. Low-intensity cardio
3. Low-volume strength training 
4. Light walking and jogging  
5. Include planks and squats
6. Aerobic exercises
7. Cycling
8. Short lap of swimming (with menstrual cup or tampons)
9. Dancing to your favourite music

Do I need a doctor to cure PMS?

Well PMS is pretty common and there is no need to go to the doctor.
With that being said, If you feel that they interfere in your daily routine and disturb you then probably you should seek medical advice.

What is PMDD?

PMDD stands for Premenstrual dysphoric disorder. PMS in its worst form becomes PMDD. It can cause severe depression and anxiety attacks. This is a rare condition and only affects 5% of women most of the childbearing age.
Some of the common symptoms of PMDD include-
1. Suicidal thoughts
2. Miserable feeling
3. Uncontrollable anger
4. Anxiety
5. Panic attacks
6. Binge eating or complete loss of appetite
7. Trouble in thinking and focusing
8. Feeling out of control
9. Insomnia
10. Crying without reason

What are the good supplements to have for PMDD?

According to the Mayo Clinic, these supplements may be worth a try:
Calcium– It can help ease physical and emotional symptoms.
Magnesium– It can help ease breast soreness and bloating.
Vitamin E– It can help reduce prostaglandins in the body. Prostaglandins are known to cause pain.
Vitamin B-6– It can help ease fatigue, irritability, and insomnia.

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