preventing PMS

Overview

Premenstrual syndrome (PMS) is a group of physical and emotional symptoms that many people experience in the days before their period. It is not a disease — it is a normal response to the hormonal changes that happen during the menstrual cycle.

Yes. Most people who menstruate have some PMT (premenstrual tension) at some point in their lives. For many, the symptoms are mild, but for a smaller number, they can be severe enough to affect daily activities.

PMS affects people who have menstrual periods. It is most common in women in their 20s and 30s, but it can start or change at any time during the reproductive years, including the teenage years and the lead-up to menopause.

Symptoms

Common symptoms

• Bloating and a heavy or full feeling in the tummy
• Tender or swollen breasts
• Headaches or migraines
• Feeling tired or having trouble sleeping
• Mood swings, irritability, or feeling down
• Anxiety or feeling more emotional than usual
• Cravings for sweet or salty foods
• Cramps or a dull ache in the lower tummy

Symptoms in children

• Teenagers may experience similar symptoms, including moodiness, spots, tummy pain, and breast tenderness before their periods.
• They may also feel more sensitive or self-conscious about their changing bodies.
• If symptoms are very painful or affect school and friendships, it is still important to see a healthcare provider.

Symptoms in older adults

• In the years before menopause (perimenopause), PMS symptoms may become stronger or start earlier in the cycle.
• Some people notice more trouble sleeping, hot flushes, or mood changes. Periods may also become irregular.
• After menopause, PMS stops because periods stop, but other health issues can still cause similar symptoms, so check with a doctor if you are concerned.

Causes

Main causes

• The exact cause of PMS is not fully known, but it is linked to changes in hormone levels (oestrogen and progesterone) during the menstrual cycle.
• These hormone changes can affect brain chemicals such as serotonin, which helps control mood, sleep, and appetite.
• PMS is not caused by anything you did or did not do — it is a normal bodily response.

Risk factors

• High levels of stress
• Poor sleep or a busy, irregular routine
• Low amounts of regular exercise
• A diet low in certain nutrients, such as calcium or magnesium
• Smoking or drinking a lot of alcohol or caffeine
• Having experienced depression or anxiety in the past

When to see a doctor

See a doctor urgently if:

• If your symptoms make it hard to work, study, or look after yourself
• If you feel very depressed, anxious, or have thoughts of self-harm
• If your pain is not relieved by usual over-the-counter painkillers or makes you unable to function

Book a routine appointment if:

• If you get PMS most months and would like help managing it
• If you want to keep a symptom diary and ask a doctor about treatment options
• If you are thinking about starting a contraceptive method to help with PMS

Diagnosis

There is no specific test for PMS. A doctor or nurse will usually ask you about your symptoms and may ask you to keep a diary for one or two months to see if your symptoms are linked to your menstrual cycle.

Tests that may be done

• A symptom diary tracking your periods and symptoms daily
• A physical examination, if needed, to rule out other causes
• Blood tests are usually not needed, but they may be done if the doctor suspects another condition such as anaemia or a thyroid problem

What to expect at your appointment

A healthcare professional will listen to your experiences and ask about your medical history, periods, and any medicines you take. They may also ask about your mental health, because PMS can affect mood. Based on this, they can suggest a personal care plan.

Treatment

PMS cannot be cured completely, but most people find that symptoms can be greatly reduced with a combination of self-care, lifestyle changes, and professional support. Treatment is tailored to your own symptoms and needs.

Self-care at home

• Keep a record of your symptoms for a month or two to understand your own patterns.
• Aim for regular gentle exercise, such as walking, swimming, or cycling.
• Try to eat balanced meals and avoid too much sugar, salt, and caffeine, especially in the second half of your cycle.
• Get enough sleep and try to keep a regular sleep schedule.
• Find ways to relax, like deep breathing, yoga, or reading.
• Talk to a trusted friend or partner about what you are feeling.

Medical treatments

Some people benefit from certain types of hormonal contraception, which can help steady hormone levels. A doctor may also suggest cognitive behavioural therapy — a talking therapy that helps you manage thoughts and behaviours. Other medical options may be discussed with you, but they should always be prescribed and supervised by a qualified healthcare professional. Always ask your doctor or pharmacist before trying any supplement or medicine.

When is surgery considered?

It is omitted here because surgery is not a usual treatment for PMS. In very rare and severe cases, surgery to remove the womb may be considered, but this is a major decision and only after trying other treatments. You would need a full discussion with a specialist.

Living with this condition

Living with PMS means learning what helps you feel at your best. Planning ahead for the days before your period can help — for example, scheduling lighter tasks, making sure you have comfortable clothes, and giving yourself extra time to rest.

Lifestyle tips

• Try to keep stress low by taking regular breaks and doing things you enjoy.
• Reduce salt, sugar, alcohol, and caffeine in the second half of your cycle.
• Move your body every day — even a short walk can help lift your mood.
• Set a consistent sleep routine and try to avoid screens late at night.
• Consider a warm bath or a heat pad on your tummy to ease cramps.

Diet and exercise

A healthy diet rich in fruits, vegetables, whole grains, and lean proteins may help. Regular exercise is one of the best ways to boost your mood and reduce bloating and fatigue. Try to include some gentle movement most days of the week. Eat small, frequent meals to keep blood sugar stable, and drink plenty of water.

Mental health and emotional wellbeing

PMS can feel like an emotional rollercoaster. You may feel irritable, tearful, or anxious. These feelings are real, not imaginary. If they are severe, they can be a sign of a more serious condition called premenstrual dysphoric disorder (PMDD), which needs proper support.

Prevention

PMS cannot be fully prevented, because it is linked to natural hormonal changes. However, many people can reduce the severity of symptoms before they start by following a regular routine, eating well, exercising, and managing stress. Tracking your cycle can help you prepare for the harder days.

Vaccines

There is no vaccine for PMS. Keep your general vaccinations up to date to stay healthy overall.

Screening programmes

There is no routine screening for PMS. Regular check-ups for your general health are still worthwhile, especially if you notice any changes in your periods or symptoms.

Complications

If left untreated

• Severe PMS can affect relationships, work, and study if not addressed.
• It may increase feelings of anxiety or depression.
• Some people develop premenstrual dysphoric disorder (PMDD), a severe form of PMS with serious mood symptoms.

Long-term outlook

With the right support, most people with PMS find that their symptoms improve and are manageable. You can learn to cope better with the monthly cycle, and more severe problems can also be treated successfully. There is every reason to be hopeful.

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