Premenstrual syndrome (PMS)

Premenstrual syndrome (PMS) is a condition that affects a woman’s emotions, physical health, and behavior during certain days of the menstrual cycle, generally just before her menses. PMS is a very common condition. Its symptoms affect more than 90 percent of menstruating women.


PMS and PMDS are connected with female sex hormones. The complaints are common in women of childbearing age – many feel negatively affected during the days just before her menstruation.  


Many feel that symptoms worsen with age, but premenstrual syndrome does disappear when periods stop during menopause. A more severe form of PMS is premenstrual dysphoric disorder (PMDD) that is characterized by unusually severe symptoms, including anger, irritability, tension and anxiety. It can affect your relationships, everyday life and work.


It is not clear what causes premenstrual disorders, but they appear to have a particular link to the female sex hormone progesterone, also called yellow body hormone. After ovulation and up to menstruation, the progesterone level is particularly high. If you have PMS or PMDD, you are probably more sensitive to these changes.


Premenstrual disorders often cause both mental and physical changes. You may feel depressed, easily irritated or close to crying. It is common for the body to accumulate fluid so that you feel swollen and temporarily gain weight.


The symptoms can be more or less severe and usually begin after ovulation or just before the menstruation. When the menstruation starts, your symptoms usually disappear, but often return after the next ovulation.


Common mental symptoms include:



Common physical symptoms include:


  • swollen, tense and tender breasts
  • tense and swollen abdomen
  • general feeling of swelling in all the body
  • joint pain
  • headaches
  • fatigue and lack of energy
  • increased appetite.


In the case of PMDD, the mental disorders tend to be more severe and affect your everyday life. You may feel strong anxiety, have concentration difficulties and experience symptoms similar to depression. Other illnesses can be temporarily aggravated by PMS and PMDD, such as migraine and genital herpes.


PMS is characterized by temporary problems after ovulation, which usually disappear when the menstruation starts. Depression can cause similar psychological symptoms. Sometimes, chronic fatigue syndrome and thyroid problems such as hypothyroidism can be mistaken for PMS.

Prevention and Protection

PMS can often be alleviated by being physically active – exercise counteracts both physical discomfort and depression, and normalizes sleep. It can also help to keep a journal of your menstrual cycle to be prepared for hormonal changes after ovulation. At pharmacies you can find non-prescription pain-relieving drugs.


Here’s how you can relieve your symptoms by yourself:


  • be physically active – exercise releases endorphin which counteracts depression
  • eat a healthy diet – calcium and vitamin D have a particularly positive impact on PMS and PMDD
  • sleep enough – after rest, your body can better fight stress
  • drink less coffee 
  • avoid alcohol – the negative effects can aggravate your symptoms
  • If you smoke, try to quit smoking – smoking affects your body negatively and can also strengthen PMS and PMDS.
  • try relaxation exercises – studies show that yoga, acupuncture and mindfulness can have a positive effect
  • Seek help if you feel bad – if self-care doesn’t help, contact a doctor or psychologist to alleviate your symptoms.


Menstruation affects different people in different ways, so treatment also varies. Some need no help at all, while others have severe symptoms that can be alleviated in a variety of ways.


Sometimes antidepressants can help with PMS and PMDD, even though there is no clear serotonin deficiency. They are then used only during the period before menstruation. In some women hormonal contraceptives can help reduce premenstrual disorders. Studies also show that cognitive behavioral therapy (CBT) can be a good alternative to drugs.


If you use any form of hormones, such as birth control pills, PMS or PMDD may be a side effect of the medicines. In this case, it may be advisable to try another method of contraception.

When to consult a doctor

Seek care if PMS or PMDD negatively impact the quality of your life, if you have severe physical or mental symptoms. Many people feel uncomfortable during these days – but there is help.

How APPOTEK can help

You can contact us at APPOTEK for help with PMS and PMDD. A nurse or physician will make an individual assessment based on your symptoms during the care meeting. You may then be prescribed medicines or referred for further treatment.


In the case of PMS, we can also offer continuous follow-up and visits to doctors and psychologists – for example, you can get help with cognitive behavioral therapy.


Valeria Chernikova, Neurologist, M.D.