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Why have I been referred to the PMS Clinic?

You have been referred to the PMS Clinic because you suffer from some of the following symptoms:

  • Abdominal bloating
  • Appetite changes and food cravings
  • Breast tenderness
  • Crying spells
  • Depressed mood
  • Fatigue
  • Headache
  • Joint or muscle pain
  • Mood swings and irritability or anger
  • Tension or anxiety
  • Trouble falling asleep (insomnia)
  • Weight gain from fluid retention

What is Premenstrual Syndrome (PMS)?

Premenstrual Syndrome is a combination of  these symptoms. These symptoms will happen a few days before your period. An estimated three of every four menstruating women experience some form of premenstrual syndrome. It is more common in women between their late 20s and early 40s.

The symptoms tend to recur in a predictable pattern. Yet the physical and emotional changes you experience with premenstrual syndrome may be more or less intense with each menstrual cycle.

Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome.

For some women, the physical pain and emotional stress are severe enough to affect their daily routines.

What Causes PMS?

Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition. Changes in hormones seem to be an important factor. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and also disappear with pregnancy and menopause.

Chemical changes in the brain also may be involved. This may contribute to other symptoms of PMS, such as fatigue, food cravings and sleep problems. Some PMS symptoms have been linked to low levels of vitamins and minerals.

Other possible contributors to PMS include eating a lot of salty foods, which may cause fluid retention, and drinking alcohol and caffeinated beverages, which may cause mood and energy level disturbances.


How can I prepare for my appointment?

Prior to your appointment, it would helpful to keep a record of your signs and symptoms on a calendar or in a diary for at least two menstrual cycles and bring your record to your appointment. Note the day that you first noticed symptoms appear and disappear. Also be sure to mark the day your period started and ended.

Can PMS be treated?

PMS can be treated. The goal of treatment is to control symptoms. Your doctor may prescribe one or more medications for premenstrual syndrome. The success of medications in relieving symptoms varies from woman to woman. Commonly prescribed medications for premenstrual syndrome include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin, others) can ease cramping and breast discomfort.

Oral contraceptives
These stop ovulation and stabilize hormonal swings, thereby offering relief from PMS symptoms.

Selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac,), paroxetine (Paxil) and sertraline (Zoloft), have been successful in reducing symptoms such as fatigue, food cravings and sleep problems. These drugs are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.

Medroxyprogesterone acetate (Depo-Provera)
For severe PMS this injection can be used to temporarily stop ovulation. However, Depo-Provera may cause an increase in some signs and symptoms of PMS, such as increased appetite, weight gain, headache and depressed mood.

What are things I can do on my own?

You can manage or sometimes reduce the symptoms of premenstrual syndrome by making changes in the  way you eat, exercise and approach daily life. Try these approaches:

Modify your diet
Eat smaller, more frequent meals each day to reduce bloating and the sensation of fullness. Limit salty foods to reduce bloating and fluid retention. Choose foods high in carbohydrates, such as fruits, vegetables and whole grains. Choose foods rich in calcium. If you can’t tolerate dairy products or aren’t getting adequate calcium in your diet, you may need a daily calcium supplement. Take a daily multivitamin supplement. Avoid caffeine and alcohol.

Incorporate exercise into your regular routine
Engage in brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate symptoms such as fatigue and a depressed mood.

Reduce stress
Get plenty of sleep. Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).

Record your symptoms for a few months
Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.

Still have questions? Check out these Web sites for more information.

  • North American Menopause Society (NAMS):
  • National Institute of Mental Health:
    Tel.: 301-443-4513
  • American College of Obstetricians and Gynecologists (ACOG)Resource Center
    Tel: 202-863-2518
  • The Society of Obstetricians and Gynecologists of SOGC):
    Tel.: 1-800-561-2416
  • American Psychiatric Association:
    Tel.: 202-682-6000
  • The Hormone Foundation:
    Tel.: 800-467-6663