PMS (premenstrual syndrome) is the name for the symptoms women can experience in the weeks before their period. Most women have PMS at some point. You can get help if it affects your daily life.

Symptoms of PMS

Each woman's symptoms are different and can vary from month to month. The most common symptoms of PMS include:

• mood swings
• feeling upset, anxious or irritable
• tiredness or trouble sleeping
• bloating or tummy pain
• breast tenderness
• headaches
• spotty skin
• greasy hair
• changes in appetite and sex drive

Things you can do to help

Do

• exercise regularly
• eat a healthy, balanced diet – you may find that eating frequent smaller meals (every 2-3 hours) suits you better than eating 3 larger meals a day
• get plenty of sleep – 7 to 8 hours is recommended
• try reducing your stress by doing yoga or meditation
• take painkillers such as ibuprofen or paracetamol to ease the pain
• keep a diary of your symptoms for at least 2 to 3 menstrual cycles – you can take this to a GP appointment

Don’t

• do not smoke
• do not drink too much alcohol

Treating PMS

As well as changes to your lifestyle, a GP can recommend treatments including:

• hormonal medicine – such as the combined contraceptive pill
• cognitive behavioural therapy – a talking therapy
• antidepressants
• dietary supplements

If you still get symptoms after trying these treatments, you may be referred to a specialist. This could be a gynaecologist, psychiatrist or counsellor.

Complementary therapies and dietary supplements

Complementary therapies and dietary supplements may help with PMS, but the evidence of their effectiveness is limited. They can include:

• acupuncture
• reflexology
• supplements such as vitamin B6, calcium and vitamin D and magnesium (check with a GP or pharmacist if you are also taking medicines before starting to take regular supplements)

Causes of PMS

It's not fully understood why women get PMS. But it may be because of changes in their hormone levels during the menstrual cycle. Some women may be more affected by these changes than others.

Premenstrual dysphoric disorder (PMDD)

A small number of women may experience more severe symptoms of PMS known as premenstrual dysphoric disorder (PMDD). Symptoms of PMDD are similar to PMS but are much more intense and can have a much greater negative impact on your daily activities and quality of life. Symptoms can include:

• physical symptoms such as cramps, headaches and joint and muscle pain
• behavioural symptoms such as binge eating and problems sleeping
• mental and emotional symptoms, such as feeling very anxious, angry or depressed.

The exact causes of PMDD are unknown but it has been linked to sensitivity to changes in hormones or certain genetic variations (differences in genes) you can inherit from your parents.