Premenstrual syndrome: how to alleviate the symptoms

Premenstrual syndrome: how to alleviate the symptoms

Premenstrual syndrome corresponds to a set of manifestations that precede the onset of periods . Affecting 20 to 40% of women of childbearing age, these hormonal disorders are common but trivialized. While some women never suffer from it, others, however, experience this period of the cycle in a very uncomfortable manner with significant physical and psychological symptoms that impact their quality of life. Like many other inconveniences linked to a woman's biological life, this premenstrual syndrome is often experienced as an inevitability. Women rarely report the existence of these disorders to their doctor, perhaps wrongly thinking that there are no means to alleviate them. But effective solutions exist. Before exposing them, let's first see what this syndrome corresponds to and what the signs are.

What causes premenstrual syndrome?

Causes still obscure

Menstrual cycles being an eternal start again (the average length of a cycle is 28 days in general), each month can have its share of difficult days. Varying from a few hours to a few days before the start of your period , this set of symptoms disappears quickly after the onset of your period. The gradation goes from a simple temporary discomfort to a priesthood lasting several days.

This syndrome involves hormonal factors although the exact mechanisms are still difficult to specify and are not yet all well identified.

Even if the hypothesis of a link with physiological hormonal fluctuations seems expected, it appears that a genetic predisposition can also be considered.

Other hypotheses have also emerged such as serotonin deficiency (1) or magnesium and calcium deficiency, but these have yet to be documented.

A common syndrome

Despite its frequency, this problem is too often overlooked. As women do not speak out on the subject, no cause will be sought and therefore no treatment will be put in place. However, a woman has menstrual cycles for approximately 38 years of her life!

In fact, 20 to 40% of women in their fertile period (in other words of childbearing age) are affected by premenstrual signs, and this continues until menopause (2) . In a third of them, we speak of premenstrual syndrome because they suffer from unpleasant symptoms which reduce their quality of life.

Finally, in 5% of cases, these disorders represent a real handicap, impacting personal, professional and social life. In this case, we speak of Premenstrual Dysphoric Disorder (PMDD) because it represents a severe form of premenstrual syndrome which is unfortunately still too often underdiagnosed.

How can premenstrual syndrome manifest?

The most common signs can be classified into 2 main categories: psychological symptoms and physical symptoms . They are mostly non-specific , that is to say they are not characteristic of premenstrual syndrome, and of variable intensity . They are important to compile because the diagnosis is based solely on them and the time of their occurrence. The intensity of the symptoms varies.

Unpleasant physical phenomena

Premenstrual pain

Pain in the lower abdomen , also called dysmenorrhea , represents a classic sign (3) of the imminent arrival of menstruation. These pains can take the form of cramps or heaviness or even be global in the lower part of the abdomen. They can also be located in the lower back or sacrum region .

Headaches (or headaches) sometimes join the rest of the celebrations and for some women, can even represent the only annoying sign they perceive.


This term refers to a feeling of heaviness or tension in the breasts commonly described by many women. The chest may be tender spontaneously or only to touch.

Water retention

This retention causes edema as well as transient weight gain but possibly explains the fact that the breasts are tense and painful.

Digestive disorders

Some women describe nausea that can lead to vomiting in the days before their period arrives. Bloating and heartburn are sometimes part of the cocktail of inconveniences.

Confusing emotional ups and downs

Premenstrual syndrome can also result in psychological problems. Among the panoply regularly described by a large number of women (and potentially by those around them!), we find difficulty concentrating, irritability, emotionality, anxiety, agitation, anger, insomnia, or even downright depression. These sometimes intense emotional variations show that the nervous and hormonal systems are linked in their functioning. The more medical term dysphoria is also used to name these mood changes . It can also lead to transient but intense psychological disorders such as depressed mood.

Concerning vitality, it is generally altered, ranging from intense fatigue to lethargy.

A purely clinical diagnosis

Additional examinations are not necessary unless certain symptoms point to other hypotheses such as endometriosis or polycystic ovary syndrome. On the other hand, to confirm the diagnosis of premenstrual syndrome, women are invited to write in a dated manner the inconveniences they present in the context of this hypothesis.

