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Health Information | 04/19/2023

Navigating Premenstrual Syndrome

By  Courtney LeBlanc, CNM
Premenstrual syndrome, more commonly known as PMS, is a combination of physical and emotional symptoms that menstruating people experience after ovulation and before the start of their period. Research shows that up to 90 percent of menstruating people experience PMS symptoms from time to time, making it a common issue. While the cause of PMS is unclear, researchers believe it’s related to the changing hormone levels of the menstrual cycle.

Symptoms of PMS

Many menstruating people experience painful and inconvenient symptoms before the start of their period. Understanding why it happens, what it is, and finding ways to relieve symptoms can positively impact your mental and physical health. Physical symptoms can include:
  • Cramps
  • Swollen/tender breasts
  • Bloating
  • Constipation or diarrhea
  • Headaches
  • Fatigue
  • Increased hormonal acne
Emotional symptoms can include:
  • Mood swings
  • Changes in sleep
  • Changes in appetite
  • Increased irritability
  • Depression, sadness, and crying
  • Anxiety
PMS is different for everyone. Some people will feel nothing or have very mild symptoms, while others may find it hard to do everyday activities. Symptoms typically occur in a predictable pattern, but the physical and emotional changes experienced can vary. As you approach menopause, hormone fluctuation might cause an increase in PMS symptoms. However, PMS symptoms stop once you stop getting a period.

What can be done to relieve PMS symptoms?

Many people find that mild symptoms go away once their period starts and they are back to normal. However, there are things you can do at home to relieve some of your PMS symptoms.
  • Take over-the-counter pain relievers such as ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol)
  • Take a hot bath or use a heating pad to reduce cramps and bloating
  • Aerobic exercise can reduce depression and fatigue and help lessen the symptoms of PMS
  • Eat a balanced diet and avoid salt, caffeine, and alcohol
  • Try meditation, massage therapy, yoga, and breathing exercises to promote relaxation and sleep
  • Don’t smoke. Smoking can increase and worsen PMS symptoms.

When to see your clinician for PMS

For most people, PMS symptoms are easily managed and don’t impact their daily lives. If you find that your PMS becomes unmanageable with lifestyle changes and it starts to affect your health, it may be time to talk with your Atrius Health provider. If your symptoms are severe, they may suggest hormonal birth control methods or an antidepressant to help with your mood. Severe cramps that aren’t relieved by over-the-counter pain medication and last longer than your period can be a sign of endometriosis, a condition where the lining of your uterus grows outside of your uterus, or pelvic inflammatory disease, an infection in your reproductive organs. These conditions can require treatment beyond what is recommended for PMS, so you should be sure to discuss all your symptoms with your provider to determine if it is a cause for concern.
Courtney LeBlanc CNM

About The Author

Courtney LeBlanc, CNM

Courtney LeBlanc is a board-certified nurse midwife at our Cambridge practice. Courtney received her BS in nursing from Simmons University in Boston and her MS in nursing from Georgetown University in Washington, DC. Courtney’s clinical interests include natural childbirth and contraception.

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