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West Florida Hospital

Symptoms of Premenstrual Syndrome (PMS)

The content below is part of the “Health Library” and is not indicative of services available at the facility.

Premenstrual syndrome (PMS) is characterized by physical and emotional symptoms that occur in a regular cycle beginning 1-2 weeks before the onset of menstrual flow and improve when menstrual bleeding starts. These symptoms 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
  • Lightheadedness
  • Gastrointestinal upset
  • Muscle pain

Although the symptoms of PMS may vary, the most common complaints are:

  • Irritability
  • Backache
  • Muscle pain
  • Bloating

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-5), 5 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

Revision Information

  • Premenstrual syndrome. EBSCO DynaMed website. Available at: Updated June 14, 2012. Accessed August 24, 2012.

  • Premenstrual syndrome. American Congress of Obstetricians and Gynecologists website. Available at: Accessed August 24, 2012.

  • Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at: Accessed August 24, 2012.

  • Saedi GA. The inclusion of PMDD in DSM-5. Psychology Today website. Available at: Updated February 13, 2012. Accessed August 24. 2012.