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Your Ultimate Guide to PMS (Premenstrual Syndrome)

4 weeks ago9 min read
Last updated: Jan 28 2023

There are so many different experiences of PMS (premenstrual syndrome). We’ll take you through the details of the symptoms and causes (and what scientists still need to learn).

PMS (Premenstrual Syndrome)

PMS is your reproductive system calling ahead to let you know your period is on its way.











In some bodies, it’s a polite message at a barely audible volume.

For others, it’s a deafening scream.

Before we go any further, know that whatever your experience is, you don’t have to write it off as just “that time of the month.”

For 20% of the people that experience PMS, it’s enough to significantly disrupt their daily lives.

If that’s the case for you, talk to your doctor about possible treatments for your symptoms.

Your health and well-being matter.

With that in mind, let’s dive in.

In this article: 📝

  • What is PMS?
  • When can PMS symptoms start?
  • What causes PMS?
  • What PMS feels like
  • Why do I have PMS but no period?
  • Why does PMS get worse with age?

What is PMS?

PMS stands for premenstrual syndrome.

It’s an umbrella term for the range of symptoms affecting your mental and physical health shortly before your period arrives.

It’s a tough one to define (even for scientists) because there are so many different symptoms and levels of severity.

But while we all go through it differently, one thing we do know is that most of us go through it.

In fact, as many as 90% of us experience symptoms like headaches, moodiness, and bloating in the week before our period.

Some people struggle with a specific type of PMS called premenstrual dysphoric disorder (PMDD), a mental health condition that can be really debilitating.

If you are battling this, it’s important to reach out.

And if getting to a doctor feels too much, start with a friend or someone in your Peanut community.

When can PMS symptoms start?

So when does PMS start?

While there’s no one-size-fits-all here, a good ballpark is somewhere between five and fourteen days before your period arrives.

This part of your menstrual cycle, between ovulation and the start of your period, is called the luteal phase.

What causes PMS?

The truth is, we don’t know for sure.

But researchers believe it likely has to do with hormonal fluctuations.

Specifically, during the luteal phase, progesterone rises, and estrogen falls.

It appears that as our estrogen levels drop, there is also a decrease in serotonin, a chemical in your brain responsible for mood regulation and the control of all sorts of physical functions, including sleep and hunger.

It’s possible that this is what leads to some PMS symptoms, though the research is still unclear.

What PMS feels like

PMS is different for everyone.

But some common symptoms pop up over and over, including bloating, cramps, irritability, mastalgia (breast pain and tenderness), and joint and muscle pain.

Let’s look at some of these symptoms in detail.

PMS cramping

PMS cramps are really common, with about 70% of women experiencing them.

They’re usually felt in the abdomen and around your lower back and thighs.

PMS cramps are thought to be caused by prostaglandins.

In very basic terms, prostaglandins cause your uterus to expand and contract to squeeze out the uterine lining during your period.

Sometimes you can’t even feel this squeezing, and sometimes the pain is so bad that you have to stay home curled up in bed with a heating pad.

Remember, it’s totally okay to speak to your doctor about the symptoms you are experiencing.

You don’t have to just suck it up.

(If you need a solution right now, here’s our guide to reducing period pain.)

PMS anxiety and mood swings

As your period approaches, you may fluctuate between anger, irritability, and sadness, and this can make it extremely difficult to feel centered.

Know that you’re not alone.

Emotional extremes and feelings of anxiety are so common that, according to this recent study out of the University of Virginia, “they represent a key public health issue globally.”

The research showed that about 64% of women experience them.

(Also, some things are genuinely annoying or upsetting. Don’t let your partner/boss/client/sibling tell you the reaction that you’re having to a specific situation is just PMS. Your feelings are valid.)

PMS depression

If your PMS mood swings feel extreme, you could be struggling with a more severe health condition known as premenstrual dysphoric disorder (PMDD).

Again, we’re not totally sure what causes this condition, but the signs point to a link to serotonin levels.

While the feelings accompanying this disorder may go away a few days into your period, like any other mental health condition, PMDD should be taken seriously.

Help is available.

The FDA has approved three different antidepressants for the treatment of PMDD, as well as a birth control pill containing a progestin (a form of the hormone progesterone) called drospirenone.

Other treatment options include talk therapy, pain meds, and stress management techniques.

PMS headaches

You may know these as menstrual migraines or hormone headaches — and for some people, they can be seriously taxing.

