Premenstrual syndrome (PMS) can occur five to 11 days prior to the first day of a woman’s period. Symptoms vary, but often include:

The severity of these symptoms generally peak around a woman’s late 20s and early 30s, and begin to dissipate when a woman enters menopause.1

The physical symptoms will generally occur every month; however, the emotional symptoms may be severe one month and hardly noticeable the next. The causes of PMS are not entirely known by the medical community, but there are some factors doctors believe contribute to the severity of the PMS symptoms women experience.

Chemical Fluctuations in the Brain
The rise and fall of serotonin in the brain is responsible for mood swings. Insufficient amounts of serotonin in your brain can trigger depression, food cravings and fatigue.

Depression
Women with severe PMS symptoms (known as PMDD) usually have undiagnosed depression. The cyclical hormonal changes and fluctuations in the body during a woman’s menstrual cycle can trigger the emotional onset of depression.

Poor nutrition
Studies have shown poor nutrition and eating habits may also contribute to severe PMS symptoms. Women who are lacking important vitamins and minerals, and eating too many salty foods, alcohol and caffeinated beverages are more prone to retaining fluids and experiencing mood swings.

Treatments
Women no longer need to feel like they are held hostage by their PMS symptoms, as there are many treatments and lifestyle changes one can make to help alleviate the most severe PMS symptoms.

Lifestyle changes
Modifying your diet to exclude salty foods and incorporating at least 30 minutes of exercise everyday such as biking, walking or swimming can also help reduce unbearable PMS symptoms. To combat mood swings try to alleviate stress by meditating or practicing yoga.

Anti-depressants
For women who experience serious depression and emotional mood swings during PMS, your doctor may prescribe anti-depressants such as Prozac, Sarafem, Paxil or Zoloft. These anti-depressants have also been used to help women fight food cravings, fatigue and depression. Be sure to have a conversation with your physician about the potential side effects.

Over the Counter Medication
Anti-inflammatories such as ibuprofen or acetaminophen (like Advil or Tylenol) can also help with cramping and breast tenderness. For water retention, diuretics can help shed excess water weight and even most oral contraceptives have a hormonal stabilizer that can alleviate rapid mood swings.

Sources:
1. 1 http://www.mayoclinic.com/health/premenstrual-syndrome/DS00134