Dealing with premenstrual syndrome (PMS)

In fact, research shows that almost half of women of reproductive age experience symptoms like these, with approximately one in five encountering symptoms severe enough to impact their day-to-day lives.¹

These symptoms form part of a condition called premenstrual syndrome (PMS) – a combination of various physical and emotional symptoms that people will often experience a week or two before their period.²

But why does this happen? And what can you do to relieve symptoms when they occur?

Before we can answer these questions, we first need to get a more detailed understanding of what exactly PMS is and how it impacts the body.

PMS is the name given to the various physical and emotional symptoms you can experience in the time before your period starts.²

An incredibly common condition across the world, statistics show that 40% of women experience PMS symptoms and, of these, 5–8% suffer from a more severe form.³

While PMS can impact women at any age before they reach menopause, studies show that women aged between 35 and 44 years old are typically most impacted, showing the greatest symptom severity relative to other age groups in research.^4,5

The symptoms experienced can also vary drastically from one person to another. Some people can get their periods with only mild symptoms, whereas others may struggle to go to work or attend school due to the severity of their symptoms.

Researchers still aren’t 100% sure what causes PMS. However, it’s thought to be linked to the different hormonal changes that your body goes through during your menstrual cycle between ovulation (when the ovaries release eggs) and the arrival of your period.

These fluctuating levels of hormones, progesterone and oestrogen, are thought to be responsible for PMS and its associated symptoms.

But, why do some people experience more intense symptoms than others?

During the build-up to your period, oestrogen levels start to decline and progesterone levels increase. When this happens, the hypothalamus in your brain triggers the release of a chemical called norepinephrine, which then leads to declined levels of various other hormones, including acetylcholine, dopamine, and serotonin.⁶

Some of us are believed to be more sensitive to this than others, which can then lead to the onset of more severe symptoms.

There are many different types of PMS symptoms you might experience, and these can vary from person to person.²

Ranging from mild to severe, some people may be relatively unaffected while others may find that their symptoms are severe enough to disrupt their day-to-day life and activities.¹

The PMS symptoms you experience can change throughout your life and may fluctuate from month to month,² but you might find that you have the same few symptoms around the same time each month.

The length of time your PMS symptoms last can vary too – often anywhere from two days up to two weeks.¹

For both of these reasons, some people find it useful to keep a diary of their symptoms.

Having a record of when your symptoms appear in this way, and recording how much they impact your day-to-day life, can not only help you better understand your condition but also allow your doctor to determine whether PMS is the cause.

While PMS symptoms can be painful and difficult to deal with, there are several effective treatments and lifestyle changes you can make to help reduce their impact on your daily life.

The first step is to track symptoms when they occur. