Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, including tender breasts, mood swings, food cravings, fatigue, irritability, and depression. It is estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Emotional and behavioral signs and symptoms

1. Tension or anxiety
2. Depressed mood
3. Crying spells
4. Mood swings and irritability or anger
5. Appetite changes and food cravings
6. Trouble falling asleep (insomnia)
7. Social withdrawal
8. Poor concentration
9. Change in libido

Physical signs and symptoms

1. Joint or muscle pain
2. Headache
3. Fatigue
4. Weight gain related to fluid retention
5. Abdominal bloating
6. Breast tenderness
7. Acne flare-ups
8. Constipation or diarrhea
9. Alcohol intolerance

Causes

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

1. Cyclic changes in hormones:

   Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.

2. Chemical changes in the brain:

   Fluctuations of serotonin, a brain chemical (neurotransmitter) that's thought to play a crucial role in mood states, could trigger symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression and fatigue, food cravings, and sleep problems.

3. Depression:

   Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.

Treatment

For many women, lifestyle changes can help relieve PMS symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.

The success of medications in relieving symptoms varies among women. Commonly prescribed medications for premenstrual syndrome include:

1. Antidepressants:

   Selective serotonin reuptake inhibitors (SSRIs) have been successful in reducing mood symptoms. These medications are generally taken daily. But for some women, the use of antidepressants may be limited to the two weeks before menstruation begins.

2. Nonsteroidal anti-inflammatory drugs (NSAIDs):

   NSAIDs when taken before or at the onset of your period can ease cramping and breast discomfort.

3. Diuretics:

   When exercise and limiting salt intake aren't enough to reduce weight gain, swelling, and bloating, taking water pills can help your body shed excess fluid through your kidneys. Diuretics can help ease some of the symptoms of PMS.

4. Hormonal contraceptives:

   These prescription medications stop ovulation, which may bring relief from symptoms.