Premenstrual syndrome (PMS) is now widely recognised as a medical condition that affects many women in the days leading up to their period. More than 100 symptoms are sometimes attributed to PMS. These tend to improve once the period starts. PMS is also sometimes called premenstrual tension (PMT).


  • Pain & discomfort in the abdomen.
  • Fluid retention and bloating.
  • Breast tenderness.
  • Headaches.
  • Changes to skin & hair.
  • Insomnia.
  • Tiredness.
  • Nausea.
  • Weight gain (up to 1kg)
  • Dizziness.
  • Mood swings.
  • Feeling emotional.
  • Feeling irritable or angry.
  • Forgetfulness.
  • Changed libido.
  • Appetite changes.
  • Clumsiness.
  • Restlessness.

What causes PMS?

Fluctuating hormones are thought to be the main cause of PMS. The female sex hormones oestrogen and progesterone rise and fall throughout your menstrual cycle. PMS tends to improve after the menopause when hormone levels are stable.

Changes in levels of brain chemicals are also thought to cause some PMS symptoms. Neurotransmitters (brain chemicals) such as serotonin, that help regulate mood, also fall and rise with our menstrual cycle. Low levels of serotonin likely contribute to PMS symptoms such as insomnia and tiredness.

Women who are obese or too sedentary also seem more prone to PMS, and high stress levels can make PMS worse. Alcohol and caffeinated drinks, plus a deficiency in vitamins and minerals may also aggravate the condition.

How is PMS treated?

Over-the-counter painkillers such as aspirin and ibuprofen can help ease stomach cramps, sore breasts, headaches and muscle and joint pain associated with PMS.

Sometimes contraceptives may be prescribed to help stabilise hormone levels which may be causing mood swings. For more severe PMS antidepressants (selective serotonin reuptake inhibitors or SSRIs) are sometimes prescribed. These help relieve tiredness, food craving, insomnia and mood changes.

If all other methods have failed Gonadotrophin-releasing hormone (GnRH) analogues may get prescribed. These are synthetic hormones that block the production of oestrogen and progesterone to create a temporary menopause and stop periods. They are given in the form of an injection. GnRH is only given when PMS is debilitating. This form of PMS is known as premenstrual dysphoric disorder or PMDD.

Alternative remedies & self-help:

Whatever your symptoms, sufferers can usually benefit from dietary changes, exercise, relaxation, stress avoidance and other lifestyle modifications.

Exercise such as walking and swimming can help alleviate tiredness and depression, while stretching and breathing exercises such as yoga and pilates help reduce stress and insomnia.

Calcium-rich food such as milk may improve some physiological symptoms of PMS, as will eating fruit and veg which are rich in vitamins and minerals. You can also take supplements such as magnesium, vitamin B6 and vitamin E.

Large meals and salty food should be avoided to reduce bloating and fluid retention. It's also important to keep well hydrated to reduce headaches and tiredness.

Alternative remedies such as homeopathy and acupuncture are sometimes used to treat PMS.