November 9, 2025
PMS, short for Premenstrual Syndrome, refers to a variety of emotional, physical, and behavioral symptoms that often arise in the 7 to 10 days before menstruation begins. Although the exact cause isn’t fully understood, experts believe that fluctuations in estrogen, progesterone, and serotonin levels during the luteal phase of the menstrual cycle play a key role. There may also be a hereditary component, as PMS appears to be more common in certain families.
Most people who menstruate report experiencing some degree of PMS at some point, with many noticing recurring symptoms month to month.
PMS affects both the mind and body. Some of the most frequently reported physical symptoms include:
Emotionally, PMS may cause:
While symptom severity can range from minor to disruptive, many effective strategies exist to reduce the impact of PMS on everyday life.
There’s no lab test that specifically identifies PMS. Instead, tracking your symptoms over the course of two full menstrual cycles can reveal clear patterns. A hallmark of PMS is that symptoms typically fade between days 4 and 12 of the cycle. Reviewing these symptom logs with a healthcare provider—especially a mental health specialist—can help confirm a diagnosis and rule out other conditions.
Regular cardiovascular exercise, such as walking or biking, has been shown to ease PMS symptoms. Practices like deep breathing, mindfulness, and yoga can also help manage stress and improve mood. Small dietary changes—like limiting caffeine, alcohol, sugar, and fatty foods—can improve hormonal balance. Eating smaller, more frequent meals may help stabilize blood sugar and reduce irritability or fatigue.
For some, therapy—especially cognitive behavioral therapy (CBT)—can ease the mental and emotional burdens of PMS. CBT helps by addressing unhelpful thoughts and reactions, and replacing them with more balanced, constructive patterns. One goal of CBT is to reduce the disruption PMS causes in daily routines, relationships, and work.
CBT sessions usually begin by exploring how your emotions and thoughts shift throughout the menstrual cycle. A therapist may guide you in identifying triggers for certain moods and provide tools to reframe or cope with them. You might also be asked to keep a journal of symptoms and menstrual patterns, which helps track progress and pinpoint what strategies are most effective.
Some healthcare providers may recommend SSRIs (selective serotonin reuptake inhibitors) to help regulate mood symptoms associated with PMS. Even for those who don’t have anxiety or depression the rest of the month, SSRIs can improve premenstrual mood, energy, and focus. These medications work by increasing serotonin levels and reducing the breakdown of allopregnanolone—a neurosteroid influenced by progesterone. Some individuals may only need to take SSRIs during the second half of their cycle, rather than daily.
The intensity of PMS symptoms can fluctuate throughout your life. Stress, hormonal changes during puberty, after childbirth, or as menopause approaches may cause PMS to become more noticeable or more difficult to manage. Other times, symptoms may lessen or temporarily disappear.
If PMS is affecting your life, consult your primary care physician, OB-GYN, or a licensed mental health provider. They can assess whether PMS is the cause of your symptoms or if another condition—such as hormonal imbalances, fibroids, or a mood disorder—is contributing. Together, you can develop a personalized plan for relief.
For more detailed information about PMS, including research findings and treatment guidelines, visit the Office on Women’s Health at womenshealth.gov.
Seeking treatment for PMS offers life-changing benefits by helping individuals stabilize their mood, restore daily functioning, and improve overall well-being.
At Psychiatry Telemed, our virtual care model ensures accessible, consistent, and compassionate treatment from licensed professionals. Combining evidence-based therapy with medication management, patients gain the tools they need to navigate PMS while staying empowered and in control of their mental health.
Our 60-minute consultation offers a thorough assessment of your mental health needs, helping us understand your challenges and goals. We'll discuss symptoms, treatment options, and create a personalized healing plan.
Follow-up sessions provide ongoing support and may include medication management to ensure your treatment plan is effective and tailored to your needs.
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