Article reviewed by
Dr Rhiannon Bray
Maybe you feel a little more down-in-the-dumps than usual. Maybe your boobs are hurting. Or maybe you’re dealing with a breakout of pimples on your chin. If this sounds all too familiar, you might be dealing with premenstrual syndrome symptoms, or PMS, unofficially known as The Worst. It can happen like clockwork in the week leading up to your period, and PMS symptoms may appear in different ways for people. But knowing what’s actually happening inside your body can go a long way in helping you feel better, ASAP. Here’s why it’s happening – and what you can do to deal with it.
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What does PMS mean? Premenstrual syndrome is the unfortunate combination of symptoms that women, or those who bleed, may experience in the week before their period starts. While the exact cause of PMS is still unknown (it’s one of the great mysteries of women’s health), there are a few factors that may be at play, such as changes in both your hormones and the chemicals in your brain¹. Now for some good news: PMSing is an entirely normal part of the menstrual cycle, and usually not a huge deal for your health. Plus, since it follows a pretty predictable pattern, you can at least identify when you’re dealing with PMS as opposed to something else. If you’re feeling breast tenderness, for instance, you can use it as a heads up that your period is on its way and maybe stash some tampons in your bag – just in case.
Still, even though PMS is very common, it doesn’t exactly make life easy for you. The combo of physical discomfort and emotional stress that accompanies PMS can interfere with your daily life, interrupting your usual activities and making school or work feel downright miserable. A small number of women may even experience debilitating symptoms, meaning the physical or emotional distress is so intense that you need to cancel plans or take a sick day. This is known as premenstrual dysphoric disorder(PMDD), and it’s basically an even more intense version of PMS – think severe irritability, anxiety and depression². If this sounds familiar, talk to your doctor ASAP, because there are options out there that can help you.
On the bright side: no matter how it happens, premenstrual syndrome symptoms are always temporary. For most people, PMS symptoms go away within four days after their period starts. If your premenstrual symptoms don’t, talk to your doctor so you can get to the bottom of it.
PMS symptoms start in the last phase of the menstrual cycle - the luteal phase - and disappear with the onset of menstrual bleeding. This means that PMS can start approximately 7 to 12 days before the onset of menstruation. Breast pain, irritability, anger and emotional upset - these are the most common and very annoying symptoms of PMS. They usually appear about 6 days before the planned menstruation, and are often most severe 2 days before bleeding.
PMS can occur throughout the reproductive years, from the first period to the last. The most intense discomfort is observed in women between the ages of 25 and 35. As we age, hormone levels can become more variable, and for some, PMS may become more intense. This is particularly common in the years leading up to menopause, usually after the age of 40.
If you’re PMSing, you may experience a combination of various premenstrual symptoms, which usually fall into two categories: emotional and physical. PMS usually includes at least five of these symptoms, and they can range from mild to severe, depending on you and your body. On top of that, every menstrual cycle is different, even for yourself. You might have food cravings and feel like crying for no reason one month, and experience a breakout and mood swings the next. Not ideal, but once you have a good idea of what to expect, you can be better prepared to handle it like a pro. Here are some symptoms of PMS to watch out for:
Physical PMS symptoms can affect everyone differently. Sometimes they can make you feel uncomfortable or tired, and that might mean you don’t feel like hanging out with friends or doing your usual activities.
The most common physical symptoms of premenstrual syndrome include:
The emotional side of PMS is often the one you notice the most. You might find yourself feeling more sensitive, annoyed, or emotional than usual, and that’s totally normal. PMS can also make it harder to focus or concentrate on things like schoolwork or conversations. Everyone experiences this differently, but some common emotional and behavioural symptoms of PMS can include:
Mood swings can also occur during your period. Find out how to deal with them!
PMS fatigue usually occurs the day before menstruation and appears along with other premenstrual symptoms. These symptoms are part of a woman's natural biological cycle, which allows her to adapt to the hormonal changes that occur in her body. So, if you feel tired, exhausted even, maybe a little listless, about once a month around your period, then you’re not alone. PMS fatigue affects many girls and can be made worse by some common PMS habits, like reaching for a bunch of junk food. Or not doing a lot of physical activity. (Fight through those cramps and get moving! You’ll feel less tired and your cramps will get some relief.)
It is also important to take care of the quality of our sleep. PMS fatigue can also be overcome if you get a good night's sleep. It's best to go to bed earlier than usual and not fall asleep with your phone in your hand.
