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Premenstrual syndrome (PMS) refers to the emotional and physical changes many people experience in the days before a menstrual period, including anxiety, low mood, irritability, fatigue, and bloating. At its most severe, when symptoms are debilitating and interfere with daily life, it is known as premenstrual dysphoric disorder (PMDD). Despite affecting an estimated 250 million people worldwide, we still do not fully understand why these symptoms occur.