PMS Health Center

Most women normally have one or more troubling physical and emotional symptoms between the time they ovulate and the first days of their menstrual period. These are called premenstrual symptoms. When premenstrual symptoms interfere with your relationships or responsibilities, they are called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), a severe form of PMS.

Although PMS cannot be cured, you do have a number of lifestyle and medication choices that can reduce your symptoms and improve your quality of life.

Basic PMS treatment

If you have PMS, keep a menstrual diary, make lifestyle changes, and use home treatment measures. After a few menstrual cycles, you should notice some improvement in symptoms. Whether or not you then decide to add medication treatment, the following home treatment may help you:

• Take daily calcium and vitamin B6 (50 mg to 100 mg). Both of these nutrients affect the hormone-producing endocrine system. Calcium may help relieve PMS symptoms. Daily vitamin B6 may improve PMS depression and physical symptoms.
• Reduce your caffeine, refined sugar, and sodium intake, at least during the premenstrual phase of your cycle. These substances are linked to emotional and physical PMS symptoms, such as insomnia, tension and anxiety, food cravings, pain, and bloating.
• Get regular exercise. Exercise helps reduce depression. Women often report that exercise helps relieve tension, pain, and mood-related PMS symptoms.
• Reduce stress. While stress is not a cause of PMS, it may make your symptoms worse. In turn, coping with stress can be more difficult during the premenstrual period.
• Use nonprescription medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), for headache, joint or muscle pain, or cramps. NSAIDs work best when taken before and continued at regular dosage intervals throughout the premenstrual pain period. For some women, this continues into the first days of menstrual bleeding, to relieve painful cramps.

See examples of menstrual symptom diaries or use this menstrual diary(What is a PDF document?).

Additional treatments for PMS

If you still have moderate to severe symptoms after two or three cycles of healthy lifestyle and home treatment measures, talk your health professional about further treatment options. Consider the following for specific symptoms.

All physical and mood-related symptoms

The selective serotonin reuptake inhibitor (SSRI) class of antidepressants is often the first-choice medicine for moderate to severe premenstrual symptoms, including aggression, depression, anxiety, and physical symptoms. Most women gain relief by taking an SSRI either continuously or only during their premenstrual days. If you try an SSRI but find it ineffective, it's a good idea to try another type of SSRI before moving on to another class of medicine. For more information, see:

PMS: Should I Try an SSRI Medicine for My Symptoms?

The birth control pill with estrogen and drospirenone may help relieve symptoms in women with severe PMS or PMDD. This pill is sold as YAZ (very low-estrogen) or Yasmin (low-estrogen).