Premenstrual Syndrome (PMS)

Diagnosis

There are no specific physical findings or laboratory tests that can definitively diagnose premenstrual syndrome. A healthcare provider may link certain symptoms to PMS when they occur as part of a consistent and predictable premenstrual pattern.

To help identify this pattern, you may be asked to track your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. It is important to note the day symptoms begin, the day they end, and when your menstrual period starts and finishes. This record helps clarify whether symptoms are closely related to the menstrual cycle.

Some conditions can cause symptoms similar to PMS. These include chronic fatigue syndrome, thyroid disorders, and mood conditions such as depression or anxiety. To rule out other causes, your healthcare provider may recommend tests such as thyroid function testing or mental health screening assessments.

Treatment

For many women, lifestyle changes can help reduce premenstrual syndrome symptoms. When symptoms are more severe or persistent, medications may be recommended. The effectiveness of treatment varies from person to person and may involve one or more approaches.

Common treatment options include:

• Antidepressants
  Selective serotonin reuptake inhibitors, such as fluoxetine, paroxetine, and sertraline, are effective in reducing mood-related PMS symptoms. These medicines are considered first-line treatment for severe PMS and premenstrual dysphoric disorder. They are often taken daily, although in some cases they may be used only during the two weeks before menstruation begins.

• Nonsteroidal anti-inflammatory drugs
  Pain relievers such as ibuprofen or naproxen sodium can help ease menstrual cramps, headaches, and breast tenderness when taken before or at the start of a period.

• Diuretics
  When exercise and reduced salt intake do not relieve bloating or fluid retention, diuretics may be prescribed. These medications help the body remove excess fluid through the kidneys. Spironolactone is one option that may reduce swelling and discomfort linked to PMS.

• Hormonal contraceptives
  Hormonal birth control pills prevent ovulation and may help reduce or eliminate PMS symptoms in some women. The response to hormonal contraceptives can vary depending on the individual and the medication used.