PMS is a group of physical and emotional symptoms that appear in the days before a period and ease soon after it
starts. Most women notice some changes; for some, they are severe enough to disrupt work, relationships and
daily life. The pattern — not any single symptom — is what defines PMS, so tracking it is the first step.
Effective help is available.
What is PMS?
PMS is linked to the normal rise and fall of oestrogen and progesterone after ovulation. Hormone levels are usually
normal in women with PMS; instead, some women's brains are more sensitive to these changes, affecting chemical
messengers such as serotonin. Stress, poor sleep, low activity and a family history make symptoms worse. PMS
doesn't happen before puberty, in pregnancy or after menopause, because the hormone cycle has stopped.
Slow, unforced breathing and gentle yoga help manage stress. Avoid breath-holding and forceful techniques if you have heart disease, high blood pressure or are pregnant.
When symptoms happen
If symptoms are present all month, or also in the week after the period, something other than PMS — such as depression or anxiety — is more likely and deserves its own care.
Record symptoms daily for at least two cycles, using a diary or a period app. Take it to your appointment — it is the most useful diagnostic tool.
Physical: bloating, breast tenderness, headaches, tiredness, joint or muscle aches, acne, weight fluctuations
Behavioural: food cravings, changes in sleep, loss of interest in usual activities
PMDD: severe PMS
About 1 in 20 women have premenstrual dysphoric disorder (PMDD), a severe form in which mood
symptoms — depression, anxiety, anger, feeling out of control, sometimes thoughts of suicide — seriously disrupt
life each month. PMDD is a recognised medical condition, not a character flaw, and it responds to treatment.
If you have thoughts of harming yourself, call Tele-MANAS on 14416 or 112.
Treatment
Lifestyle measures (see self-care) help mild PMS.
Cognitive behavioural therapy helps with coping and mood.
SSRI antidepressants are the most effective medical treatment for severe PMS and PMDD. They work quickly and can be taken only in the second half of the cycle, or daily.
Hormonal options — some combined pills taken continuously, or other hormonal treatments that stop ovulation — under a gynaecologist.
Pain relief such as ibuprofen for cramps, headaches and breast pain.
Calcium (from food or a supplement) has some evidence. Avoid high-dose vitamin B6 supplements — long-term use can damage nerves.
Ayurvedic view
Identify the dominant dosha pattern → keep Apana Vata flowing smoothly → steady routine and digestion in the second half of the cycle.
Classical texts describe the menstrual cycle (Rituchakra) and a routine for the days of menstruation, but
don't name PMS as a single disease. Ayurvedic practitioners group premenstrual symptoms by dosha:
Vata type — anxiety, insomnia, constipation, cramps; Pitta type — irritability, anger, breast
tenderness, acne, loose stools; Kapha type — bloating, heaviness, sadness, cravings, sleepiness. Care is
tailored to the pattern: warmth and routine for Vata, cooling foods for Pitta, lighter food and
activity for Kapha.
Herbs & safety
Shatavari — nourishing and cooling; used for irritability and breast tenderness
Brahmi and Jatamansi — for anxiety and sleep
Ashoka — a classical uterine tonic
Ginger and fennel teas — for cramps and bloating
Evidence is limited. Calming herbs can add to the effect of sedating medicines and interact with antidepressants.
Avoid herbs if you may be pregnant, and use licensed products from a qualified practitioner.
Self-care
Exercise regularly — brisk walking, cycling, swimming or yoga, most days of the month.
Eat small, regular meals with whole grains, pulses and vegetables; this steadies energy and cravings.
In the second half of the cycle, cut down on salt (bloating), caffeine (anxiety, breast pain), sugar and alcohol.
Protect sleep; plan demanding tasks outside the PMS window where you can.
A warm-oil massage (abhyanga) and slow breathing (Nadi Shodhana, Bhramari) calm the nervous system.
Talk to people close to you about the pattern — understanding reduces conflict.
When to see a doctor
Symptoms that affect your work, study or relationships
Low mood, hopelessness or thoughts of self-harm — urgently
Symptoms that don't follow the cycle pattern, or continue after the period
