What is PMS?

Premenstrual syndrome is a spectrum of symptoms that may affect menstruating women any time from ovulation until the onset of menstruation and usually resolves with menstruation. These symptoms may range from mild to severe and at their most severe can cause severe disruption and debilitation to the woman affected and to her family. Up to 50 to 75% of all women may experience mild symptoms. 20-30% of women suffer moderate to severe symptoms and 2-10% of all women suffer very severe and debilitating changes which may affect their lifestyle and relationships.

Symptoms of PMS

Women suffering from PMS may report a wide variety of symptoms but the key to diagnosis is a history of changes that occur at or around the time of ovulation and resolve with menstruation. Symptoms that occur at ovulation may resolve and recur as the period approaches or may persist throughout the luteal phase of the cycle. Significant PMS may be classified as symptoms that occur for 4 or more days in the luteal phase of the cycle. Symptoms of PMS may include depression, tearfulness, irritability, bloating, carbohydrate craving, fatigue, breast tenderness, weight gain, headaches and insomnia.

Many women will experience mild mood changes or physical discomfort at the time of their period but if this lasts less than 4 days it should not be considered true PMS.

PMS & Natural Family Planning

Women who are interested in using natural family planning should inform their NFP teacher if they have any symptoms suggestive of PMS.  This is important as for some women, PMS may make it difficult to utilise the available definitely infertile time after ovulation and may also make it difficult to maintain a temperament consistent with the practice of natural family planning.

PMS & Dietery Advice

Many symptoms associated with PMS can be alleviated by dietary advice, e.g. restrict caffeine consumption, avoid high peak-sugar levels by taking frequent small meals of slow-release carbohydrates (e.g. starchy type foods) and cutting down on chocolate.

Women suffering from PMS are often hypoglycaemic (i.e. suffer from low blood sugar levels or dips in their blood sugar levels). These women often benefit from dietary modification. Carbohydrates that release their sugars quickly (e.g. chocolate) can cause sudden drops in blood sugar levels and thus are best avoided. Slow release carbohydrates promote more stable blood sugar levels and therefore a diet based on these foods is recommended. It is important that a woman follows this diet throughout her cycle and not just in the pre-menstrual phase.

The basic dietary principles to help avoid hypoglycaemia include:

  • Wholegrains, nuts and seeds should replace refined sugars and flours.
  • No caffeinated beverages (tea, coffee, cola etc) but plenty of water.
  • No decaffeinated coffee or tea.
  • Frequent (every 2-3 hours) snacks and small meals.

Causes of PMS

The underlying cause of many cases of PMS is low progesterone levels in the luteal phase of the cycle. Hypoglycaemia can contribute to symptoms and there is evidence that women suffering from PMS may in some cases have low beta endorphin levels.

Investigation & Treatment

NaPro Technology (Natural Procreative Technology) is a new and advanced scientific medical system of procreative health care which has been developed in the USA by Dr Thomas Hilgers a clinical professor in the Dept of Obstetrics & Gynaecology at Creighton University School of Medicine, Omaha, Nebraska. It can be used to treat a wide range of gynaecologic disorders including PMS and infertility. If PMS symptoms are severe, consultation with a doctor who specialises in NaProTechnology is suggested for investigation and treatment. Contact details of two such clinics in Ireland are given below:

Galway : https://naprobaby.ie

Dublin: https://neofertility.ie


PMS can range from being a nuisance and inconvenience to being a significant debilitating condition in a woman’s life. Appropriate investigation and treatment can significantly improve a woman’s quality of life.  The Natural Family Planning teacher has a unique opportunity to identify women who may benefit from further investigation and treatment.

Further reading

Dr. Thomas Hilgers; ‘The Medical and Surgical Practice of NaProTechnology’, 2004; Published by Pope Paul VI Institute Press, 6901 Mercy Road, Omaha, Nebraska 68106, USA; ISBN 0-9744147-0-0.