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Premenstrual syndrome, or PMS, refers to the physical and emotional symptoms that many women experience in the lead-up to a period (menstruation). Symptoms ease during the woman’s period and there is usually at least one symptom-free week before the symptoms return.

It is thought that most women who have periods have premenstrual symptoms, ranging from mild (in 75 per cent of women) to severe (in 20 to 30 per cent of women). For 8 per cent of women with severe symptoms, PMS is linked to reduced quality of life.

PMS is a complex condition that includes physical and emotional symptoms. Research shows that:

Although the cause of PMS isn’t clear, you can manage it with medication and other strategies.

PMS differs from one woman to the next. PMS symptoms can include physical and mood symptoms.

Physical symptoms of PMS can include:

Mood symptoms of PMS can include:

The cause of PMS is unknown. Factors that may contribute to PMS symptoms include:

Incorrect theories about the causes of PMS have included oestrogen excess, progestogen deficiency, vitamin B6 deficiency, abnormal glucose metabolism and electrolyte imbalances.

Between 3 and 8 per cent of menstruating women suffer from seriously debilitating PMS, which is sometimes known as premenstrual dysphoric disorder (PMDD). The symptoms may have a serious impact on a woman’s mental health and can be so severe that an affected woman is unable to carry out her normal activities.

There are no specific diagnostic tests for PMS, as hormone levels are within the normal range. Diagnosis relies on an examination of your medical history and a description of the symptoms.

In most cases, it is recommended that you keep a daily symptoms diary to help identify whether you have PMS. Include the details of your menstrual cycle – for example, the first and last days of your menstrual period. Keep this daily diary for at least two menstrual cycles. If the symptoms don’t resolve at menstruation, other causes may be suspected and would need to be investigated.

If you’re not sure if you have PMS, or if you need help understanding your symptoms, talk to your doctor.

There is no cure for PMS, but symptoms may be managed successfully with:

You may have to experiment to find the balance of treatments that works best for you.

It’s a good idea to continue your PMS diary and record any symptoms while you try out these therapies and treatments. Consult with your doctor or healthcare professional during this trial period.

Recommended lifestyle changes include:

If you experience PMS symptoms you may crave high-fat and high-sugar foods like chocolate, biscuits and ice cream, which can cause weight gain.

You can manage your weight and help reduce your PMS symptoms by making a few dietary changes. You might like to try:

There are different types of medications and hormone treatments available to help you manage your symptoms.

Treatments that have been proven to relieve symptoms include:

Treatments that have not been proven to relieve symptoms include:

Many women feel they benefit from a variety of other therapies, such as cognitive behaviour therapy, and complementary therapies.

If you would like to use complementary therapies, it is important to seek advice from a qualified professional. Let your doctor know about any herbal or complementary therapies you are using. Complementary therapies should be viewed as a medicine and treated with the same respect.

Complementary therapies that can help reduce PMS symptoms include calcium, vitamin D and vitex agnus-castus. Gingko biloba, evening primrose oil, lemon balm, curcumin, vitamin B6, isoflavones, St John’s wort and wheatgerm have been shown to provide some benefit.

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