Premenstrual Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Premenstrual Syndrome?
An obstetrician-gynecologist, or ob-gyn, is a doctor with special training in women's health. This doctor usually diagnoses and treats premenstrual syndrome (PMS). A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is premenstrual syndrome?
Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS. The symptoms go away after the period starts. They can be mild or severe.
A more severe type is called premenstrual dysphoric disorder, or PMDD. With PMDD, the symptoms are severe enough to interfere with your life. PMDD is much less common than PMS.
Symptoms
PMS symptoms are different for everyone. You may get physical symptoms, emotional symptoms, or both. Your symptoms may also change throughout your life.
Physical symptoms can include:
- Breast swelling and tenderness.
- Bloating and weight gain.
- Headache, backache, and joint pain.
- Constipation or diarrhea.
- Food cravings.
Emotional symptoms can include:
- Irritability and mood swings.
- Crying spells.
- Depression or anxiety.
- Sleeping too much or too little.
- Trouble with concentration and memory.
Other conditions can look like PMS or overlap with it. Examples are depression, anxiety, perimenopause (the time leading up to menopause), and thyroid disease. About half of women who seek treatment for PMS have depression or anxiety. Depression often causes symptoms all month long, not just before a period.
Causes and who gets it
Researchers do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others.
PMS happens more often in women who are between their late 20s and 40s. It is also more common in women who have had at least one child, or who have a personal or family history of major depression. Symptoms often get worse in the late 30s and 40s as menopause approaches.
How doctors diagnose it
There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed, your symptoms must happen in the five days before your period for at least three menstrual cycles in a row. They must end within four days after your period starts. They must also keep you from doing some of your normal activities.
Keeping a record of your symptoms can help. Write down and rate your symptoms each day for at least 2 to 3 months. Your provider may also do a medical history and a physical exam, including a pelvic exam, to rule out other causes.
Treatment
No single PMS treatment works for everyone. If your symptoms are not severe, these steps may help:
- Regular exercise. Aerobic exercise lessens PMS symptoms for many women.
- Enough sleep.
- Healthy foods, and less salt, caffeine, sugar, and alcohol in the two weeks before your period.
- Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen for cramps, headaches, backaches, and breast tenderness.
Talk with your provider before taking pain relievers often. Long-term use may cause stomach bleeding or ulcers. Using them with water pills at the same time may cause kidney problems.
Some studies show that calcium and vitamin B6 may help with some symptoms. There is not enough evidence to prove that herbal supplements work. Check with your provider before taking any vitamins or supplements.
If you cannot manage your symptoms, your provider may suggest prescription medicines:
- Hormonal birth control may help with physical symptoms. It can sometimes make emotional symptoms worse.
- Antidepressants, such as SSRIs, may help with emotional symptoms.
- Diuretics, also called water pills, can reduce bloating and breast tenderness.
- Anti-anxiety medicine can ease anxiety.
Most women who are treated for PMS symptoms get good relief.
When to see a doctor
Contact your provider if PMS does not go away with self-care. Also call if your symptoms are so severe that they limit your ability to function. If you feel like you want to hurt yourself or others, call or text 988 (the Suicide and Crisis Lifeline) right away. You can also call 911 or go to the nearest hospital emergency room.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can go over your symptom record and talk about other conditions that can look like PMS. They can also help coordinate care with an ob-gyn when needed.
Common questions
Is PMS the same as PMDD?
No, but they are related. PMDD is a severe type of PMS, and its symptoms are severe enough to interfere with your life. PMDD is much less common than PMS.
Is there a test for PMS?
No, there is no single test for PMS. Your provider diagnoses it by talking with you about your symptoms and when they happen. Your provider may also do tests to rule out other conditions.
Can exercise help with PMS?
Yes, for many women. Regular aerobic exercise lessens PMS symptoms, and it may reduce fatigue and depression. It helps to exercise regularly, not just on the days you have symptoms.
Do PMS symptoms go away after the period starts?
Yes, they usually do. The symptoms go away after your period starts. To count as PMS, symptoms must end within four days after your period begins.
Sources
- MedlinePlus - Premenstrual Syndrome
- MedlinePlus - Premenstrual syndrome (Medical Encyclopedia)
- American College of Obstetricians and Gynecologists - Premenstrual Syndrome (PMS)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
