PMS is characterized by physical and emotional symptoms that occur in a cycle one to two weeks before the onset of menstruation. Symptoms, which often improve when menstrual bleeding starts, can be extremely distressing and may include:

  • Irritability
  • Mood swings
  • Anxiety
  • Depression
  • Low self-esteem
  • Difficulty concentrating
  • Sleep problems
  • Appetite changes (sugar and/or salt cravings; overeating)
  • Weight gain
  • Fatigue
  • Bloating
  • Headache
  • Breast swelling and tenderness
  • Palpitations
  • Dizziness
  • Gastrointestinal upset
  • Diffuse muscle pain

Although the symptoms of PMS may vary, the most common complaints are: irritability, backache, muscle pain, and bloating.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), five or more of the following symptoms must be present for a diagnosis of PMDD:

  • Physical symptoms such as breast tenderness, bloating, and joint pain
  • Severe depression, possibly with suicidal thoughts
  • Anxiety, tension, or panic attacks
  • Severe irritability and anger
  • Mood swings
  • Difficulty concentrating
  • Fatigue
  • Teariness
  • Difficulty sleeping
  • Feeling out of control
  • Lack of interest in relationships, activities
  • Food cravings or binges