PMS - Signs and Symptoms

Signs and Symptoms

More than 200 different symptoms have been associated with PMS, but the three most prominent symptoms are irritability, tension, and dysphoria (unhappiness). Common emotional and non-specific symptoms include stress, anxiety, difficulty in falling asleep (insomnia), headache, fatigue, mood swings, increased emotional sensitivity, and changes in libido. Formal definitions absolutely require the presence of emotional symptoms as the chief complaint; the presence of exclusively physical symptoms associated with the menstrual cycle, such as bloating, abdominal cramps, constipation, swelling or tenderness in the breasts, cyclic acne, and joint or muscle pain—no matter how disruptive these physical symptoms are—is not considered PMS.

The exact symptoms and their intensity vary significantly from woman to woman, and even somewhat from cycle to cycle. Most women with premenstrual syndrome experience only a few of the possible symptoms, in a relatively predictable pattern. For example, one woman with PMS may be anxious and tense for three or four days before her menstrual period begins, and this will happen with only small variations each cycle, such as being somewhat more tense (or less tense) than in previous cycles.

Women with PMS do not experience completely different symptoms each cycle, such as anxiety with one cycle, depression the next, anger in the following cycle, and so forth. Each woman with PMS has her own personal pattern of symptoms. While one woman might be anxious and tense, another woman might experience PMS as causing her to be depressed and tearful for two days each cycle, and another woman might find that she is easily irritated by problems that she normally considers minor. Each woman's pattern, although different from what other women with PMS experience, will be relatively predictable and stable for the woman who experiences it.

Under typical definitions, symptoms must be present at some point during the ten days immediately before the onset of menses, and must not be present for at least one week between the onset of menses and ovulation. Although the intensity of symptoms may vary somewhat, most definitions require that the woman's unique combination of symptoms be present in multiple, consecutive cycles.