One culture may report different symptoms from another culture. But people from all walks of life are affected.

But only 5% to 10% say they have symptoms severe enough to interfere with daily life.

Severe cases of PMS are often called premenstrual dysphoric disorder (PMDD).Dysphoric means the opposite of euphoric, which is a comfortable, happy feeling.

Some people have physical changes. Others have emotional changes. Not all people have all symptoms. Of the 150 symptoms, these are among the most major: Physical symptoms include belly (abdominal) bloating, headache, weight gain, and breast swelling. Emotional changes include grouchiness, mood swings, food cravings, and tension. Mental changes include depressive mood, anxiety, lack of focus, and poor impulse control.

It can also be confused with diabetes, thyroid problems, allergies, and endometriosis.

The exact things that cause PMS aren’t yet understood. But serotonin, progesterone, and estrogen, plus other hormones and chemicals, may play a role.

Symptoms appear after ovulation, about the 14th day of your monthly cycle. They go away 2 weeks later, when your period begins. In addition, the symptoms must affect your life. Other illnesses, such as depression, must also be ruled out before a diagnosis of PMS can be made. PMS can co-exist with and may make other illnesses and conditions worse. Asthma symptoms, for instance, can get worse with PMS. Typically, your healthcare provider will ask you to keep a diary of symptoms for 2 to 3 months before making a diagnosis.

Your healthcare provider may advise taking calcium, magnesium, and vitamin E to help relieve symptoms. Recent research has shown that estrogen regulates the levels of calcium and magnesium in the body. So taking extra calcium may help symptoms. Taking magnesium may help with symptoms of fluid retention and breast soreness. For severe cases of PMS, a provider may prescribe an antidepressant known as a serotonin selective reuptake inhibitor.