Premenstrual Syndrome (PMS) involves symptoms that begin 7 to 14 days prior to onset of a menstrual period and usually cease once menstruation begins.

Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS. The severity of these symptoms cause impaired social and occupational functioning and often affect interpersonal relationships.

Symptoms of PMS and PMDD may include bloating, constipation, depression (often with sadness and crying), fatigue, headache, backache, increased hunger, food cravings, weight gain, irritability, breast tenderness, skin problems, sleep complaints, swollen hands and feet, and increased or decreased sex drive.

Risks of PMS, PMDD increases with elevated stress, caffeine and salt intake, smoking, or a  personal or family history of mood disorders.

Natural measures to improve PMS, PMDD can include regular aerobic exercise, relaxation therapy such as breathing exercises, meditation, yoga, massage, biofeedback therapy and self-hypnosis. Getting enough sleep is also important to help lessen moodiness and fatigue.  Reducing intake of fat, salt, sugar, caffeine, alcohol and nicotine can improve symptoms. Research has shown that a diet rich in calcium and vitamin D is helpful in improving symptoms. A number of supplements on the market claim to provide relief for PMS and PMDD. Use common sense and caution before experimenting with these supplements; some may have unexpected side effects, including interactions with other medications.

Treatment of persistent PMS, PMDD can be prescribed after evaluation by a medical provider. Drugs to prevent ovulation, such as hormonal contraceptives, may lessen symptoms. Antidepressant, anti-anxiety, tranquilizer or sedative drugs may occasionally be necessary to control mood symptoms. Diuretics (water pills) can help relieve bloating and fluid retention. Referral to a mental health provider may be necessary depending on severity of symptoms. Any increase or change in symptoms need follow-up with a healthcare provider.