PMS

PMS Overview

You probably get some signs that your period is coming. For most women, it’s no big deal — maybe tender breasts or a taste for sweets. But for others, the days before their period are harder. If it messes with your daily life, you might have premenstrual syndrome (PMS).

Your period is a natural part of your life. And you can do anything you would do any other time of the month. If PMS is a problem for you, there are ways to manage it.

PMS is a group of changes that can affect you on many levels. They can be physical, emotional, or behavioral. The changes come 1 to 2 weeks before your period. Once your period starts, they go away.

Symptoms

Most women have at least one sign of PMS each month. But it’s not the same for everyone. It can change as you get older. It can be hard to know if you just have a few symptoms before your period, or if it’s really PMS.

One way to think about it is to ask the question: “Do these changes get in the way of my regular life? Do they cause trouble at work or with family and friends?” If you answer yes, it might be PMS. Another way to know is if you have symptoms on the 5 days before your period, for 3 months in a row.

Women with PMS deal with it in lots of ways. You can make changes to improve your diet, sleep, and exercise. You can also learn ways to relax their mind and body. If what you try doesn’t seem to work, you could talk to your doctor.

What It’s Like

PMS shows up in many different ways. Everything in this list could be a sign of PMS. But most women get just a few of these, not all of them.

Physical signs

  • Bloated tummy
  • Cramps
  • Tender breasts
  • Hunger
  • Headache
  • Muscle aches
  • Joint pain
  • Swollen hands and feet
  • Pimples
  • Weight gain​ ​
  • Constipation or diarrhea

Emotional signs

  • Tense or anxious
  • Depressed
  • Crying
  • Mood swings
  • Can’t sleep
  • Don’t want to be with people
  • Feel overwhelmed or out of control
  • Angry outbursts

Behavioral signs

  • Forget things
  • Loss of mental focus
  • Tired

Girls and women who still get their period can get PMS. But it’s most common in women who:

  • Are in their late 20s to early 40s.
  • Have had a child.
  • Have family members with depression.
  • Had baby blues (postpartum depression), depression or bipolar disorder.

Causes

Even though PMS is common, doctors don’t know exactly what causes it. It probably has to do with changes in your body chemistry around the time of your period.

Some conditions affect PMS, but don’t cause it. PMS can be brought on, or can get worse if you:

  • Smoke
  • Are under lots of stress
  • Don’t exercise
  • Don’t sleep enough
  • Drink too much alcohol or eat too much salt, red meat, or sugar
  • Are depressed

Women with other health problems may find that those problems get worse before their period. Some of those are migraine headaches, asthma, and allergies.

What You Can Do

There are lots of ways to manage PMS. Even if you can’t totally fix it, it’s nice to know you have the power to help yourself. These ideas might help:

  • Exercise about 30 minutes a day.
  • Eat healthy foods like whole grains, fruits, and vegetables.
  • Try to get enough calcium from foods (think dairy, green leafy vegetables, and canned salmon).
  • Avoid salt, caffeine, and alcohol.
  • Don’t smoke.
  • Get plenty of sleep.
  • Work to lower stress.
  • Track your moods and symptoms in a journal.
  • Try over-the-counter pain relievers like ibuprofen, acetaminophen, or naproxen. Be sure to follow the dosing instructions exactly as it says on the label.

Some women take vitamins and minerals like folic acid, magnesium, vitamin B-6, vitamin E, and calcium with vitamin D. Others find that herbal remedies help. If you take any vitamins or supplements, check with your doctor first to make sure it’s safe for you.

What Your Doctor Can Do

If you’ve tried different things, but still have bad PMS, it’s probably time to get help. Make an appointment with your doctor or gynecologist. She’ll ask about your symptoms, your health, and medicines you take. She may take some blood tests to make sure the problem is PMS and not something else.

Your doctor may prescribe medicine. Birth control pills sometimes help with headache and cramps. Antidepressants (medicines that help treat depression) may be an option. Some women take medicine to get rid of extra fluid that makes them feel bloated. Doctors call these diuretics (water pills).

