Start during the second half of a woman's menstrual cycle (14 or more days after the first day of your last menstrual period)
Go away within 1 to 2 days after your menstrual period starts
Keep a diary of symptoms
Keeping a calendar or diary of your symptoms can help you identify the symptoms that are causing you the most trouble. This can help you manage the times when they are likely to occur. In your diary or calendar, be sure to record:
The type of symptoms you are having
How severe your symptoms are
How long your symptoms last
You may need to try different things to treat PMS. Some things you try may work, and others may not. Keeping track of your symptoms may help you find the treatments that work best for you.
Healthy lifestyle changes
A healthy lifestyle is the first step to managing PMS. For many women, lifestyle changes alone are enough to control their symptoms.
Changes in what you drink or eat may help. During the second half of your cycle:
Eat a balanced diet that includes lots of whole grains, vegetables, and fruit. Have little or no salt or sugar.
Drink plenty of fluids like water or juice. Avoid soft drinks, alcohol, or anything with caffeine in it.
Eat frequent, small meals or snacks instead of 3 large meals. Have something to eat at least every 3 hours. But do not overeat.
Getting regular exercise throughout the month can help reduce how severe your PMS symptoms are.
Medicines, vitamins, supplements
Your health care provider may recommend that you take vitamins or supplements.
Vitamin B6, calcium, and magnesium may be recommended.
Tryptophan supplements may also be helpful. Eating foods that contain tryptophan may also help. Some of these are dairy products, soy beans, seeds, tuna, and shellfish.
Pain relievers, such as aspirin, ibuprofen (Advil, Motrin, and others), naproxen (Naprosyn, Aleve), and other medicines may help symptoms of headache, backache, menstrual cramping, and breast tenderness.
Tell your health care provider if you are taking these medicines most days.
Your health care provider may prescribe stronger pain medicines for severe cramping.
Your health care provider may prescribe birth control pills, water pills (diuretics), or other medicines to treat symptoms.
Follow the directions for taking them.
Ask about possible side effects and tell your provider if you have any of them.
Vigod SN. Understanding and treating premenstrual dysphoric disorder: an update for the women's health practitioner. Obstet Gynecol Clin North Am. 2009;36:907-924, xii.
Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.