How to alleviate symptoms related to premenstrual syndrome?

Although no specific treatment has yet been developed, it involves trying different strategies to determine what may work for one woman better than another.

Trying Some Classic Tips and Treatments

Ibuprofen (non-steroidal anti-inflammatory drug) (4) and paracetamol are the most frequently used analgesics to relieve premenstrual pain. Beyond these medications, solutions to relieve symptoms target hormonal regulation. Thus, the oral contraceptive pill can be prescribed with the intention of regularizing menstrual cycles and alleviating associated pain. If you are not in favor of traditional medications, be aware that a study has shown that the use of local heat applied to the lower abdomen (with a hot water bottle for example) is sometimes enough to relieve dysmenorrhea (5) .

Use a food supplement

Certain food supplements are formulated with plants and vitamins to promote better comfort at the end of the cycle. These supplements allow hormonal regulation throughout the cycle but their composition also acts on pain and the nervous system. Certain natural components , identified as having an action on the feminine sphere, can provide a global response to the main inconveniences.

Potentilla anserine , for example, is known for its calming properties for painful periods. Magnesium contributes to the balance of the nervous system. PEA (Palmitoyl Ethanol Amide) is a molecule naturally produced by our body in painful situations and intervenes at the level of receptors in the pain circuit to reduce it (6) . Studies have shown that Japanese knotweed extract contains an interesting polydatin content and that the latter acts in interaction with PEA. Some serious studies have shown that their association would be relevant for menstrual pain and discomfort (7) .

Change your lifestyle habits

To alleviate certain symptoms, for some women, it is sometimes enough simply to change their eating habits. All healthy and balanced diet recommendations are valid, but in particular reducing the consumption of fast fats and sugars can be beneficial (8) . Furthermore, stress , as well as lack of sleep and physical activity , can negatively influence the intensity of premenstrual symptoms. Even if it is not always easy to control these parameters, taking them into account can really improve the few delicate days which precede your period.

Serotonergic therapy

Serotonin is a neurotransmitter that acts in the loop that conditions our mood. A deficiency in serotonin is known to contribute to depression. It seems that this mechanism also comes into play in premenstrual syndrome and its psychological symptoms detailed a little above.

Studies have shown the effectiveness of selective serotonin reuptake inhibitors on severe premenstrual syndrome (9) , provided there is a good indication. Also, some general practitioners and gynecologists sometimes use it as a prescription for women whose mood disorders are very marked a few days before the arrival of their periods.

Premenstrual discomfort doesn't have to be inevitable. It can be relieved by different means which concern lifestyle habits as well as allopathic or natural therapies. By speaking with your doctor or gynecologist, you will be advised to no longer endure this sometimes very unpleasant period of the cycle.


1. Recommendations_glaucome.pdf 2. Jünemann AGM, Grieb P, Rejdak R. Bedeutung von Citicolin bei der Glaukomerkrankung. Ophthalmol. 2021;118(5):439‑48. 3. Ottobelli L, Manni GL, Centofanti M, Iester M, Allevena F, Rossetti L. Citicoline oral solution in glaucoma: is there a role in slowing disease progression? Ophthalmol J Int Ophthalmol Int J Ophthalmol Z Augenheilkd. 2013;229(4):219‑26. 4. Rossi GCM, Rolle T, De Silvestri A, Sisto D, Mavilio A, Mirabile AV, et al. Multicenter, Prospective, Randomized, Single Blind, Cross-Over Study on the Effect of a Fixed Combination of Citicoline 500 mg Plus Homotaurine 50 mg on Pattern Electroretinogram (PERG) in Patients With Open Angle Glaucoma on Well Controlled Intraocular Pressure. Front Med. Apr 29, 2022;9:882335. 5. Aydin B, Onol M, Hondur A, Kaya MG, Ozdemir H, Cengel A, et al. The effect of oral magnesium therapy on visual field and ocular blood flow in normotensive glaucoma. Eur J Ophthalmol. Feb 2010;20(1):131‑5.