Premenstrual syndrome, or PMS, is something all women know. PMS is characterized by the presence of both physical and behavioral symptoms. The most common behavioral symptom is mood swings. Other frequent symptoms include irritability, anxiety, depression, and diminished interest in activities. The most common physical symptoms are bloating and extreme fatigue. Hot flashes, dizziness, and breast tenderness are not uncommon. PMS has been associated with decreased work productivity, increase in work absences, and increase in visits to the hospital.