AWARE Women's Health Snapshot- Premenstrual Syndrome


Premenstrual Syndrome

PMS can affect daily functioning and interfere with work, school performance or interpersonal relationships. But don’t despair- help is available!

How common is PMS?

PMS is common! Four in ten women (40%) experience PMS and up to 8% of these have severe symptoms.

What are the symptoms?

Symptoms are quite variable but the key element is that symptoms only appear before the period and disappear the week after the period. Most women then have about a week when they feel well again.

Psychological symptoms include depression, anxiety, irritability, loss of confidence and mood swings.

Physical symptoms include bloating, fluid retention and breast tenderness (mastalgia).

What causes symptoms?

Predominately symptoms seem to be caused by progesterone, which is produced during the menstrual cycle at the time of ovulation, or they may relate to the effect of oestrogen and progesterone on the neurotransmitters serotonin and GABA.

What can be done?

When PMS is severe the most convincing evidence of benefit is with hormone treatment and the use of medication or even surgery to reduce or eliminate symptoms. You will need to speak with your doctor or our AWARE Women’s Health doctors about these. The best evidence supports use of these treatments in combination with Cognitive Behavioral Therapy from a qualified Psychologist.

However here is a list of Complementary Therapies for which there is some evidence of benefit. You might like to try some of these first. Please be aware that the safety profile of some of these complementary medications is unclear:

Calcium/ Vitamin D, Vitex agnus castus (chasteberry), Gingko biloba, Saffron, Evening Primrose Oil, Lemon balm, Curcumin, Wheat germ, Exercise, Acupuncture, Reflexology.

Up dated Guidelines for Management of Premenstrual Syndrome published by RCOG are available at:

AWARE Women’s Health

Gynaecology, Women’s Health General Practice, Psychology, Physiotherapy