Your doctor might suggest talk therapy. It’s a way to feel better and learn new skills to overcome challenges by talking with a mental health counselor.

If you have notes about your symptoms, bring it to the appointment. Plan ahead about the questions you want to ask. That way you’ll get the best help from your doctor.

Lots of women get pelvic painand cramping, but your period isn’t always to blame. Cysts, constipation, pregnancy — even cancer — can make it feel like your monthly visitor is about to stop by.

It can be tough to tell whether the pain’s being caused by something simple or more serious. But these are 13 common reasons for it.

1. An Inflammatory Bowel Disease (Crohn’s Disease or Ulcerative Colitis)

What it is: You get long-term (chronic) swelling and irritation in different parts of your digestive tract. It happens when something goes haywire in your immune system. It isn’t the same as irritable bowel syndrome (IBS). Crohn’s can affect any part of your digestive tract (including your mouth). Ulcerative colitis involves only the large intestine (colon).

What the cramps feel like: It depends on the type of IBD you have. With Crohn’s, you’ll feel cramps and pain in the right lower or middle parts of your belly. They can be mild to severe. If you have ulcerative colitis, the cramps will be on the lower left side of your stomach.

Other symptoms: Which ones you have depend on the specific type of IBD. They include:

  • Severe changes in bowel movements (diarrhea, constipation)
  • Urgent need to pass a bowel movement
  • Feeling that your bowels aren’t completely empty after you go
  • Blood in your poop
  • Weight loss
  • Fever
  • Fatigue

2. Ovulation

What it is: If you haven’t gone through menopause and still have your ovaries, you might get cramps mid-month, about 10-14 days before your period. This happens when your ovaries release an egg to ready your body for a possible pregnancy. The harmless twinge of discomfort is called “mittelschmerz,” which means middle pain.

What the cramps feel like: You’ll notice pain on one side of your lower belly. It lasts a few minutes to a few hours. It can be sharp and sudden, or you might just have a dull cramp. The side of the pain depends on which ovary released the egg. It may switch sides every month or strike the same place each time.

Other symptoms: There aren’t any.

3. Ruptured Ovarian Cyst

What it is: A cyst is a sac of fluid. Sometimes they form on your ovaries. One type, called a follicular cyst, breaks open to release an egg and later dissolves in your body. If this doesn’t happen, a different cyst can form. Most are harmless. But if one grows large, it could burst.

What the cramps feel like: A ruptured cyst doesn’t always cause pain. If it does, you might have sudden, sharp cramps on either side of your lower stomach below the belly button. The location depends on which ovary had the cyst.

Other symptoms: You may also have some spotting. Before the cyst ruptures, you may feel pain or pressure in your lower belly, thighs, or lower back.

4. Pregnancy Pain

What it is: Your growing baby is attaching to the lining of your womb, or uterus. This is called “implantation pain,” and it’s a sign of pregnancy progress.

What the cramps feel like: You might have a few slight cramps about 4 weeks into your pregnancy — around the time when you’d get your period. If you aren’t sure whether you’re a mom-to-be, it’s a good idea to take a test.

Other symptoms: There are none. If you’re pregnant, you might start to feel queasy around the fifth or sixth week.

5. Ectopic Pregnancy

What it is: This is when a baby grows somewhere other than your womb. Most often it happens in one of your two fallopian tubes. It’s life-threatening for the mother and can’t result in a live birth.

What the cramps feel like: You may have mild cramps followed by sudden, sharp, stabbing pains on one side of your lower belly. The pain can get so severe that you also feel it in your shoulder and lower back.

Other symptoms: Before the cramps, you may have had typical pregnancy signs, like nausea and sore breasts. But not all women with an ectopic pregnancy have those. You might not even know you’re pregnant.

6. Miscarriage

What it is: It’s the loss of an unborn baby before the 20th week of pregnancy.

What the cramps feel like: They might start out like period pains, and then get more severe.

Other symptoms: You may have vaginal bleeding or spotting. Some pregnant women have these symptoms but don’t miscarry. But if you’re expecting and either one happens, always call your doctor.

