Premenstrual syndrome (PMS) refers to a wide range of symptoms. The exact cause of PMS is not known but PMS symptoms may be related to social, cultural, biological and psychological factors. Changes in brain hormone levels play a role.  Up to 3 out of every 4 women experience PMS symptoms during their childbearing years. The symptoms often get worse in women in their late 30s and 40s as she approaches the transition to menopause.  PMS symptoms may become severe enough to prevent you from functioning normally. We can help you explore coping strategies, medications, and  alternative therapies for treatment.