Premenstrual syndrome - Navani Menopause Clinic

Premenstrual Syndrome (PMS)

PMS is a collection of recurring physical and psychological symptoms which impact quality of life and typically appear 2 weeks before a period and resolve with the onset of periods.

Affected women with PMS should keep a PMS diary for at least 2 cycles recording their symptoms. A Daily Record of Severity of problems (DRSP) chart can be accessed at HERE.

Further information on PMS can be accessed at www.pms.org.uk

If you prefer to record your symptoms on an app - a free PMDD app (ME vs PMDD) is available :

App Store

Play Store

FAQs - Premenstrual Syndrome (PMS)

What are the typical Symptoms and how is it diagnosed?

Symptoms can be physical or psychological, which may impact your quality of life.

Physical: bloating, breast tenderness, headaches and weight gain. Some women experience worsening of migraines, asthma and epilepsy attacks in the premenstrual phase.

Psychological: depression, mood swings, tension, increase anxiety, irritability, food cravings.

What is Premenstrual dysphoric disorder (PMDD)?

PMDD is a severe form of PMS, mainly a mood disorder which can affect 3- 5% of women in reproductive age group. This includes physical symptoms and psychological symptoms of depression, irritability, anxiety, suicidal thoughts, mood swings, emotional lability, difficulty concentrating, lethargy, excessive sleep or in some cases insomnia which recur 1-2 weeks before a period and symptoms remit with onset of periods and these have a significant impact on daily life.

It is important to distinguish PMDD from other mental health disorders such as depression, bipolar and perimenopause as these may have similar symptoms.

What is the cause of PMS and PMDD?

The exact cause is not known but some women are very sensitive to progesterone, a hormone released after ovulation. Other contributory factors are low levels of serotonin and a metabolite of progesterone called allopregnanolone which has an effect on GABA receptors in the brain.

What are the treatment options?

Complementary treatments are recommended first, however these may not work for all women. These include Cognitive behavioural therapy, lifestyle modifications, yoga, managing stress, meditation and regular exercise.

Herbal treatments such as Agnus Castus maybe helpful.

Vitamin B6 (Pyridoxine) with a dose that does not exceed 10 mg daily.

Reducing alcohol, caffeine intake can help reduce symptoms.

Antidepressants are first line treatments for PMDD and severe PMS, and can be taken daily or during second half of cycle after ovulation. Contraception is advised when using these treatments.

Hormonal treatments: Combined contraceptive pill (specific ones) taken continuously instead of cyclically every month with a break is a licensed treatment for PMS. In severe cases, your doctor will discuss other hormonal treatment options with you.