Premenstrual syndrome

Alternative Names

Symptoms

A wide range of physical or emotional symptoms have been associated with PMS. By definition, such symptoms must occur during the second half of the menstrual cycle (14 days or more after the first day of the menstrual period) and be absent for about 7 days after a menstrual period ends (during the first half of the menstrual cycle).

The most common symptoms include:

• Headache
• Swelling of ankles, feet, and hands
• Backache
• Abdominal cramps or heaviness
• Abdominal pain
• Abdominal fullness, feeling gaseous
• Muscle spasms
• Breast tenderness
• Weight gain
• Recurrent cold sores
• Acne flare-ups
• Nausea
• Bloating
• Constipation or diarrhea
• Decreased coordination
• Food cravings
• Less tolerance for noises and lights
• Painful menstruation

Other symptoms include:

• Anxiety or panic
• Confusion
• Difficulty concentrating
• Forgetfulness
• Poor judgment
• Depression
• Irritability, hostility, or aggressive behavior
• Increased guilt feelings
• Fatigue
• Slow, sluggish, lethargic movement
• Decreased self-image
• Sex drive changes, loss of sex drive
• Paranoia or increased fears
• Low self-esteem

Exams and Tests

There are no physical examination findings or lab tests specific to the diagnosis of PMS. It is important that a complete history, physical examination (including pelvic exam), and in some instances a psychiatric evaluation be conducted to rule out other potential causes for symptoms that may be attributed to PMS.

A symptom calendar can help women identify the most troublesome symptoms and to confirm the diagnosis of PMS.