In the days leading up to your period, fluctuations in female hormones like estrogen and progesterone can interact with brain chemicals, particularly serotonin, which helps regulate mood. These hormonal changes can cause emotional shifts both before and during your period.

What is PMS?

Premenstrual Syndrome (PMS) refers to the physical and emotional symptoms that can be experienced leading up to beginning your period. Everyone will experience this at some degree, no matter what age! Some may experience more symptoms than others, or experience symptoms more severely than others.

Common symptoms of PMS

Emotional and behavioural symptoms

• Anxiety → this could look like a racing heart, sweating, shaking, trouble sleeping, nausea, feeling irritable, restlessness, tension, etc

• Depressed mood → this could look like low mood, sadness, lacking motivation or interest, finding it hard to make decisions, feeling tired, having difficulty concentrating, etc

• Irritability or anger

• Appetite changes such as an increased or decreased appetite → you may eat more or less than you usually would!

• Food cravings → common food cravings include chocolate, salty snacks, and foods with a high carb content like pizza or pasta!

• Social withdrawal → it is okay if you do not feel like hanging out with friends or being around family! The most important thing is that you communicate to them why this is by explaining that you are on your period and you just feel like having some me time!

Physical symptoms

• Muscle pain (not just in the stomach)

• Headaches

• Fatigue (tiredness)

• Weight gain → this is because your body is retaining water, so you may feel bloated and swelling in the stomach, legs, and/or arms. Please note that this is completely normal and your weight will go back to how it normally is!

• Breast tenderness

• Constipation or diarrhea → Please note that it may be helpful if you experience constipation to incorporate foods high in fiber into your diet such as fruits, veges, nuts, and seeds! On the other hand, if you experience diarrhea, then it is important to drink plenty of water and eat foods that are low in fiber such as bread, rice, and pasta!

• Acne flare ups → It is completely normal to notice changes in your skin before or during your period! You may notice that your skin is more oily than usual, or that you have some new pimples that have made an appearance. To be prepared for this, it might be handy to buy an acne face wash.

When does PMS occur?

PMS symptoms typically occur 1-2 weeks before menstruation, known as the last week of the luteal phase. During this phase estrogen levels fluctuate and progesterone levels drop, which are responsible for the changes in mood.

Symptoms tend to be of greatest intensity and severity four days before the period begins, with symptoms easing within four days after bleeding has begun. The symptoms do not begin again until at least day 13 in the cycle. This pattern of symptoms tends to remain fairly consistent until menopause, however, they can vary from cycle to cycle.

How PMS impacts everyday life

PMS can significantly affect daily life, with 45.2% of women in America reporting that their symptoms lead them to take days off work. Commonly affected areas include energy levels (89.3%), mood (86.9%), concentration (77.2%), and interest in work (71.6%).

On average, women needing time off due to PMS miss about 5.8 workdays per year.

The overall impact of PMS on quality of life is often greater than conditions like type 2 diabetes or high blood pressure and is comparable to chronic conditions such as rheumatoid arthritis and osteoarthritis.

Recognising these effects is essential for developing strategies to help menstruators manage PMS and continue their daily activities.

Work: it can affect your ability to work, especially symptoms such as fatigue and pain. A survey of Flo app users found the majority reported a moderate to severe impact of their menstrual cycle on their workplace productivity. Meanwhile, a survey of 33,000 menstruators showed 13.8% reported absenteeism during their period and 80% reported presenteeism - the act of showing up at work or school without being productive.

Study: physical symptoms of PMS (e.g. fatigue, pain, headaches, etc) affects not only the ability to attend school or university, but the ability to sustain concentration. This can result in it taking longer to complete tasks or create difficulties in understanding the content.

Parenting: PMS can affect how you engage with your children - this is especially relevant when experiencing the emotional and behavioural symptoms. You may find yourself becoming irritated more easily than normal or that you are telling them off for things that are trivial. You may also want to socially withdrawal and have some time to yourself, however, this is not always possible with kids.

Community participation: If you are feeling fatigued, are in pain and feel socially withdrawn, you may struggle to participate in your usual sports and leisure activities, church and other regular commitments.

PMS across life stages

Post-partum: Once the menstrual cycle returns following childbirth, some women notice a difference in their PMS symptoms, cramps, duration, flow, and/or mood. This is because hormones change significantly after having a baby. Some notice them shift again after having a second or third child, while others notice no change at all.

Perimenopause: This is when the body begins to transition to menopause and can begin as mid-30s through to mid-50s. During this time, ovaries begin to produce less hormones, causing the menstrual cycle to become irregular and unpredictable. This hormone fluctuation can intensify existing symptoms or cause them to start in those who haven't experienced them before. Menstruators that experience PMS are twice as likely to experience symptoms in perimenopause.

Managing PMS symptoms

• Communication is key! It may be helpful to let your friends and family know that you have started your period and what symptoms you are experiencing, so that they can understand that the mood swings are because of your period and not because of you!

• Engage in self-care! This is extremely important to do on a regular basis for looking after your emotional health, especially before or during your period! This may look like doing something that you enjoy and will help you feel relaxed, such as watching your favourite movie or TV show, listening to your favourite songs, taking a nap, painting your nails, doing a face mask, etc! 

• It may be helpful to keep a journal and record the symptoms you notice yourself experiencing before and during your period, and whether these were easy to manage, difficult to manage, or very challenging to manage.

• Listen to a relaxation app! Apps that we recommend include Headspace, Calm, or any mindfulness or meditation videos on YouTube. 

• Work on breathing! This can be done by tracing the frame of a window - as you breathe in you trace one side of the window, and as you breathe out your trace the next side - repeat until you have traced the whole window about 3-5 times.

• Practice good sleep hygiene: try chamomile tea, a pillow spray, listen to a guided meditation or enjoy reading a book before bed rather than being on a device.