7. Endometriosis

What it is: This is a long-term (chronic) condition in which tissue similar to your womb’s lining attach to other organs and begin to grow.

What the cramps feel like: They seem like regular period cramps, but they can happen any time of month. You may also have cramps and pain in your low back and stomach below your belly button.

Other symptoms: Sex that involves deep penetration may be painful. Some women have painful bowel movements. Endometriosis can make it hard to get pregnant.

8. Pelvic Inflammatory Disease (PID)

What it is: It’s a bacterial infection that’s usually spread by sex. It affects the parts that help you conceive and grow a baby. This includes your fallopian tubes, womb, ovaries, vagina, and cervix.

What the cramps feel like: You’ll have pain on both sides of your lower belly and lower back. It can happen any time of the month.

Other symptoms: PID causes abnormal vaginal discharge and, sometimes, spotting. You might have pain or burning during sex or when you pee. Your periods might be heavier or longer. You might run a fever or have nausea and vomiting. You’ll need to get the disease treated by a doctor.

9. Pelvic-Floor Muscle Dysfunction

What it is: Severe spasms happen in the muscles that support your bladder, womb, vagina, and rectum. It can happen after you have trauma with vaginal childbirth or after an injury, like a car accident.

What the cramps feel like: They’re severe — like sudden leg cramps in your lower belly. You may also have ongoing pain in your groin and back.

Other symptoms: You might have pain during your periods or sex, a burning feeling in the vagina, and problems pushing out stools. It could burn when you pee, or you may have a strong urge to go all the time. If you have these symptoms, see a doctor for a urine test to rule out a bladder infection. If you have one, the doctor will see bacteria in your urine.

10. Interstitial Cystitis

What it is: This long-term condition affects your bladder. Some doctors call it “painful bladder syndrome.”

What the cramps feel like: You’ll notice them in your lower stomach (pelvic) area and in your genitals, along with pain and tenderness. They’ll get worse as your bladder gets full and when it’s almost time for your period.

Other symptoms: You’ll feel like you have to pee a lot, and it’ll be urgent. Sex might also hurt.

11. Irritable Bowel Syndrome

What it is: This disorder causes stomach pain and bloating with diarrhea, constipation, or both.

What the cramps feel like:They’re sudden and in your belly. They might go away after you poop. Your specific pain will depend on whether you have constipation or diarrhea. You might go back and forth between the two or only have one type. Symptoms usually get worse during your period.

Other symptoms: You might feel pressure, like you tried to go, but couldn’t fully empty your bowels. You might feel sick to your stomach, have gas, or spot mucus in your poop.

12. Appendicitis

What it is: It’s irritation and swelling of a small pouch (appendix) on the end of your large intestine.

What the cramps feel like: You may notice pain around your belly button at first. Then, it gets worse and moves to the right lower side of your stomach. Cramps get bad fast, and they may wake you up. It could hurt if you cough, sneeze, or move.

Other symptoms: About half of people with appendicitis also have a fever, feel sick in their stomach, or throw up. Medical treatment is a must. A burst appendix can be life-threatening.

13. Ovarian Cancer

What it is: This type of cancer starts in the ovaries, the organs that make your eggs.

What the cramps feel like: Vague. You may write the pain off as something else, like constipation or gas. But the hurting and pressure in your lower belly won’t go away.

Other symptoms: Your belly may swell so much that you find it hard to button your pants. You might get full quickly when you eat and notice a strong, frequent need to pee. See a doctor if you have these symptoms for more than 2 weeks.

Always call a doctor if you have cramps that won’t go away. She’ll want to know if your pain is sudden or ongoing. The more details you provide, the faster she can diagnose and treat you. Get medical help right away if you have sudden, severe belly pain that continues to get worse.

Think you know all there is to know about your period? Women have about 450 periods during their lifetime, which means you have plenty of chances to learn all about it.

Even so, your period can still manage to surprise you — and not just by showing up when you least expect it.

