Premenstrual Syndrome (PMS)

  • Overview

    As many as 75 percent of girls and women experience unpleasant symptoms or painful pelvic cramps before or during their monthly menstrual cycle, called premenstrual syndrome (PMS).

    • Some girls and women have significant PMS symptoms, but are able to forget about them after a pain reliever. For others, periods bring so much discomfort that they have to miss school or work.
    • Less than an estimated 10 percent of females have symptoms so extreme they are considered disabled by the condition.
    • PMS symptoms may last from a few hours to many days.
    • Although PMS symptoms usually cease when menstruation starts, some girls may have PMS that lasts throughout their menstrual cycle.

    How Boston Children's Hospital approaches premenstrual syndrome

    At the Gynecology Program at Boston Children's Hospital, we understand the issues that a teenage girl or young woman deals with during PMS. Our staff provides high quality treatment and counseling, especially if her symptoms are extreme and disrupt her daily activities.

    The Center for Young Women's Health provides extensive and easy to access information for girls with questions about PMS and menstrual cycles. The following guide may be helpful to her: Premenstrual Syndrome (PMS).

  • In-Depth

    What are the symptoms of PMS?

    There are many possible PMS symptoms that your daughter is experiencing. Every adolescent experiences them differently. Common symptoms include:

    Psychological symptoms

    • irritability
    • nervousness
    • lack of control
    • agitation
    • anger
    • insomnia
    • difficulty concentrating
    • lethargy
    • depression
    • severe fatigue
    • anxiety
    • confusion
    • forgetfulness
    • decreased self image
    • paranoia
    • emotional hypersensitivity
    • crying spells
    • moodiness
    • sleep disturbances

    Gastrointestinal symptoms

    • abdominal cramps
    • bloating
    • constipation
    • nausea
    • vomiting
    • pelvic heaviness or pressure
    • backache

    Fluid retention

    • edema (swelling of her ankles, hands, and feet)
    • periodic weight gain
    • oliguria (decreased urine formation)
    • breast fullness and pain

    Skin problems

    • acne
    • neurodermatitis (itchy skin inflammation)
    • aggravation of other skin conditions, including cold sores

    Respiratory disorders

    Neurologic and vascular symptoms

    • headache
    • vertigo
    • fainting
    • numbness, prickling, tingling or heightened sensitivity of arms and/or legs
    • easy bruising
    • heart palpitations
    • muscle spasms

    Eye complaints


    • decreased coordination
    • painful menstruation
    • diminished sex drive
    • increased appetite and food cravings
    • hot flashes

    What causes PMS?

    Premenstrual syndrome seems to be related to fluctuations in estrogen and progesterone in the body during the menstrual cycle. The symptoms don't necessarily signal an ovarian condition. Suggested causes of PMS include:

    • estrogen-progesterone imbalance
    • hyperprolactinemia (an excessive secretion of prolactin, the hormone that stimulates breast development)
    • excessive aldosterone, or ADH (hormone that helps to regulate the metabolism of sodium, chloride, and potassium)
    • carbohydrate metabolism changes
    • retention of sodium and water by the kidneys
    • low blood sugar
    • allergy to progesterone
    • psychogenic factors

    How can my daughter prevent PMS?

    Simple, healthy lifestyle changes may help your daughter manage the pain and annoyance of PMS. Encourage her to:

    • exercise regularly, at least three to five times a week
    • eat a well-balanced diet, with plenty of whole grains, vegetables and fruits
    • lower her intake of salt, sugar, caffeine and alcohol
    • get plenty of sleep and rest.
  • Tests

    How is PMS diagnosed?

    Diagnostic procedures for PMS are currently quite limited. Your daughter's complete medical history, physical and pelvic exam will help her physician identify causes for her discomfort.

    • Your daughter's physician may ask her to keep a journal of her symptoms for several months to track the timing, severity, onset and duration of the symptoms.
    • A psychiatric evaluation might be recommended to rule out other possible conditions.
  • PMS treatment at Children's

    Besides counseling with her physician and engaging in healthy habits and stress management, possible treatments of PMS include:

    • diuretic use prior to the time symptoms are usually noted (to reduce fluid retention)
    • prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen), to reduce pain
    • oral contraceptives (to prevent ovulation)
    • progesterone (hormone treatment)
    • tranquilizers
    • dietary changes
    • vitamin supplements (i.e., vitamin B6, calcium, and magnesium)
    • regular exercise
    • antidepressants (or other medications)

    The Center for Young Women's Health provides extensive and easy to access information for girls with questions about PMS and menstrual cycles. The following guide may be helpful to her: Premenstrual Syndrome (PMS).

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Doctors Who Treat "Premenstrual Syndrome (PMS)"

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