Premenstrual syndrome (PMS) is defined as symptoms that appear in the days leading up to the menstrual period (bleeding). With nine out of ten women experiencing symptoms, many accept PMS as a normal part of being female. This is unfortunate, because lifestyle changes and treatments are available that can help you reduce or manage your symptoms.

What is it?

PMS varies for each woman. Most only have a few symptoms out of a possible 200 symptoms that women can experience. The main ones are:

  • Physical: fluid retention, breast swelling or discomfort, muscle aches, constipation or diarrhoea, pelvic pain, clumsiness, appetite changes/food cravings, acne, fatigue, insomnia
  • Psychological: irritability, depression, poor concentration or judgement, tension or anxiety aggression, mood swings, decreased feelings of wellbeing, social withdrawal, restlessness

A specific cause of PMS hasn’t been identified. However it’s known that normal ups and downs of hormones are associated with PMS and when these changes stop, such as during pregnancy or after menopause, symptoms disappear. In addition, PMS is more likely in women with depression, high stress and poor diet.


For mild cases, lifestyle changes are recommended, including:

  • Eat small, frequent meals
  • Increase low-GI (Glycaemic Index) foods, which digest more slowly
  • Avoid salt, alcohol, caffeine
  • Regular exercise
  • Relaxation techniques
  • Psychological treatment such as Cognitive Behavioural Therapy (CBT)

Complementary treatments with good medical research include: calcium and vitex agnus-castus (herb). Others, such as evening primrose oil, are popular but there’s not enough research to support recommending them.

Conventional medications that may be recommended include: aspirin or anti-inflammatories for headache and muscle ache symptoms, anti-depressants (SSRIs) for severe PMS, and diuretics when lifestyle changes don’t reduce fluid retention and swelling. Oral contraceptive (the pill), despite widespread usage, in fact has little research evidence to support recommending it.

Speak to your GP for more information. Visit

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