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That Time of the Month
PMS Symptoms: How to Cope at Work When They're Bad
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Laura Berlinsky-Schine,
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What are signs your period is coming? For some women, one of the earliest warnings is PMS. 

Premenstrual syndrome (PMS) is a collection of symptoms that occurs in women after ovulation. It is an incredibly common syndrome: Over 90 percent of women report having PMS symptoms at some point in their lives. PMS is a real medical condition with real symptoms. While some women experience mild symptoms that are merely annoying, others may have physical and psychological symptoms so severe that they may have trouble getting out of bed and going to work.

There are some ways women with PMS can cope with and lessen their symptoms. Read on for seven practical steps you can take to mitigate severe PMS symptoms.

What are the first signs of PMS?

PMS has more than 150 associated symptoms, so it can be difficult to diagnose. Usually, menstruating women whose symptoms happen around the same time in their menstrual cycles with some regularly receive this diagnosis when other conditions with similar symptoms are ruled out. Other conditions with similar symptoms include anemia, eating disorders, diabetes, birth control side effects, endometriosis, and others.

There are a number of PMS symptoms, and they can vary in severity from person to person. Some of the more common symptoms include:

• Irritability
• Fatigue
Anxiety
• Depression
• Crying spells or uncontrollable crying
• Mood swings (including bouts of extreme anger or sadness)
• Increased or decreased libido
• Headaches
Memory and concentration problems
• Weight gain
• Food cravings
• Cramps or stomach pain
• Bloating
• Breast tenderness or soreness
• Diarrhea or constipation

If at least five PMS symptoms are present in an extreme form in menstruating women, they may be diagnosed with premenstrual dysphoric disorder (PMDD). PMDD symptoms include many of the same symptoms as PMS, but PMDD includes at least one of the following psychological symptoms to be diagnosed: extreme anxiety, persistent and intense anger or irritability, depression or feelings of hopelessness, or periods of sadness or bouts of crying. If these symptoms occur at times aside from the time between ovulation and menstruation, you may be suffering from depression instead of PMDD.

How many days before your period do you have PMS?

PMS usually occurs 1-2 weeks before the start of a menstrual period.

Is it normal to get tired before your period?

As noted above, fatigue is a very common symptom of PMS. This often goes away when your period begins. If fatigue lasts for an unusually long time, you should consult your doctor.

Causes of PMS

The exact causes of PMS and PMDD are unknown, but some scientists have proposed theories.

Roughly five days into a woman’s menstrual cycle, the ovaries release estrogen, which helps thicken and prepare the uterus for implantation if the woman conceives. Around 14 days into the cycle, ovulation—the release of the egg—occurs. If the egg is not fertilized during ovulation, resulting in pregnancy, there is a drop in the hormones estrogen and progesterone. The lining of the uterus sheds and the menstrual period occurs.

Some scientists believe that estrogen and progesterone interact with neurotransmitters, causing PMS symptoms. For instance, the drop in estrogen may be linked to a drop in serotonin, which regulates mood, sleep patterns, and well-being.

There may also be a genetic factor in PMS. Women with relatives who experience PMS may be more likely to have the symptoms themselves. The genetic link requires more research for confirmation, however.

Diet may also play a role in PMS. Complex carbohydrates, found in whole grains and vegetables, may increase levels of serotonin, causing some relief, while simple carbohydrates, found in white bread and foods high in sugar, can exacerbate symptoms. Alcohol, caffeine, salt, and nicotine can also exacerbate symptoms.

Coping with PMS at work

It can be difficult to deal with PMS symptoms in the workplace. You might find a coworker’s annoying behavior all the more obnoxious. Concentration issues or headaches may get in the way of your productivity. You may feel so tired that you wish you could take a nap under your desk. Your cramps may be so intolerable that you're unable to move. If you're experiencing severe physical symptoms, you might have to use sick days to miss work.

Fortunately, there are some steps you can take to mitigate the physical and emotional symptoms of PMS and learn how to cope with them.

1. Exercise.

Don’t just limit exercise to during your period (in fact, you’re probably not going to feel like going for jog if you’re tired, sad, and bloated). Exercise regularly. It can help with depression, anxiety, concentration, and fatigue.

2. Improve your diet.

Try to avoid overdoing the alcohol, caffeine, salt, and sugar, especially in the two weeks leading up to your period.

3. Sleep better.

Most adults need 7-9 hours of sleep, and many of us aren’t getting it. Aim for at least eight hours during your period; lack of sleep may exacerbate your symptoms.

4. Keep track of your cycle.

If you know when to expect your period, you won’t be caught off guard by your symptoms. Keeping track of when different symptoms occur can help you better manage and cope with them. For instance, if you know that you’re most irritable or have mood swings during certain times, you can identify when you're feelings are PMS-related and avoid taking out your anger on coworkers.

5. Engage in relaxation therapies.

Yoga, meditation, and other relaxation therapies may help mitigate some psychological symptoms.

6. Take medication.

Some medications, including oral contraceptives (birth control pills) and antidepressants can help relieve symptoms of PMS and PMDD. If your symptoms are severe, you may want to talk to your doctor about going on these medications. Your doctor can help you weigh the benefits of taking them against the risks of potential side effects.

Over-the-counter medications, such as ibuprofen, naproxen, aspirin, and vitamins, can also help relieve PMS symptoms.

7. Discuss your PMS with your manager.

If your PMS impacts your work life, you may want to discuss it with your boss. This may feel embarrassing, particularly if you have a male boss, but it’s important to communicate that issues that occur during “that time of month” aren’t the result of poor performance. You may ask to work out a plan for how your work can change when you’re coping with severe PMS and whether you can take off days as needed.

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