Variable group of symptoms occurring before menstruation in 40% of women, severe in about 10% of those.
Physical symptoms may include headache, cramps, bloating, and constipation or diarrhea. Emotional symptoms range from irritability, lethargy, and mood swings to hostility, confusion, and depression. Theories as to the cause centre on hormones, nutrition, and stress (known to affect severity). Depending on the symptoms, treatment may involve exercise, stress management, nutritional therapy, or drugs. Dietary measures include low sodium and high protein and complex carbohydrate intake and avoidance of xanthines (including caffeine). Increasing calcium intake has been shown to prevent or reduce cramps, which are best treated with ibuprofen.