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Is it PMS or something else?

Painful cramps, bouts of irritability or sadness, sleep issues—sometimes it's more than PMS.

Updated on April 19, 2024

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Are intense emotions and physical symptoms affecting your day-to-day life when you have your period?

Premenstrual syndrome (PMS) could be the cause. But in many cases, there's an underlying health condition that may be at play. Here’s what you need to know.

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First, what exactly is PMS?

PMS is a group of symptoms that people tend to experience around the time of their menstural period. It usually starts a few days before menstruation.

"The symptoms are categorized as emotional or physical, but many people have both," explains Christopher Manipula, MD, an OBGYN in Chester, Virginia.Show More

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Depression

"Depression and anxiety disorders are the most common conditions that overlap with PMS," says Manipula. "In fact, about a half of all people who seek treatment for PMS have one of these two disorders." Symptoms that could indicate depression include:

  • Loss of interest in the activities you
  • Show More
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The transition to menopause

The average age that people begin menopause is 51. But the transition to menopause, called perimenopause, can start years before that. Many people experience irregular periods during perimenopause.

Perimenopause symptoms are similar to PMS and may overlap. Because ovulation can still occur duringShow More

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Endometriosis

Endometriosis may affect approximately 5 million women in the United States. Many researchers believe the actual number is higher, however, since the condition is often ignored or mistaken as PMS.

"Many of the symptoms are the same, like bloating, pain, and cramping," says Manipula. "I think that’sShow More

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Ovarian Cancer

Ovarian cancer may be highly treatable when found early, but the American Cancer Society predicts that 12,740 women will die of ovarian cancer in 2024. That’s because ovarian cancer is often diagnosed at later stages, when it is often more difficult to treat. Symptoms can be vague and mistaken forShow More

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Premenstrual Dysphoric Disorder (PMDD)

"PMDD, or premenstrual dysphoric disorder, is a severe form of PMS," says Manipula. "It’s diagnosed when someone has at least five symptoms, such as frequent crying, anger that leads to conflict, a lack of interest in favorite activities, appetite changes, headaches, muscle pain, bloating, andShow More

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Dysmenorrhea

The terms PMS and dysmenorrhea are often used interchangeably, but they are not the same thing. Dysmenorrhea refers to especially painful periods, usually involving cramps in the lower back and abdomen. Cramping typically lasts for 12 to 72 hours around the start of menstruation.

Pain may be causedShow More

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When to get help for PMS

If PMS is affecting your job performance, your relationships, or your daily life, make an appointment with an HCP. Not sure if you’re experiencing PMS or something else?

"My philosophy with all of my patients is if you're concerned about anything, just come see me," says Manipula. "If something isShow More

Slideshow sources open slideshow sources

Cleveland Clinic. Dysmenorrhea. July 13, 2014.
National Institute on Aging. What Is Menopause? June 27, 2017.
American Cancer Society. Key Statistics for Ovarian Cancer. January 8, 2020.
InformedHealth.org. Premenstrual syndrome: Overview. June 15, 2017. 
UpToDate.com. Treatment of premenstrual syndrome and premenstrual dysphoric disorder. October 2020.
F Shobeiri, FE Araste, et al. Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstetrics & Gynecology Science. 2017 Jan;60(1):100-105.
Merck Manual Consumer Version. Premenstrual Syndrome (PMS). July 2019.
American College of Obstetricians and Gynecologists. Premenstrual Syndrome (PMS). May 2015.
Mayo Clinic. Menopause. October 14, 2020.
WomensHealth.gov. Endometriosis: A Fact Sheet From the Office on Women’s Health. August 18, 2014.
Sona Pharmacy + Clinic. Is it PMS or Perimenopause? Accessed December 7, 2020.
American Cancer Society. Signs and Symptoms of Ovarian Cancer. April 11, 2018.
WomensHealth.gov. Premenstrual dysphoric disorder (PMDD). March 16, 2018.
Cleveland Clinic. Premenstrual Dysphoric Disorder (PMDD). November 23, 2020.
American College of Obstetricians and Gynecologists. Dysmenorrhea: Painful Periods. June 2020.
Cleveland Clinic. Dysmenorrhea: Management and Treatment. November 20, 2020.

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