Did you know these five facts about your monthly visitor?

1. You can get pregnant during your period.

It’s time to squash that age-old myth: Your period doesn’t protect you from pregnancy. There are a couple of reasons why. First, some women may bleed when their ovaries release an egg each month, called ovulation, and mistake it for their period. You’re at your peak fertility when you ovulate. So if you have sex during this time, it could actually make you more likely to get pregnant.

Second, you may ovulate before your period is over or within a few days after the bleeding stops. Since sperm can hang out in your body for up to 3 days, having sex during your period could lead to conception.

Use a condom or other form of birth control to prevent an unplanned pregnancy, no matter what time of the month it is.

2. The period you get while on the pill isn’t a ‘true’ period.

Sure, you bleed during the week that you take the sugar pills. But technically that’s “monthly withdrawal bleeding.” It’s slightly different than a regular period.

Normally, you ovulate in the middle of your menstrual cycle. If the egg your ovaries release isn’t fertilized, your hormone levels drop, causing you to shed the lining inside your uterus, and you get your period.

Birth control pills, though, prevent ovulation. With most types, you take hormones for 3 weeks followed by 1 week of pills without them. Though they keep your body from releasing an egg, they don’t prevent it from building up the lining of your uterus all month. The period-like bleeding during that fourth week is your body’s reaction to the lack of hormones from the last week of the pill.

3. Your period changes throughout your life.

Just when you start to feel like you can predict exactly when your period is going to show, everything can change. For that, you can thank the hormone shifts that happen throughout your lifetime.

Once you get your very first period, your cycles may be longer, meaning more time may pass between when one period starts to the next. A typical cycle for a teenage girl may be 21 to 45 days. Over time, they get shorter and more predictable, averaging about 21 to 35 days.

Hormone changes that happen during perimenopause — the years before menopause when your body starts to make less estrogen — can throw you for a loop. The time from one period to the next may get shorter or longer, and you may have heavier or lighter bleeding during your period. This phase can last up to 10 years before you start menopause and stop getting your period for good.

Gradual life changes are normal, but sudden, unusual issues like very heavy bleeding or missed periods are not. Talk with your doctor if you notice that something seems off.

4. Tampons and pads aren’t your only choices.

You have more options to help you manage that time of the month.

A menstrual cup is a flexible cup that fits inside your vagina and collects blood during your period. Period panties are super-absorbent, and you can wear them on their own on your lighter days or with a tampon during heavier times. Reusable cloth pads can be washed and worn again.

These products can be cost-savers, since you can reuse them, and they also create less waste. In some cases, they give you more time between changes. For example, you need to change a tampon every 4 to 8 hours, but you may be able to go up to 12 hours with a menstrual cup before you empty it.

There are pros and cons to all these options, just as there are with tampons and pads. But you can find one that works best for you with some trial and error.

5. PMS is still a mystery.

It’s 1 or 2 weeks before your period starts, and here come the breakouts, sluggishness, cravings, bloating, and mood swings. Sound familiar? Every woman is different, but for many, PMS is a fact of life.

But doctors don’t know exactly why that is. It seems to be a mix of hormone changes during your menstrual cycle, chemical changes in the brain, and other emotional issues you might have, such as depression, that can make PMS worse.

What’s more, once you get your period, the rollercoaster may continue. One study found that period-related pains such as cramps, bloating, backaches, and headaches can cloud your thinking, because the pain may make it harder for you to focus on the tasks at hand. Not that you can’t still do them — you can. It may just feel like it takes more work.

Lifestyle changes are usually the best way to take control of PMS. Aim to get about 30 minutes of exercise most days of the week, get 8 hours of shut-eye per night, and don’t smoke. Your diet makes a difference, too, so fill up on fruits, veggies, and whole grains while you limit salt (hello, bloating) as well as sugar, caffeine, and alcohol.

Let your doctor know if PMS keeps you from doing what you normally do, or if you have symptoms of depression or anxiety. You may have a more serious condition called premenstrual dysphoric disorder (PMDD) that needs medical attention.​

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