How to Identify PMS

Four Parts:Recognizing Psychological SymptomsRecognizing Physical SymptomsRuling Out Other Causes of Similar SymptomsUnderstanding PMS

Premenstrual syndrome (PMS) is a set of physical and emotional symptoms that affects women 5 to 11 days before their monthly menstrual cycle. It can be a little difficult to identify, but there are several signs you can look out for.

Part 1
Recognizing Psychological Symptoms

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    Look for signs of mood changes. You may find yourself crying for no reason at all, and experience feelings of anxiety, anger, depression, sadness or irritability. This is because reduced levels of estrogen during the luteal phase (starts from the ovulation day where the egg is released from the ovary) leads to a drop in serotonin.
    • The brain chemical serotonin is responsible for the regulation of mood and sleep patterns and gives a woman the feeling of well-being. A reduction in serotonin will cause mood changes in a woman.
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    Monitor any changes in mental functioning. You may experience an inability to concentrate or remember things. When hormones in a woman are functioning normally, the level of estrogen aids in regulating the level of cortisol (a stress hormone).
    • Cortisol can affect the function of neurotransmitters - brain chemicals used for communication.
    • As estrogen levels drop, cortisol levels are no longer controlled .properly. As a result, neurotransmitters start to malfunction, creating lapses in memory.
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    Take note of any changes in your sex drive. As a result of PMS, your libido can be decreased. Norepinephrine or noradrenaline is a brain hormone that controls sleep, arousal, and emotions. A decrease in this hormone results in a loss of interest in sex.
    • When ovulation starts, estrogen levels drop. This also reduces the levels of norepinephrine because estrogen competitively inhibits the enzyme responsible for inactivating norepinephrine, thus stimulating its production[1].

Part 2
Recognizing Physical Symptoms

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    Take note of the appearance of acne. Hormonal imbalances during menstruation can result in the overproduction of androgens – male hormones present in both men and women.
    • This produces a flare-up of acne by overstimulating the oil glands and changing the development of skin cells that line the skin’s hair follicles[2].
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    Press your breasts to check for tenderness. The breasts have many hormone receptors such as progesterone and estrogen which are affected by small changes in the balance of hormones.
    • The breasts undergo multiple changes each month in preparation for breastfeeding. The ducts in the nipple swell and become tender during PMS because they are filled with fluids[3].
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    Recognize cramping. During ovulation, the body will send a twinge of sharp pain or a series of cramps to one side of the lower abdominal area (this is the side that a woman is ovulating). This shows that the egg has already matured and is being released by the ovary.
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    Keep track of any difficulty sleeping that you experience. The brain chemical serotonin is responsible for the regulation of a person’s sleep pattern.
    • Reduced levels of estrogen during ovulation cause serotonin to drop, resulting in difficulty in sleeping.
    • This difficulty sleeping can also lead to fatigue.
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    Look out for fluid retention or bloating. Aldosterone levels increase during the start of ovulation (also known as the luteal phase of the menstrual cycle).
    • This hormone is also called the anti-diuretic hormone because it prevents excretion of water from the body through urination. It does this by reabsorbing sodium; since sodium attracts water, water cannot be excreted easily.
    • High levels of aldosterone cause accumulation of fluids in different parts of the body, leading to bloating during PMS.
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    Keep track if you suddenly develop food cravings. Estradiol, which is the major component of the estrogen hormone groups, decreases hunger by affecting the appetite center of the brain (which is located in the hypothalamus) directly.
    • During the first half of the cycle, estrogen dominates. In the second half, there is a surge in the level of progesterone.
    • Unlike estradiol, progesterone stimulates the woman’s appetite by opposing and blocking out estrogen’s effects on the brain. As a result, a woman may crave specific foods at certain times during her menstrual cycle.
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    Note any headaches, joint or muscle pain. Estrogen increases the production of opioid and endorphin by the hypothalamus, which are natural painkillers. Reduced levels of estrogen during ovulation makes the body vulnerable to various kind of pain, so you make experience more headaches and muscle or joint pain.
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    Watch out for an upset stomach, diarrhea or constipation. In the second half of the menstrual cycle, there is a surge in the level of progesterone. This hormone affects the contractility of the gastrointestinal tract, which can result in an upset stomach.
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    Check your weight. Reduced levels of estrogen during ovulation cause the body to compensate by finding other sources of estrogen.
    • Fat cells have the ability to produce estrogen, so during PMS a woman’s body converts calories into fat in order to increase the levels of estrogen.
    • Unfortunately, fat cells do not burn calories the same way as muscle cells do, which causes weight gain.

