Premenstrual syndrome (PMS) is characterized by the presence of both physical and behavioral symptoms that occur repetitively in the second half of the menstrual cycle. It affects 75% of women with regular cycles and relieved with onset of menses.

Physical symptoms: abdominal bloating (90%), breast tenderness, and headaches (50%)

Behavioral treatment: sense of fatigue (90%), irritability, depressed mood (80%), increased appetite (70%), and forgetfulness and difficulty concentrating (50%). Other common symptoms include acne, over-sensitivity to environmental stimuli, anger, easy crying, and gastrointestinal upset, hot flashes, heart palpitations, and dizziness occur in 15-20%. 

Treatment: Adopt healthier life; exercise regularly, get enough sleep, decrease smoking, find ways to manage stress in your life. Avoid salt, sugary foods, caffeine, and alcohol. Multivitamins containing folic acid and calcium supplement.

Severe cases birth control pills (stops ovulation), ibuprofen, diuretics, or antidepressants (alter serotonin levels in the body).


Premenstrual Dysphonic Disorder (PMDD)

Symptoms: anger, irritability, and internal tension, occurring 3-8% women. Severe symptoms lead to problems with relationships and carrying out normal activities. Physical symptoms seen are headache, joint, and muscle pain, lack of energy, and breast tenderness. At least five symptoms must be present for diagnosis.

Treatment: Selective serotonin reuptake inhibitors, sertraline (Zoloft), and Fluoxetine (Sarafem).