What should you know about PMS and PMDD symptoms?

Physical PMS symptoms may include cramps, bloating, breast tenderness, headaches, acne, appetite changes, tiredness, or sleep disturbance. Emotional and thinking changes can include irritability, tearfulness, anxiety, low mood, reduced concentration, or feeling more sensitive to conflict. A breast symptom can be explored further in [Breast Pain](/symptoms/breast-pain/).

PMDD is distinguished by more intense premenstrual mood symptoms and a meaningful effect on relationships, responsibilities, or self-care. The timing matters: symptoms commonly build before menstruation and improve after it begins. Symptoms that remain throughout the cycle may point to another or additional health concern.

Use a calendar or symptom app to record each symptom daily, along with bleeding, sleep, stress, medicines, and whether normal activities were affected. Note both symptom-free days and difficult days; this gives a clinician a clearer picture than recalling a whole month at once. Gentle activity, regular meals, reliable sleep, and practical support may reduce the burden for some people.

If symptoms are troublesome, arrange an assessment. Treatment may involve talking therapy, medicines, or hormonal approaches such as the [Combined Pill](/treatments/contraception-and-family-planning/combined-pill/), depending on your circumstances.

Seek medical advice if symptoms are recurring, worsening, or interfering with work, study, relationships, or personal care. Get urgent help for thoughts of suicide, self-harm, or inability to stay safe. Contact emergency services in an immediate danger situation and tell someone you trust.

Ask which symptoms are most relevant to diagnosis, how long to keep a diary, whether another condition could be contributing, and which treatment could address both mood and physical symptoms. Ask what to do if symptoms do not follow a cycle.