Part 3
Ruling Out Other Causes of Similar Symptoms

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    Understand that there are limitations on how doctors diagnose PMS. There is no single test to diagnose premenstrual syndrome. However, there are some strategies that doctors may use to help identify its presence.
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    Set up a thyroid test. Thyroid disorders often occur in women of childbearing age. Some symptoms of thyroid disorders such as weight gain are similar to the symptoms of premenstrual syndrome.
    • Therefore, the doctor may order a test to evaluate thyroid function. Thyroid hormone blood tests are done by getting a blood sample from the patient’s vein using a sterile needle and syringe.
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    Keep a PMS symptoms diary. The doctor may ask you to keep a diary to assess the frequency and severity of your symptoms. This can determine if the symptoms correspond to certain times in a your monthly cycle.
    • While symptoms may vary from month to month, a pattern or trend can appear after tracking the symptoms for a few months.
    • If a woman notices that symptoms occur frequently within a time span of 5 days before a period is due or begin up to 15 days before, she must inform her physician for further medical management.
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    Consider the possibility that you have PMDD. Premenstrual syndrome can also be very similar to premenstrual dysphoric disorder (PMDD). PMDD is a severe and sometimes disabling extension of premenstrual syndrome.
    • Although PMS and PMDD can have both physical and emotional symptoms, PMDD can produce extreme mood shifts that can disrupt a woman’s work and damage her relationships.
    • In both PMDD and PMS, the symptoms usually start 7 to 10 days prior to the start of the period and may continue for the first few days of the period. However, in PMDD, at least one of these emotional and behavioral symptoms stands out.
    • Possible symptoms include: anxiety, extreme moodiness, marked irritability or anger, sadness or hopelessness.
    • In both PMS and PMDD, underlying depression and anxiety are the common denominator. So, it is possible that changes in the level of hormones during the menstrual cycle can trigger the worsening of symptoms.
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    Be aware that PMS symptoms can be similar to perimenopause symptoms. PMS symptoms can also be very similar to perimenopause. Perimenopause means "around menopause" and refers to the time when a woman is approaching menopause. This usually occurs during a woman’s 40s but can be noticed as early as mid-30s.
    • PMS and perimenopause are both caused by hormonal imbalance and their physical and emotional symptoms are usually the same.
    • However, PMS symptoms correlate with the menstrual cycle because the symptoms disappear once a woman gets her period unlike in perimenopause. Perimenopause symptoms continue throughout the menstrual cycle and continue even if a woman has her period.

Part 4
Understanding PMS

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    Know that hormones play a major role in PMS. Researchers believe that the main factor in the development of PMS symptoms is the balance of hormones during the menstrual cycle. PMS tends to develop 7-14 days before menstruation occurs.
    • During the menstrual cycle, a matured egg is discharged from the ovaries for potential fertilization. Normally, five days before menstruation occurs, the female hormone estrogen is released by the ovaries.
    • Estrogen aids in thickening the uterus which will sustain an embryo if fertilization occurs. During the 14th day, ovulation (a process wherein matured egg is released) occurs.
    • Following the process of ovulation, the luteal phase (last phase) of the menstrual cycle starts. In this phase, symptoms of premenstrual syndrome commonly appear.
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    Be aware of the potential effect estrogen and progesterone have on your neurotransmitters. Experts think that estrogen and progesterone interact with neurotransmitters in the brain to affect mood and add up to other PMS symptoms. The neurotransmitters that are believed to be affected by estrogen and progesterone hormone during the menstrual cycle include:
    • Serotonin. This controls mood and sleep patterns. It also generates feelings of well-being. A drop in the level of estrogen during the luteal phase of the menstrual cycle may be associated with a decline in serotonin levels. Reduced levels of serotonin contribute to the development of anger, yearning for carbohydrates, depression and irritability, which are all signs of PMS.
    • Gamma-aminobutyric acid (GABA). This is linked with depression and anxiety which can be heightened by the production of progesterone.
    • Endorphins. These intensify feelings of pleasure and reduce pain. Endorphins can be affected both by estrogen and progesterone hormones.
    • Norepinephrine and epinephrine. These affect the body’s response to stress. The production of estrogen can disturb the production of these neurotransmitters, which can affect the blood pressure, heart rate and mood of a woman.
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    Be aware that your diet and nutrition play a part in your PMS symptoms. Some studies reveal that an unhealthy diet - particularly one that lacks in certain vitamins and minerals - can aggravate PMS symptoms. Such a diet may include:
    • A disparity in calcium and magnesium levels and a deficiency in B6 and Vitamin E.
    • A high intake of salty foods, leading to bloating and fluid retention.
    • Consumption of alcohol and coffee, which may exacerbate mood swings during PMS.
    • A high intake of simple carbohydrates that can boost irritability, water retention and other PMS symptoms. Simple carbohydrates are present in white bread and sugary snacks.
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    Know that some foods can lessen your PMS symptoms. However certain diets and vitamins are good to take during PMS such as:
    • Complex carbohydrates that could elevate the levels of serotonin. Reduced levels of serotonin can contribute to PMS-related depression. Complex carbohydrates are found in vegetables and whole grain.
    • Multivitamins rich in folic acid which are vital for a growing fetus, should fertilization occur.
    • Calcium supplements combined with Vitamin D help to keep the bones strong, which may facilitate a reduction in PMS symptoms. An exact explanation as to how diets rich in Vitamin D and calcium could ward off PMS symptoms is still being researched, but it is believed that it may have something to do with calcium’s effect on estrogen during the menstrual cycle.
    • Vitamin B6 can help to alleviate PMS symptoms, specifically depression. However precautionary measures should be taken as high doses of Vitamin B6 (500 mg to 2000 mg per day) can cause nerve damage.


  • Premenstrual syndrome has more than 150 physical and psychological symptoms. These symptoms can vary from person to person, from cycle to cycle and can be mild to severe.
  • The number of days that a woman suffers from PMS differs too. Some women experience it starting 4 days before the menstruation. Other women have it in as early as two weeks before the scheduled period.

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Categories: Women’s Health | Menstrual Cycles