Premenstrual syndrome, often called PMS, is a complex, yet extremely common, health concern for women. Symptoms usually occur during the days leading up to menses and go away after the first day or two of menstrual flow. PMS involves a variety of physical, mental and behavioral symptoms tied to a woman’s menstrual cycle. The key to diagnosis is that there is a symptom-free time after the menstrual flow. If your PMS symptoms do not go away within 3-4 days of menses, it is important to seek out medical attention. Blood and x-ray tests can be needed to rule out other potential causes. It is also important to keep in mind that concurrent medical conditions can dramatically affect the severity of the PMS symptoms.

Common PMS emotional symptoms include irritability, oversensitivity, depression, crying and mood swings. Cravings for certain foods like chocolate and salty foods are not unusual during the PMS period. Some physical signs include abdominal cramping, headaches, breast tenderness and weight gain or bloating. For some women, these symptoms can be controlled with medications and lifestyle changes such as exercise and nutrition.

Dietary strategies that may help include:
  1. Decreasing caffeine intake.
  2. Avoiding foods high in salt, especially during the week before your period.
  3. Avoiding candy, soda and other sugary foods.
  4. Eating small, frequent, healthy meals.
Supplements that may help include:
  1. Vitamin E taken at 300-400 IU daily (unless already in your multivitamin). Good sources of vitamin E include avocado, spinach and sunflower seeds.
  2. Calcium taken at 1,200 mg total daily through a combination of normal eating and supplementation.
  3. Magnesium taken at 300-400 mg daily. Good sources of magnesium include nuts, legumes, whole grains, dark green vegetables and seafood.

Lifestyle changes that may help, include regular aerobic exercise and movement programs. Physical activity overall improves general health and helps to release tension and anxiety. Muscle relaxation techniques and massage therapy also help relieve many of the mood symptoms associated with PMS.

Certain herbs are thought to be useful in combating PMS, but more research is needed to truly identify their complete benefit. The following might help alleviate symptoms:

  1. Black cohosh (40-160 mg daily) may help with abdominal discomfort associated with PMS.
  2. Evening primrose oil helps with breast tenderness, bloating and weight gain.
  3. Chasteberry helps with irritability, mood swings, headache and breast fullness. Do not use if you take birth control pills.

When the typical symptoms of PMS become so severe that your daily activities and lifestyle are drastically altered, talk with your health care provider. PMS can still be present and aggravate symptoms related to the other conditions, but it cannot be the sole cause of constant or noncyclic symptoms. Blood tests, among other tests, may be ordered to help rule out other potential issues.