Wondering what is PMS and where comes from? PMS happens because your hormone levels naturally change during your menstrual cycle. After you ovulate (which is usually halfway through your cycle), the levels of oestrogen made by your ovaries drop. At the same time, another hormone called progesterone rises as your body gets ready just in case a fertilised egg needs to implant. These shifting hormones can affect how you feel, both physically and emotionally. Everyone experiences PMS differently. Some people are more sensitive to the natural hormone changes that happen each month, and things like genetics or how their brain chemicals work can play a role too. That’s why some people get strong PMS symptoms, while others hardly notice anything at all , every body works in its own unique way.
Other PMS causes also include:
PMS is diagnosed based on the timing and pattern of symptoms across your menstrual cycles. Your doctor may ask you to keep a diary or symptom tracker for two or more cycles to help confirm the diagnosis. There is no blood test that can confirm PMS, but in some cases especially if symptoms are unusual or severe, your doctor might run blood tests (e.g. thyroid function, iron levels) to rule out other conditions that can mimic PMS.
While there’s no way to prevent premenstrual syndrome, proactive steps can help at least minimise your discomfort and lower your stress levels a notch, making this monthly rite of passage just a little more bearable. From the very beginning, it’s worth trying a few lifestyle tweaks that can help ease how you’re feeling. Small changes can sometimes make a big difference in managing PMS and finding some relief:
Explore PMS natural remedies:
Jot down notes in a notebook or on your phone about the symptoms you’re experiencing. Whether you’re more tired than usual or have a stomach-ache for no apparent reason, taking a note of it will help you figure out patterns so you can better prepare yourself in the months ahead.
A lack of sleep can make everything worse – PMS included – and you’re basically starting at a disadvantage when you wake up already feeling exhausted. Get a full eight hours of sleep a night, every night. It seems so simple, but you can fight that drained feeling so much better on a full night’s sleep. When you wake up from a deep sleep, it gives you a fresh, confident look, even when you feel your worst.
Food cravings have nothing on an otherwise healthy diet. Load up on complex carbs like whole grains, fruits and vegetables to keep things moving in your gut, and hold off on salt, which can help keep bloating and water retention to a minimum. Calcium-rich foods are good too. Think salmon and spinach. Next, split your usual meals into smaller portions that you can eat throughout the day, which may help you feel less uncomfortably full (a not-so-fun side effect of bloating). Eating more frequently might help your blood sugar to stabilise better, helping you to feel better. And take a break from caffeine and alcohol, both of which can mess with your digestive system, disrupt sleep and make you more irritable – and trust us, that’s the last thing you need right now.
Keep your mood swings to a minimum by getting your stress levels in check. If you have headaches, trouble falling asleep, or anxiety, try deep-breathing exercises. Reading and meditating are also calming activities, and you can’t go wrong with a little yoga session; some poses can even help with cramps and bloating. (Do you experience cramps every month? Learn more about menstrual cramp causes, symptoms, and treatments.)
In addition, stress can also affect your period.
If you feel up to it, a warm bath, possibly with calming herbs like chamomile, or gentle massage can help ease discomfort and make PMS more bearable. Some small studies suggest that massage or aromatherapy might ease cramps, mood swings or stress, though effects vary. These methods shouldn’t be seen as guaranteed cures but can be a gentle complement to other treatments. If you try essential oils or herbal remedies, make sure to test for skin sensitivity first, and use them safely (dilute, avoid eyes/mouth, and follow instructions).
Exercise is the ultimate problem-solver: it can make you feel less stressed, ease bloating and cramping, and help you feel more energised. And although a 5K probably doesn’t seem appealing when you’re feeling like a beached whale in a bad mood, it’ll probably be worth it afterwards. If tender breasts make jogging a no-go, even a brisk walk or cycling would work. Exercise will lift your mood and may even help you to sleep better too.
If you’re interested in trying supplements, talk to your doctor first. They can help you choose what’s safe and suitable for you, especially if you take other medications. Some people find that supplements like calcium, magnesium, or vitamin E can help with PMS symptoms , but what works can vary from person to person.
Certain medications can also help with physical PMS symptoms, especially if you take them at the onset of your period. In particular, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help you deal with the discomfort of breast tenderness and cramping.
Premenstrual tension is no walk in the park but knowing what symptoms of PMS to expect – like physical and emotional changes – can make it way easier to handle when it comes around. Who says you need to be miserable every month?