Healthdirect notes that PMS is the same as premenstrual tension (PMT), so whichever name you grew up with, it describes the same changes before a period. It also points out that the severe form, premenstrual dysphoric disorder (PMDD), affects about 8 in every 100 women.
Here we explain PMS symptoms and causes, how a doctor confirms it, the treatment options healthdirect describes and what it all means if you use a period cup.
Quick answer: PMS, also called PMT, is a set of physical and emotional changes in the second half of your cycle that ease shortly after your period starts. Its exact cause is unknown, but people with PMS may be more sensitive to normal hormone changes. Recording symptoms for at least 2 cycles helps your doctor confirm it and rule out other conditions.
What does PMS feel like?
Healthdirect lists bloating, breast tenderness, headaches and fatigue as common physical changes, with mood swings, irritability, anxiety and feeling sad or depressed on the emotional side. Jean Hailes adds trouble concentrating, loss of confidence, fluid retention, acne, constipation or diarrhoea, nausea and aching muscles or joints. Symptoms are typically the same each month, and Jean Hailes says PMS is very common in the teenage years and during perimenopause.
What causes PMS?
Nobody knows exactly. Healthdirect says people with PMS or PMDD may be more sensitive to the hormonal changes of the menstrual cycle, and that PMS has been linked to brain chemicals including serotonin and GABA. Jean Hailes says research suggests several overlapping factors: brain sensitivity to hormone changes, genetics, stress and inflammation.
How does a doctor confirm PMS?
There are no specific tests. Your doctor will ask about your symptoms and cycle, and healthdirect says a record covering at least 2 cycles helps identify patterns and rule out other conditions. A blood test may check your thyroid function, and irregular periods may lead to a referral to a gynaecologist.
What treatments are available?
Healthdirect describes options ranging from self-care to medicine:
- about 30 minutes of exercise daily, good-quality sleep and quitting smoking or vaping;
- stress management such as yoga, meditation or mindfulness;
- a heat pack or warm bath for cramps;
- cognitive behavioural therapy (CBT);
- antidepressants, including SSRIs and SNRIs, and the combined oral contraceptive pill.
For the food and supplement evidence, see our article on superfoods and PMS. On days your breasts feel tender, Jean Hailes suggests a soft cotton or bamboo bra.
Can you use a period cup when you have PMS?
Since healthdirect says symptoms usually ease shortly after your period starts, PMS mostly happens before the days you would wear a menstrual cup. The Australian sources we used link PMS to hormone sensitivity rather than to the period product you choose. If you want to add your flow to your symptom record, each Lunette size has two measuring lines: 5 ml and 13.5 ml on Size 1, and 7.5 ml and 15 ml on Size 2.
When to see a doctor
- Symptoms affect your daily life and lifestyle changes haven't helped.
- PMS is affecting school, work, relationships or your quality of life.
- You have thoughts of self-harm or suicide: get urgent help.
If you feel your doctor isn't listening, healthdirect says you can seek a second opinion. Lifeline is on 13 11 14, the Suicide Call Back Service on 1300 659 467 and healthdirect's nurses on 1800 022 222; call triple zero (000) in an emergency.
Frequently asked questions
Is PMT the same as PMS?
Yes. Healthdirect says premenstrual syndrome and premenstrual tension are the same thing: physical and emotional changes in the second half of the cycle that ease shortly after your period starts. Bloating, breast tenderness, headaches, mood swings and irritability are common examples. Whatever you call it, a symptom record helps your doctor.
Is PMS linked to postnatal depression?
Healthdirect says a history of PMS or PMDD is linked to a greater chance of postnatal depression. If you have had PMS and are pregnant or have recently given birth, let your doctor know so your mood can be watched. Healthdirect also notes people with PMS have a higher risk of suicidal thoughts, so seek help early.
Is PMS worse in your teens?
It can be. The Better Health Channel says symptoms can be worse in the teenage years and in the lead-up to menopause, possibly because of hormone changes, and Jean Hailes describes PMS as very common at both stages. If symptoms are disrupting school or friendships, a GP can help you find a plan.
Keeping a symptom record? The Lunette period cup has measuring lines so you can add your flow to your notes, and it can be worn for up to 8 hours. Our period cup size guide explains which menstrual cup size suits a low or higher cervix.
This information is general in nature and isn't medical advice. Your GP can help you make a plan that suits you.
