Highlights:

Premenstrual Syndrome Symptoms

Premenstrual syndrome (PMS) can produce physical and emotional or behavioral symptoms.

Physical symptoms of PMS may include:

• Breast engorgement and tenderness
• Abdominal bloating
• Constipation or diarrhea
• Headache and migraine
• Swelling of the hands or feet
• Weight gain
• Clumsiness
• Nausea and vomiting
• Muscle and joint aches or pains

Emotional and behavioral symptoms of PMS may include:

• Depression (severe depression before menstruation, called premenstrual dysphoric disorder, occurs in about 5% of women with PMS)
• Anxiety and panic attacks
• Insomnia
• Change in sexual interest and desire
• Irritability
• Hostility and outbursts of anger
• Increased appetite often with specific food cravings (especially salt and sugar)
• Mood swings
• Inability to concentrate
• Lethargy and fatigue

Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is a specific psychiatric condition marked by severe depression, irritability, and tension before menstruation. For a doctor to confirm a diagnosis of PMDD, the patient must have symptoms during the last week of the premenstrual phase and that resolve within a few days after menstruation starts.

Five or more of the following symptoms must occur:

• Feeling of sadness or hopelessness, possible suicidal thoughts
• Feelings of tension or anxiety (panic attacks, in fact, may be much more common in patients with PMDD than in the general population)
• Mood swings marked by periods of teariness
• Persistent irritability or anger that affects other people
• Disinterest in daily activities and relationships
• Trouble concentrating
• Fatigue or low energy
• Food cravings or bingeing
• Sleep disturbances
• Feeling out of control
• Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain