Premenstrual Syndrome: What is PMS?


Amanda Olson - DPT
Medically Reviewed By Dr. Amanda Olson, DPT, PRPC

PMS | Causes | Symptoms | When to See a Doctor | Relief & Remedies | Conclusion

What is PMS?

Premenstrual syndrome (PMS) is a common female condition that causes a wide range of symptoms from physical pain to emotional fluctuations. It is thought to affect over 90% of women approximately 7-14 days before menstruation. 

Symptoms, which can include mood swings, breast tenderness, food cravings, and sleeping problems can present as mild to intense, depending on the individual. 

Although the cause of PMS is not clearly understood, researchers believe the recurring symptoms are linked to a change in hormone levels at the start of the menstrual cycle. 

That said, symptoms do not have to ruin women’s lives every month. Some knowledge and understanding, as well as natural remedies, can help to ease and eliminate many PMS symptoms.          

What Are the Causes of Premenstrual Syndrome?

Precisely what causes PMS is yet to be determined, however, several studies suggest a connection between cyclical fluctuations in hormones and chemical changes in the brain.

As hormone levels fluctuate at certain times of the month, women feel the result both physically and emotionally. An increase in estrogen and progesterone, for example, is thought to contribute to irritability, mood swings, and anxiety. Alternatively, a drop in estrogen and progesterone causes menstruation to begin. 

Chemical changes in the brain are also thought to influence PMS. A decrease in the production of serotonin (a brain chemical known as a neurotransmitter) can greatly affect a woman’s frame of mind and emotions. Low serotonin levels may also escalate food cravings, and sleep problems.

PMS Symptoms

PMS symptoms generally begin around day 14 of the 28-day menstrual cycle, typically coinciding with ovulation. And symptoms can last anywhere from 4-14 days. 

As many as 80% of women have reported experiencing at least one symptom of PMS, 20-32% have reported moderate symptoms, and 3-8% have experienced severe symptoms. Some PMS symptoms can worsen with age as well as if there is an underlying condition.

What Are the Emotional Symptoms of PMS?

  • Feelings of anxiety
  • Depressed mood
  • Crying 
  • Mood swings & irritability
  • Food cravings 
  • Trouble sleeping (insomnia)
  • Reduced concentration
  • Change in libido

What Are the Physical PMS Symptoms? 

  • Muscle Pain
  • Cramping
  • Headaches
  • Fatigue
  • Fluid retention 
  • Abdominal bloating
  • Breast tenderness
  • Acne or skin flare-ups
  • Constipation or diarrhea
  • Alcohol intolerance

The promising news is that most women only experience a few rather than all of these symptoms. And symptoms usually disappear within seven days of the menstrual period beginning.

When You Should See a Doctor About PMS

While most women experience mild symptoms, a small number of women confront debilitating PMS symptoms each month. This form of PMS is called premenstrual dysphoric disorder (PMDD).

Symptoms of PMDD include but are not limited to, feelings of depression during PMS, severe mood swings, anger, disabling anxiety, difficulty concentrating, irritability, and hypertension.

Women who are unable to manage PMS symptoms with lifestyle changes and natural remedies, or find that symptoms are debilitating enough to affect their health or daily lives, should consult with a doctor about the possibility of medication to treat PMDD.  

Easing Symptoms - PMS Relief

Healthy lifestyle changes, some dietary modifications, and natural remedies can significantly help to relieve PMS symptoms for most women.

Dietary Changes

Eating smaller and more frequent meals helps to reduce abdominal bloating. Lowering the intake of raw salt and salty foods will reduce fluid retention. And consuming more fruit, vegetables, and whole-grain foods will limit food cravings. It is also highly recommended to avoid alcohol and caffeine during PMS flare-ups. 

Exercise Helps 

Setting aside thirty minutes at least three times per week to exercise not only improves overall health but is especially helpful in managing PMS symptoms. It doesn’t have to be anything strenuous. A brisk walk with a friend, some yoga or aerobics, cycling, or light jogging will help to lift low moods, relieve anxiety, and boost energy levels that combat fatigue before your period.     

Stress Busting 

Reducing stress goes a long way toward improving sleep during PMS. Practicing breathing exercises and yoga helps to release anxiety and stress, as do relaxing massages and time spent in the fresh air.  

Natural Remedies & Supplements for Premenstrual Syndrome

Herbal remedies such as ginger and chasteberry (also known as Vitex), as well as certain vitamin supplements, have been reported to relieve PMS symptoms. 

Vitex (Chasteberry) Supplements

Widely known to help rebalance hormones like estrogen and progesterone, vitex supplements such as the  Vitex Chasteberry Supplement from Intimate Rose with added ginger) is recommended by women’s health experts to relieve PMS symptoms. 

In a recent study, 93% of women who took vitex supplements over three consecutive months reported a significant improvement in PMS symptoms such as pelvic discomfort, irritability, premenstrual acne, and cravings. Research also suggests that vitex (chasteberry) can reduce headaches during menstrual cycles by 66%. 


Vitamin supplements such as magnesium, calcium, vitamins B-6, and vitamin E are also recommended to alleviate symptoms of PMS. 


Acupuncture, an ancient component of Chinese medicine where tiny stainless steel needles are gently inserted into the skin at specific energetic points of the body, is recommended by many women to help ease PMS symptoms.  


The possible symptoms of premenstrual syndrome are wide-reaching & varied and include both physical and emotional side effects. 

The good news is most women only experience a few rather than all symptoms and they typically disappear within four days of the commencement of the menstrual period. 

While healthy lifestyle changes, dietary adjustments, and herbal supplements can reduce or eliminate PMS symptoms for most women, some cases may require medical treatment. 

Keeping a record of PMS symptoms for two to three menstrual cycles will help your healthcare provider develop the most suitable treatment plan for you. 


Mayo Clinic - Premenstrual syndrome (PMS): Definition

Cleveland Clinic - Premenstrual dysmorphic disorder (PMDD). (2014, December 11)

A. Ambrosini, C. Di Lorenzo, G. Coppola, F. Pierelli - Use of Vitex agnus-castus in migrainous women with premenstrual syndrome:

M. Diana van Die, Henry G. Burger, Helena J Teede, Kerry M. Bone - Vitex agnus-astus Extracts for Female Reproductive Disorders -

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