Along with a pulsing headache, you may experience light sensitivity and dizziness, together with other common symptoms like PMS fatigue and nausea.

Menstrual migraines are likely caused by the estrogen dip that happens before your period and can be triggered by hormonal birth control and HRT for menopause.

If you are experiencing migraines, talk to your doctor.

They’ll be able to look at the medications you’re currently on and advise the best way forward.

Migraines are usually treated with anti-inflammatory medications.

The use of triptans — medication used to treat acute migraine attacks — is showing promise as a way to decrease or even prevent menstrual migraines when taken for a few days around the PMS chapter of your cycle.

PMS nausea

If you’re wondering is nausea a PMS symptom?, it can be.

There are a few reasons for this. If you experience menstrual migraines, nausea may accompany them.

But nausea, along with other gastrointestinal issues, can also just show up as a PMS symptom.

This study showed that the severity of nausea as a PMS symptom likely increases with age.
It’s probably hormones at work here, with prostaglandins (the same ones responsible for cramping) having a role to play.

Of course, if your period is due and you’re experiencing nausea, this could also be an early sign of pregnancy.

If you think you might be pregnant, head to the drugstore for a pregnancy test, or call your doctor.

PMS insomnia

With all the emotional and physical symptoms accompanying PMS, your body may find it that much harder to switch off.

Insomnia is also linked to PMDD and has been reported as one of the most common symptoms of the disorder.

Again, it’s a good idea to talk to your doctor about this one.

Lifestyle changes like eating a balanced diet, getting enough exercise, and trying relaxation techniques may help.

Practicing sleep hygiene by doing things like going to bed in a dark room at the same time every night without your devices can really help.

But sometimes, no matter what you do, you just can’t get to sleep.

That’s why it’s best to navigate this one with a healthcare professional so that they can address your specific needs.

PMS diarrhea

Yep, it just gets better and better.

PMS diarrhea (AKA period poop) can be caused by the same prostaglandins that are expanding and contracting your uterus — and also causing activity in other nearby organs (like your intestines).

If PMS diarrhea is getting in the way of your day-to-day functioning, chat with your doctor.

They can help you find a treatment and also rule out any other possible causes of your intestinal distress.

PMS weight gain

It’s normal to add a few lbs to your total just before your period.

You may experience changes to your appetite and retain water — both of which can contribute to weight gain.

(According to this study, you hit peak fluid retention on the first day of your period.)

Try not to worry too much about these ebbs and flows.
It can help to keep a diary to see what your “normal” is when it comes to feeling bloated or experiencing cravings.

That way, you can go, “Oh, it’s you again!” rather than making weight gain a source of stress every month.

PMS discharge

Most of us experience some amount of vaginal discharge on a daily basis.

If you experience discharge just before your period, it’s likely to be milky, white, and cloudy.

It’s probably less than you experience when you’re ovulating, but it can still make an appearance.

While discharge is totally normal, if it’s at all painful or itchy or has a strong smell, chat with your doctor, as it might signal a health condition.

Why do I have PMS but no period?

There are a few reasons why you might have PMS symptoms but no period.

Here are the common ones:

  • Anovulation, when an egg isn’t released from your ovary in a particular month. (This may happen from time to time, but if it occurs on a more chronic basis, it can cause struggles if you’re TTC.)
  • Pregnancy
  • Hormonal birth control
  • Stress
  • Exercising too much
  • Thyroid conditions
  • PCOS
  • Cysts or polyps
  • PID (Pelvic Inflammatory Disease)

Skipping a period here and there is not necessarily cause for concern, but if it happens often or is accompanied by other symptoms, it’s best to check in with your doctor.

Why does PMS get worse with age?

The truth is (again), we don’t know with 100% certainty — but yep, hormones appear to be at the helm again here.

As you approach menopause (a chapter called perimenopause), your hormones go through a bit of a wild dance.

For some, this may be what leads to more severe PMS.

Research shows that if you’ve struggled with PMS symptoms earlier in your life, you may have a more challenging time with the menopause transition, with more extreme PMS symptoms occurring each cycle.

The good news is that it gets better. Once you hit menopause and your periods are a thing of the past, you’ll most likely be free of all your symptoms.

Wherever you’re at on your journey, know that your Peanut community is there for you.

We’re all about figuring out ways to support each other through every life phase.

You don’t have to do this alone.

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