PMS, Premenstrual Syndrome

PMS or PMT is the description given to the symptoms that some women get in the days leading up to their period which can include a range of emotional, physical and also psychological effects.

Common symptoms of PMS, Premenstrual Syndrome

  • Disturbed sleep
  • Heart palpitations
  • Panic attacks
  • Hot flushes
  • Night sweats
  • Tiredness
  • Mood swings
  • Fluid retention and bloating
  • Changes to hair and skin
  • Back ache
  • Breast tenderness
  • Food cravings or change of appetite
PMT Treatment

Causes of PMS/PMT

Hormonal factors

Changes in hormone levels are thought to be the main cause of PMS/PMT. More specifically, it is the decline in oestrogen and rise in progesterone for up to two weeks before the period starts.

The monthly cycle

Each month a follicle containing an egg develops and oestrogen levels rise. Once the egg is released at ovulation, oestrogen levels start to decline and progesterone levels start to rise. Progesterone works against oestrogen, and this combination of falling oestrogen and rising progesterone can result in the symptoms listed above.

Chemical factors

During the menstrual cycle some chemical levels in the brain fluctuate, such as serotonin. When serotonin levels are low it may cause tiredness and low mood, similar to those symptoms caused by declining oestrogen levels.

Other associated causes of PMS, Premenstrual Syndrome

If you are suffering from the above PMS/PMT symptoms, it is a very good idea to be screened for polycystic ovaries (PCOS), as there is a strong association with high sugar levels, high insulin levels and exaggerated hormonal symptoms pre-menstrually and menstrually. This screening may include a scan and possibly blood test which can be carried out here at The Surrey Park Clinic.

Effect of diet on PMS/PMT

High sugar, high carbohydrate snacking diets make PMT worse by worsening insulin levels which inactivates circulating hormones and ‘paralyses’ their effect. Therefore, change of diet can make a great difference to PMT (see PCOS). Higher protein, low GI, no snack diets can help.

At the Surrey Park Clinic, we are specialists in the diagnosis and treatment of PMS, Premenstrual Syndrome and offer personalised care at our friendly clinic at a time to suit you. Please call 01483 454 016 to arrange your consultation.


At present there isn’t a specific test which can diagnose PMS/PMT, however if you are experiencing the symptoms above and are finding that your quality of life is affected, you can make an appointment to see a specialist gynaecologist here at The Surrey Park Clinic who will assess your symptoms and recommend appropriate solutions.

You may be asked to record your symptoms and how severe they are on a monthly chart so that we can identify patterns and assess the most appropriate treatment for you.


Oestrogen replacement

This usually involves careful timing of the onset of symptoms and replacement of the oestrogen at the appropriate time. This is around a week before the period and during the menstrual time until a new egg starts to develop, resulting in a natural rise in oestrogen levels.

What happens if hormone symptoms are erratic?

This generally means that the quality of the developing egg is different each month, so some months are better than others. In this case careful charting of symptoms is important to try and keep levels steady.

Levelling out the rise and fall of symptoms or erratic fluctuations can be very helpful. Ways of doing this include:

  • Progesterone coil (Mirena)
  • Oral contraceptives (“The Pill”)
  • Down regulation of ovarian oestrogen production such as pituitary suppressing injections including GnRH analogues such as Zoladex
  • Occasionally removal of the ovaries.

Alternative treatments/natural remedies

Natural oestrogenic products such as evening primrose oil, starflower oil and some containing trace elements such as magnesium and zinc can help.

What about natural progesterone?

Natural progesterone available in a cream form can calm the symptoms of PMS/PMT. Natural progesterone is very similar in molecular configuration to oestrogen, not as strong and therefore in many women is preferable. It is completely different in molecular configuration to the synthetic progestogens used in the Pill, and HRT.

Related topics Coils & MirenaBlood Tests, Ultrasound Scans

We can help to reduce and relieve the symptoms of PMS

Our specialist consultants can review your particular set of symptoms and prescribe appropriate treatment(s) to get you back into balance.
Call 01483 454 016 to arrange an appointment or complete the quick contact form: