Signs & Physical Symptoms

PMS symptoms are more numerous and diverse than you may think. They can either sneak up on you or hit you like a speeding truck. There are in fact, over 150 different PMS symptoms. No woman will experience every one (although during some months, many might argue this point!) and no two women are likely to experience the same pattern of PMS symptoms. The PMS experience is unique to the individual and can even vary in the same woman from cycle to cycle. Unpredictability is the only predictable thing about PMS (except for that its going to happen every month of course).

The PMS symptom spectrum covers both physical and psychological aspects and affects almost every organ system in the body. The mood related PMS symptoms include irritability, anger, anxiety, sadness, mood swings and depression. Predictability of mood is definitely not a symptom of PMS! Psychological and emotional symptoms extend to insomnia, anorexia, food cravings, fatigue, lethargy, a change in sex drive, clumsiness, dizziness or vertigo, decreased concentration and indecision. The physical symptoms of PMS include headaches, joint pain, breast tenderness, muscle pain, perspiration and sweating, heart palpitations, nausea, diarrhea, bloating, fluid retention, weight gain, oily skin and acne and greasy or dry hair.

PMS affects each woman differently and impacts her life in its own particular, peculiar way. Do you cry while watching TV commercials during PMS? Then you’re a classic weepy PMS type. Does PMS impact your life in more obvious ways, like inducing you to pour hot coffee over a co-worker? If so, then you’re more likely to be suffering from severe PMS. Severe PMS affects around 40% of the menstruating women who regularly experience PMS symptoms and is now recognized by the medical profession as a distinct condition, also referred to as premenstrual dysphoric disorder, or PMDD. The psychological and physical impact of severe PMS can be debilitating to the extent that the women affected cannot function normally during the premenstrual period. New research shows that women who suffer from severe PMS have abnormal responses to stress. Whereas most women respond to stress during PMS by producing more allopregnanolone, a hormone metabolite of progesterone, those with severe PMS or PMDD produce much less of this substance when stressed. Women with severe PMS or PMDD are also more sensitive to pain than other women and have lower circulating levels of beta-endorphins, the body’s natural pain-killers and feel good brain chemicals.

The Physical Symptoms

Sore Breasts

Sore breasts are a common symptom of PMS and while a major source of discomfort in an already unpleasant time of the month, are not a cause for concern. Excess levels of prolactin (a hormone responsible for breast development and milk production during pregnancy) during the premenstrual phase are most likely responsible for the all too common sore breast phenomena.

Prolactin triggers inflammation and swelling of the breast tissue ducts. Swollen or sore breasts during PMS may also result from the increased fluid retention common just prior to menstruation. Just as fingers and feet swell as a result, so can breasts. Increased fluid retention forces the breast tissues to expand, which stretches the nerves and makes breasts feel sore, achy or tender. Relief for sore breasts with over the counter acetaminophen or ibuprofen helps with the pain and also reduces some swelling or fluid retention in the breasts. Wearing a supportive bra for this period will definitely help, as will sleeping on your back or side rather than your stomach! Another means to alleviate symptoms of sore or tender breasts during PMS is to cut down on salty foods and caffeine. This minimizes fluid retention and the consequent increase in pressure on the breast tissue. Evening primrose oil (a source of gamma linoleic acids and vitamin E) is another tried and tested remedy for the relief of sore breasts during PMS.


Headaches are a typical feature of PMS. PMS headaches can range form a dull annoying ache, to sharp pains that require medication and at least an hour in a darkened room with a damp cloth to the forehead. Headaches during PMS are associated with a variety of other symptoms that distinguish them from a typical menstrual headache. Oh yes, you’re not only likely to suffer headaches during your period, but PMS lets you practice with warm-up headaches first!

PMS headaches usually occur in tandem with other PMS symptoms such as fatigue, joint pain, decreased urination, constipation and lack of coordination. An increase in appetite and a craving for chocolate, salt, or alcohol is also common. As with other PMS symptoms, headaches occur in response to the changes in hormone and neurotransmitter levels that occur during the final phase of the menstrual cycle. The best remedy for PMS headaches is to drink plenty of water and other clear fluids, rest and take over the counter painkillers such as ibuprofen or acetaminophen. Sleep and lie down if you need too, especially if you experience dizziness and lack of coordination. PMS headaches will pass and aren’t a sign that anything else is wrong, so hold tight, get rid of them as quickly as you can and back to your normal routine.


PMS cramps cause misery for many women. It’s bad enough that cramps are likely to strike during your period, but as a prelude to what’s in store during every woman’s least favorite time of the month, cramps can also occur during the two preceding weeks as a symptom of PMS. Some women have such severe PMS cramps so severely that what they experience is equivalent to and even worse than most women during menstruation. PMS cramps are a painful and inconvenient, but it’s important to remember that they are not an indication of bad health or a symptom that anything’s wrong. If you’re unfortunate enough to suffer PMS cramps, think more in terms of your reproductive system working hyper-efficiently to drive the natural process of the menstrual cycle along. Cramps and other PMS symptoms are an unfortunate side effect! Menstrual and premenstrual cramps are actually contractions of the smooth muscles that line the female reproductive tract to help migration of the egg (ovum) from the ovary to the uterus via the fallopian tubes for fertilization and then implantation. If this doesn’t occur then the response is to expel the now unnecessary lining of the womb. The good news is that in most cases, the discomfort caused by PMS cramps can be prevented with over the counter pain-killers (ibuprofen, acetaminophen etc.). Gentle exercise and stretching and lots of rest with a good old hot water bottle are also guaranteed to help.

