Premenstrual Syndrome: Symptoms, Causes & Treatment

Premenstrual syndrome is a group of physical, psychological, and behavioral symptoms that many women feel cyclically in the days before menstruation (in the second half of the cycle), and these symptoms usually fade with the start of the period or during its first days. It is among the most common conditions in women of reproductive age, and its severity varies greatly from one woman to another, possibly mild and negligible, or bothersome enough to affect daily life. It is thought to relate to the natural hormonal changes during the cycle and their effect on mood and body.

The symptoms of premenstrual syndrome vary and include physical and psychological aspects. Physical symptoms include: abdominal bloating and fluid retention, pain or tightness in the breasts, headache, tiredness and fatigue, back and muscle pains, changes in appetite and cravings for certain foods, and sleep disturbances. Psychological and mood symptoms include: mood swings, irritability and quick temper, tension and anxiety, sadness or crying, and difficulty concentrating. What distinguishes these symptoms is that they recur in a pattern linked to the menstrual cycle and resolve after it, and this cyclical pattern is the key to recognizing them.

In most cases, mild to moderate PMS symptoms can be controlled with lifestyle modifications without needing medications: regular exercise, adequate sleep, reducing salt, caffeine, and sugar, eating balanced meals, managing stress with relaxation techniques, and some supplements may help with the doctor's guidance. For more severe symptoms the doctor may prescribe painkillers or other medications or hormonal pills in certain cases. It is important to know that there is a more severe and less common form known as premenstrual dysphoric disorder, in which the psychological symptoms (especially mood swings, depression, and irritability) are very severe and disrupt life, and this requires specialized evaluation and treatment. Seeing a doctor is advised if the symptoms are severe or significantly affect daily life, relationships, and work.

• Physical: bloating, breast pain, headache, fatigue, back pains, appetite changes, sleep disturbance.
• Psychological: mood swings, irritability, tension and anxiety, sadness, difficulty concentrating.
• Appear before the period and resolve with its onset or after (a characteristic cyclical pattern).

• The natural hormonal changes during the menstrual cycle.
• The effect of these changes on mood and body.
• Individual factors making some women more sensitive to the symptoms.

• Recognizing the cyclical pattern of symptoms linked to the menstrual cycle.
• Recording symptoms over two or more cycles.
• Distinguishing from premenstrual dysphoric disorder (the more severe form) and other conditions.

Lifestyle modifications (sufficient for most cases)

• Regular exercise and adequate sleep.
• Reducing salt, caffeine, and sugar and balanced meals.
• Managing stress with relaxation techniques, and some supplements with the doctor's guidance.

Medications for more severe symptoms

• Painkillers or other medications or hormonal pills in certain cases by the doctor's decision.

Very severe symptoms may be premenstrual dysphoric disorder requiring evaluation. This content is educational and does not replace medical advice.

• Impact on daily life, relationships, and work with severe symptoms.
• Premenstrual dysphoric disorder (a more severe form with disabling psychological symptoms).
• Worsening of existing psychological conditions before the period.

• Regular exercise, a healthy lifestyle, and adequate sleep.
• Reducing salt, caffeine, and sugar and managing stress.
• Recording symptoms and seeing a doctor when they are severe.