Every single month many women experience PMS, with symptoms ranging from mild to severe. The etiology of PMS is uncertain, however sensitivity to the to the cycling of estrogen and progesterone in addition to a hormonal impact on neurotransmitters is thought to play a role. Interestingly, women who experience PMS have greater risk of menopausal symptoms associated with hormonal fluctuations (hot flashes, depressed mood, poor sleep, and decreased libido).

PMS can be classified into different types. These are general guidelines; many women may identify with one category in particular but may also experience symptoms from other categories:
  • PMS A (Anxiety): Prevalent anxiety is the primary symptom, in addition to weepiness, paranoia, mood swings, and irritability
  • PMS C (Cravings): Food cravings and increased appetite are the primary symptoms
  • PMS D (Depression): Primary symptoms include depression, insomnia, and mood swings
  • PMS H (Hyperhydration): Primary symptoms include water retention, swelling, breast tenderness, bloating and weight gain
  • PMS P (Pain): Pain is the main symptom, which can occur a few days prior to menses. This includes low back pain, joint, pain, headaches, and uterine cramping

No particular symptoms are diagnostic for PMS, rather it is the monthly recurrence of symptoms that is characteristic of PMS. Symptoms begin sometime after ovulation and will end shortly after menses begin.


Premenstrual dysphoric disorder (or PMDD) is similar to PMS however symptoms are more severe in nature and can be disabling. Diagnostic criteria for PMDD is outlined as follows:
  • A woman must experience at least one core symptom and five or more symptoms in total during the week before her menses;
  • Symptoms must interfere significantly with daily activities or relationships; and
  • Symptoms must have occurred during the past year.

  • Significantly depressed mood, hopelessness, self-defeating thoughts
  • Significant anxiety, tension, feeling irritable, uptight
  • Sudden mood changes of sadness, weepiness, or easily feeling rejected
  • Anger or irritability or increased conflict with others

  • Lack of motivation for usual activities
  • Difficulty concentrating
  • Lethargy, easily fatigued, low energy
  • Changes in appetite, overeating, food cravings
  • Hypersomnia or insomnia
  • Overwhelmed, feeling out of control
  • Additional physical symptoms: breast tenderness, swelling, headaches, joint or muscle pain, bloating, weight gain

  • Why seek advice from a Naturopathic Doctor for PMS:

    • An ND will customize your treatment plan to your individual needs. A benefit to treating PMS naturally is that lifestyle changes can have a positive effect on general health.
    • Treatment may include supplements, acupuncture, and dietary or lifestyle changes. An ND will check supplement interactions with current medications before prescribing to ensure there are no interactions.
    • An ND will be able to investigate hormonal imbalances that may be contributing to symptoms of PMS.
    • Hormone testing can be ordered through an ND to identify imbalances that may be contributing to symptoms.


    On your journey to better health