Water Retention

Many women feel bloated and uncomfortable every month due to PMS water retention. This is caused by circulatory, fluid balance and electrolyte level fluctuations that occur in response to the changes in hormone production each month during the PMS phase of the menstrual cycle. The result, PMS water retention, is that fluid is deposited within tissues in certain, characteristic areas of the body. PMS water retention predominantly affects the abdomen, calves and breasts, leaving these areas feeling bloated, tender and on the whole, pretty darned uncomfortable! As well as causing discomfort and making clothes feel a little tighter each month, PMS water retention can result in a slight increase in weight. PMS water retention can add a good two to four pounds. Feeling uncomfortable and gaining weight doesn’t actually help feelings of anxiety, depression and irritability experienced by many women during PMS. In fact, PMS water retention can worsen them!

Weight Gain

Weight gain during PMS can add to the misery experienced by many women during this time of the month. PMS weight gain is very common and mainly due to two factors. The first is fluid retention. Circulatory changes that occur as hormone production alters in the last two weeks of the menstrual cycle during PMS lead to fluid being retained in may tissue. This can leave us feeling bloated. By retaining rather than losing this water, we can gain as much as 2 to 4 pounds of weight during PMS. The second factor that can lead to weight gain during PMS is giving in to those all-too-common sugar and chocolate cravings. Weight gain because of fluid retention during PMS can’t always be avoided, but holding back on at least some of that chocolate and those cookies can help prevent gaining even more weight. It’s Important to remember that weight gain during PMS, as frustrating as it can be, is only your body’s response to changes going on at this time of the month. It’s only temporary (well, unless those chocolates and cookies as the major culprits!).

Anxiety and depression during PMS can be bad enough without gaining weight making you feel even more down. Don’t worry about it. Use it as an excuse to wear those “fat pants” and baggy sweats and be comfortable for the few days. It will soon pass.


It’s hardly surprising that nausea impacts many women during PMS; the body is subjected to many triggers for nausea attacks during PMS. First is the body’s swing in the production of sex hormones during PMS. Both progesterone and estrogen are linked with nausea. On top of this, cramps, bloating, headaches and dizzy spells can leave even those of us with the strongest of stomachs a little green around the gills. On the bright side, nausea during PMS tends to wear off very quickly. Few women experience PMS nausea for more than a day or so, generally at the height (or should that be low?) of each month’s bout of PMS symptoms. So how best to treat nausea during PMS? Ginger is a tried and tested, age-old remedy for nausea. Try it in supplement form, in cooking, or address those PMS sugar cravings at the same time and nibble on ginger cookies when nausea strikes. Calcium also has a very soothing effect on the stomach and intestinal tract, reducing nausea and cramping. Drink plenty of milk and eat yogurts and other dairy foods to maximize calcium levels before and during PMS. Alternatively, take calcium in supplemental form (about 1000 micrograms a day). If these home remedies don’t quell nausea waves during PMS and you still find yourself running for the bathroom every few minutes and unable to look even a French fry in the eye for a couple of days each month, consult your doctor and discuss prescription anti-sickness medication (anti-emetics) as a stronger alternative. Whichever remedy you find that works for you, stick to it and ensure that not even a single day of your life is blighted by unpleasant and inconvenient feelings of nausea every month during PMS.


Dizziness during PMS, a lack of coordination, distraction, forgetfulness and outright absentmindedness are common symptoms. There is some evidence that dizziness symptoms result from hypoglycemia caused by an altered metabolism of sugar by the body during PMS. Low blood sugar leads would certainly lead to dizziness. The sugar cravings common in PMS are most likely body’s response to these sugar dips. Dizziness may be triggered by the cyclical changes in hormone and neurotransmitter levels and may even be a side effect of some anti-depressant medications prescribed to treat psychological and emotion PMS symptoms. It’s important to read the patient information that comes with any medication to check which side effects, dizziness included, may arise and to discuss this with your doctor before and once you are taking the drug. Dizziness can result even from slight dehydration, so drink plenty of water and clear fluids. Aside from eating a balanced healthy diet, don’t drive or operate ANY heavy machinery during bouts of PMS dizziness, take it easy and relax as best you can until it passes and you’re back to your old, safe, steady, rational self again!


Constipation is an unpleasant symptom of PMS. The uterus (womb) lies directly below the intestinal tract and constipation can strike during PMS in the final phase of the menstrual cycle when the womb’s lining is at its fullest, putting just enough extra pressure on surrounding organs to cause PMS constipation. Changes in hormone, neurotransmitter and calcium levels during this phase of the menstrual cycle can affect the function of both the lining of the intestine and the smooth muscles underneath that drive intestinal motility. The result can be sluggish bowel motion and constipation.

So can you treat PMS constipation? A diet rich in complex carbohydrates (fruits, vegetables and whole wheat cereals, rice and bread etc) is also one that’s also full of fiber and that will help prevent constipation as well as sugar cravings and mood swings and anxiety during PMS. Eating more, smaller meals during the day rather than three big meals will also help prevent constipation during PMS by taking some of the pressure of the bowls. Gentle exercise and drinking plenty of fluids will promote intestinal motility, as will gentle abdominal massage. If these measures don’t work, then try gentle, herbal, over the counter remedies such as Senecot to reverse PMS constipation. PMS constipation will only last temporarily until your period begins. There’s no need to worry that this constipation is anything more than a symptom of PMS unless it continues through the month. If they do, then see your doctor and get it checked out. If you already suffer from periodic bouts of constipation, then you’re probably more likely to suffer from constipation during PMS. Seek relief from PMS constipation. This time of the month is uncomfortable enough without having to suffer further bloating and discomfort!