It's the subject of plenty of jokes, but for women with PMS, or premenstrual syndrome, their symptoms are no laughing matter.

For at least a week or two before their period begins every month, many women suffer bloating, breast tenderness, irritability and fatigue. Symptoms usually disappear once the period begins.

As many as four of every 10 women have some of the symptoms of PMS, and 85 percent of menstruating women have at least one premenstrual syndrome, according to the American College of Obstetricians and Gynecologists.

But for 5 percent to 10 percent of women, the problem is more severe. That's how many women suffer from premenstrual dysphoric disorder (PMDD), a more serious form of PMS that can trigger depression, anxiety, tension and persistent irritability or anger.

The exact cause of PMS and PMDD remains unclear, though researchers suspect that some women may be more susceptible to fluctuating hormone levels than others.

"One of the theories is that PMS women are sensitive to hormonal changes -- their hormones are not abnormal, but they are sensitive to the changes in hormone," Dr. Ellen Freeman, a research professor in obstetrics and gynecology at the University of Pennsylvania School of Medicine in Philadelphia , told HealthDay .

Freeman led a study of women with PMS and found that, during menopause, they're at greater risk of experiencing troublesome menopause symptoms, such as hot flashes, depression, restless sleep and lowered sex drive. The study results were first published last year in the journal Obstetrics and Gynecology .

But, women don't have to just grin and bear it, Freeman said. She said it's important for women to take the time to seek the care they need so they don't have to work through their symptoms. Often, she said, women "don't take care of themselves; they take care of everyone else."

For mood symptoms, antidepressant medications -- selective serotonin reuptake inhibitors such as Prozac and Zoloft -- may help treat PMDD symptoms when taken regularly.

"They eliminate symptoms, at least during the period of treatment," Dr. Kimberly Yonkers, an associate professor of psychiatry at Yale University School of Medicine, told HealthDay .

For the physical symptoms, regular exercise and a diet of healthy foods as well as over-the-counter medications often are helpful. Women with PMS also should avoid salt, foods full of sugar, alcohol and caffeine during the time they normally have symptoms.

Taking 1,200 milligrams of calcium supplements daily has also been shown to reduce PMS symptoms significantly.

If bloating is severe, a doctor can prescribe diuretics. Birth control pills stop ovulation and may relieve PMS symptoms for some women.