(PMS) is characterized by physical and emotional symptoms that occur in a regular cycle beginning 1-2 weeks before the onset of menstrual flow and improve when menstrual bleeding starts. These symptoms can be extremely distressing and may include:
IrritabilityMood swingsAnxietyDepressionLow self-esteemDifficulty concentratingSleep problemsAppetite changes (sugar and/or salt cravings; overeating)Weight gainFatigueBloatingHeadacheBreast swelling and tendernessPalpitationsLightheadednessGastrointestinal upsetMuscle pain
Although the symptoms of PMS may vary, the most common complaints are: IrritabilityBackacheMuscle painBloating
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder
(PMDD) is a severe form of PMS. According to the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders
(DSM-5), 5 or more of the following symptoms must be present for a diagnosis of PMDD:
Physical symptoms, such as breast tenderness, bloating, and joint painSevere depression, possibly with suicidal thoughtsAnxiety, tension, or panic attacksSevere irritability and angerMood swingsDifficulty concentratingFatigueTearinessDifficulty sleepingFeeling out of controlLack of interest in relationships, activitiesFood cravings or binges
Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.
Premenstrual syndrome (PMS). Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-syndrome-pms.html. Updated April 2014. Accessed August 18, 2016.
Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at:
http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.html. Updated December 23, 2014. Accessed August 18, 2016.
Last reviewed September 2016 by Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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