Written by Dr. Joseph Sgroi

What is it?

PMS refers to physical and emotional symptoms that some women experience in the lead up to menstruation. Symptoms often occur in the one to two weeks before hand and stop once bleeding begins.

PMS can interfere with day to-day activities and relationships and the severity is often measured based on this.

What are the symptoms of PMS?

There are more than 150 symptoms associated with PMS and they range from physical, behavioural, emotional, and cognitive.

The most common symptoms are:

Physical SymptomsEmotional Symptoms
Abdominal bloatingMood Swings
Extreme sense of fatigueIrritability
Tender breastsAnxiety
HeadachesSadness
Hot flushesDepression
DizzinessFood cravings
Skin outbreaksAggression
MigrainesTension
ConstipationLower coping ability
DiarrhoeaReduced libido
CrampsLess interest in doing activities

What causes it?

It is not known what causes PMS. There are a lot of factors that may contribute to PMS and increase the symptoms and many of them related to the hormonal changes our bodies go through.

Some of factors that may contribute to PMS are:

  • Your genetic makeup
  • Stress
  • Weight – Having a BMI higher than 30 makes you three times more likely to have PMS
  • Smoking – increases the likelihood of having PMS symptoms by 50%
  • Cultural and social environment

How is it PMS diagnosed?

There are no tests to diagnose PMS. We need to look at medical history and well us understand all the symptoms a woman is experiencing.

To help understand and identify whether you have PMS it is recommended you keep a diary which includes period dates and any symptoms you experience during the month. You will need to keep track of this information for at least 2 months and then discuss it with your GP who you can work through next steps with.

How is PMS treated? (Premenstrual syndrome)

There are ways to reduce symptoms of PMS through lifestyle and dietary changes as well as hormones, supplements and medications.

Some things you can do include:

  • Get active – try to exercise for 30 minutes a day. This will increase the endorphins in your body which can help reduce symptoms.
  • Quit smoking!
  • Reduce alcohol and caffeine, especially in the 2 weeks before your period.
  • Increase your water – make sure you are getting at least 8 glasses in a day.
  • Reduce the sugar and salt in your diet.
  • Keep healthy snacks on hand – these will help if you are having a craving.

Hormones, supplements and medications should be discussed with your GP.

Premenstrual Dysphoric Disorder– PMDD (Premenstrual syndrome)

Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS which affects 2 percent of women worldwide. It can be debilitating and most women with PMDD have symptoms of anger, irritability, anxiety and depression.

While many of the symptoms are similar to PMS they are usually far more intense and women with PMDD experience psychological distress as well as:

  • Trouble sleeping
  • Panic attacks
  • Feelings of sadness, or thoughts of suicide
  • Crying and mood swings
  • Feeling out of control
  • Irritability and/or anger that may affect other people and lasts a seemingly long time

Premenstrual Dysphoric Disorder is also diagnosed with a similar method to PMS diagnoses, examination and exploration of your diary of events. To be diagnosed with PMDD you must have 5 or more symptoms.

PMDD is often treated with medication and lifestyle changes. From antidepressants to contraception medication which stop ovulation, your GP will discuss the treatment plan once diagnosed.

Where to get help? (Premenstrual syndrome)

If you have concerns about your symptoms and your feelings in the lead up to your period, I recommend first starting a diary to keep a record of what is happening.


Next step is to make an appointment with your GP who will be able to help further.

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