What should you know about severe premenstrual tension?

Premenstrual tension may include [Irritability](/symptoms/irritability/), [Feeling Anxious](/symptoms/feeling-anxious/), low mood, breast tenderness, bloating, headaches, appetite changes, or reduced patience. Sleep may become difficult, followed by [Daytime Sleepiness](/symptoms/daytime-sleepiness/) and [Fatigue](/symptoms/fatigue/). Some people notice [Difficulty Concentrating](/symptoms/difficulty-concentrating/) as well. Severity is judged by the effect on work, relationships, study, self-care, and safety. A clinician compares symptoms before and after menstruation and checks for depression, anxiety, or [Insomnia](/conditions/insomnia/) that may occur outside the premenstrual phase.

Track symptoms each day for several cycles, including the first day of bleeding, sleep, mood, pain, appetite, and daily functioning. Use the record at a GP appointment. Regular movement, nourishing meals, a steady sleep schedule, and reducing avoidable stress may help some symptoms. A clinician may discuss psychological support, hormonal options, or medicine for particular symptoms. Ask before starting supplements or changing prescribed treatment, because products can interact with medicines or be unsuitable for you.

Arrange prompt medical help if symptoms are becoming harder to manage, continue after your period, or interfere with work, relationships, eating, or sleep. Seek emergency help if you have thoughts of suicide, feel unable to keep yourself safe, or cannot manage basic needs. A trusted person can help you contact care and remain with you while urgent support is arranged.

Ask whether your symptom timing fits a premenstrual disorder, what should be recorded, and which treatment options match your health, contraception, and pregnancy plans. Mention [Difficulty Sleeping](/symptoms/difficulty-sleeping/), [Fatigue](/symptoms/fatigue/), or persistent low mood so other causes are considered.