Premenstrual syndrome (PMS) is a pattern of physical and emotional symptoms, such as bloating, breast tenderness, irritability and low mood, that appear in the one to two weeks before a period and ease once bleeding starts. When mood symptoms are severe, it may be PMDD. Lifestyle changes, certain antidepressants and some hormonal contraceptives can help.
- Timing
- Luteal phase, eases with period
- Diagnosis
- Symptom diary over 2 cycles
- Severe form
- PMDD
- Self-care
- Exercise, sleep, less caffeine
- Medical options
- SSRIs, hormonal contraception
- Seen by
- Dr. Sun-Ok Lee, OB-GYN specialist
What are the symptoms of PMS?
Symptoms appear after ovulation, usually in the 5–14 days before a period, and improve within a few days of bleeding starting. They vary from cycle to cycle.
- Emotional — irritability, anxiety, mood swings, sadness, feeling overwhelmed, trouble concentrating
- Physical — bloating, breast tenderness, headaches, fatigue, joint or muscle aches, acne
- Behavioral — food cravings, changes in sleep, withdrawing from social activities
If cramps are your main problem, see painful periods.
PMS vs. PMDD: what is the difference?
| PMS | PMDD | |
|---|---|---|
| Severity | Mild to moderate, manageable | Severe; disrupts work, study or relationships |
| Main symptoms | Physical and emotional mix | Marked mood symptoms: depression, anger, anxiety, hopelessness |
| How common | Common | Much less common |
| Typical treatment | Lifestyle measures, pain relief, sometimes hormonal options | SSRIs, hormonal options, psychological support |
Symptoms that are present throughout the month rather than only before periods suggest another cause, such as depression, anxiety, thyroid disease or perimenopause, which may need different care. For hormone-related causes, see hormonal imbalance.
- Irritability or low mood before each period
- Bloating, breast pain and headaches
- Symptoms affecting work or relationships
- Unsure whether it is PMS or something else
- Pattern confirmed with a symptom diary
- Other causes such as thyroid issues checked
- Treatment aims to reduce premenstrual symptoms
- Follow-up to adjust the plan
How is PMS diagnosed?
- Track your symptoms Record symptoms daily for at least two cycles, noting the dates of your periods. Many period-tracking apps can do this.
- Consultation in English Your doctor reviews the diary to confirm that symptoms cluster before periods and ease afterwards.
- Rule out other causes Blood tests such as thyroid function may be suggested, and mood screening questions are asked with care and privacy.
- Agree a plan Starting with lifestyle steps and adding medical treatment if symptoms remain disruptive.
Treatment options
- Lifestyle — regular aerobic exercise, enough sleep, balanced meals, and reducing caffeine, alcohol and salt in the second half of the cycle.
- Calcium — some studies suggest calcium supplements can ease symptoms; ask your doctor before starting supplements.
- Pain relief — anti-inflammatory painkillers for headaches, cramps and breast tenderness.
- SSRIs — certain antidepressants are effective for PMDD and severe PMS, sometimes taken only in the second half of the cycle.
- Hormonal contraception — some combined pills, particularly continuous use, reduce cycle-related symptoms. See birth control pills in Korea.
- Talking therapies — cognitive behavioral therapy can help with coping and mood.
Every treatment has possible side effects, which your doctor will explain before you decide.
When to seek help
See a gynecologist if symptoms affect your work, studies or relationships, if self-care has not helped after a few cycles, or if symptoms are getting worse. At Yoonho Women’s Hospital in Apgujeong, Seoul, consultations are private, unhurried and in English.
Cost and documents
As a general guide, consultations are about ₩50,000–100,000; blood tests and medication are extra, and a written estimate is given after consultation. Residents with National Health Insurance are usually covered for medically necessary care — see health insurance for foreigners.
Why international patients choose Yoonho
Frequently asked questions
Is PMS just in my head?
No. PMS is a recognized condition linked to how the brain responds to normal hormone changes in the cycle. Symptoms are real and treatable.
Can birth control pills make PMS better or worse?
Some women find certain pills improve symptoms, especially when taken continuously, while others notice mood changes on hormonal contraception. Your doctor can suggest options and adjust if needed.
Do I need blood tests to diagnose PMS?
There is no blood test for PMS itself. Diagnosis is based on a symptom diary; blood tests are used only to rule out other conditions such as thyroid problems.
Can PMS change as I get older?
Yes. Symptoms can change over time and may feel stronger in perimenopause, when hormone levels fluctuate more. They end after menopause.
Can I get SSRIs prescribed at a gynecology clinic in Korea?
Your doctor can discuss whether medication is appropriate and prescribe or refer you, depending on your situation. Bring details of any current medications.
OB-GYN Specialist · Director of OB-GYN
M.D., Ewha Womans University College of Medicine · Former Clinical Instructor, Ewha Womans University Mokdong Hospital · Member, Korean Society of Menopause
Last reviewed: . This page is for general information and does not replace an in-person consultation.
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Yoonho Hospital · 304 Apgujeong-ro, Gangnam-gu, Seoul · Mon–Fri 9:00–18:00, Sat 9:00–13:00 · Walk-ins welcome.