Health Concerns

Premenstrual Syndrome (PMS)

Signs and Symptoms

The specific PMS or PMDD symptoms each woman experiences may differ. However, a woman will typically experience the same symptoms from one cycle to the next. Symptoms occur during the luteal phase of the menstrual cycle, usually peak approximately two days before menstruation, and are typically relieved by the start of menstruation or a few days thereafter. In some women, symptoms linger into the next cycle, but there must be a symptom-free period of time before the next ovulatory phase in order for the condition to qualify as PMS. PMS, by definition, cannot occur after menopause. Nevertheless, symptoms similar to those caused by PMS can occur during perimenopause or after the reproductive years, particularly if a woman is receiving combined estrogen-progestogen hormone replacement (Rapkin 2014; Yonkers 2008).

It has been reported that there are over 150 symptoms associated with PMS or PMDD (Alvero 2014). However, irritability, anxiety, depression, mood swings, bloating, abdominal discomfort, breast tenderness, headache, and fatigue are the most common symptoms. Many of these symptoms can be further aggravated by stress, alcohol or caffeine consumption, and smoking (Rapkin 2014; Alvero 2014).

Table 1:  Common Physical, Psychological, and Behavioral Symptoms of PMS or PMDD*


Physical Symptoms

  • Abdominal bloating
  • Acne
  • Breast engorgement and tenderness
  • Constipation or diarrhea
  • Headache
  • Joint or muscle pain
  • Poor coordination
  • Swelling of feet and legs
  • Weight gain

Psychological Symptoms

  • Anxiety
  • Change in libido
  • Depression
  • Fatigue
  • Irritability
  • Mood swings
  • Panic attacks
  • Reduced concentration
  • Reduced confidence
  • Sleep disturbance (insomnia or excessive sleeping)

Behavioral Symptoms

  • Angry outbursts
  • Decreased motivation
  • Food cravings
  • Hostility
  • Increased appetite
  • Paranoia
  • Withdrawal from others

*Derived from (Alvero 2014; Yonkers 2008; Rapkin 2014)