NHS Factsheet

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PMS (premenstrual syndrome)

Read more about premenstrual syndrome (PMS), the symptoms women can experience before their period, and premenstrual dysphoric disorder (PMDD).

7 March 2023

Introduction

PMS (premenstrual syndrome) is the name for the symptoms women can experience in the weeks before their period. Most women have PMS at some point. You can get help if it affects your daily life.

Symptoms of PMS

Each woman's symptoms are different and can vary from month to month.

The most common symptoms of PMS include:

  • mood swings
  • feeling upset, anxious or irritable
  • tiredness or trouble sleeping
  • bloating or tummy pain
  • breast tenderness
  • headaches
  • spotty skin
  • greasy hair
  • changes in appetite and sex drive

Things you can do to help

Do

  • exercise regularly

  • eat a healthy, balanced diet – you may find that eating frequent smaller meals (every 2-3 hours) suits you better than eating 3 larger meals a day

  • get plenty of sleep – 7 to 8 hours is recommended

  • try reducing your stress by doing yoga or meditation

  • take painkillers such as ibuprofen ↗ or paracetamol ↗ to ease the pain

  • keep a diary of your symptoms for at least 2 to 3 menstrual cycles – you can take this to a GP appointment

Don't

  • do not smoke

  • do not drink too much alcohol

See a GP if:

  • things you can do to help are not working
  • your symptoms are affecting your daily life

A GP can advise you on treatments that can help.

Treating PMS

As well as changes to your lifestyle, a GP can recommend treatments including:

If you still get symptoms after trying these treatments, you may be referred to a specialist.

This could be a gynaecologist, psychiatrist or counsellor.

Complementary therapies and dietary supplements

Complementary therapies and dietary supplements may help with PMS, but the evidence of their effectiveness is limited.

They can include:

  • acupuncture
  • reflexology
  • supplements such as vitamin B6, calcium and vitamin D and magnesium (check with a GP or pharmacist if you are also taking medicines before starting to take regular supplements)

Causes of PMS

It's not fully understood why women get PMS.

But it may be because of changes in their hormone levels during the menstrual cycle.

Some women may be more affected by these changes than others.

Premenstrual dysphoric disorder (PMDD)

A small number of women may experience more severe symptoms of PMS known as premenstrual dysphoric disorder (PMDD).

Symptoms of PMDD are similar to PMS but are much more intense and can have a much greater negative impact on your daily activities and quality of life.

Symptoms can include:

  • physical symptoms such as cramps, headaches and joint and muscle pain
  • behavioural symptoms such as binge eating and problems sleeping
  • mental and emotional symptoms, such as feeling very anxious, angry, depressed or, in some cases, even suicidal

If you need urgent advice you can:

  • call a GP and ask for an emergency appointment
  • call 111 out of hours (they will help you find the support and help you need)
  • call a helpline, such as the Samaritans (call free on 116 123)

If you feel that you may be about to harm yourself, call 999 for an ambulance or go straight to A&E. Or you can ask someone else to call 999 or take you to A&E.

Read more about getting urgent help for mental health problems ↗.

The exact causes of PMDD are unknown but it has been linked to sensitivity to changes in hormones or certain genetic variations (differences in genes) you can inherit from your parents.

The Mind website has information about PMDD ↗.