Premenstrual Syndrome (PMS)

What is PMS?

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.

What are the symptoms of PMS?

There are many possible PMS symptoms. Every adolescent experiences them differently. Common symptoms include:

Psychological symptoms

  • irritability
  • nervousness
  • difficulty concentrating
  • depression
  • fatigue
  • anxiety
  • emotional hypersensitivity
  • crying spells
  • moodiness
  • sleep disturbances

Gastrointestinal symptoms

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

Fluid retention

  • periodic weight gain
  • breast fullness and pain

Skin problems

Other symptoms

  • headache
  • diminished sex drive
  • increased appetite and food cravings

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 we care for PMS

At the Division of Gynecology and Reproductive Endocrinology and PCOS 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.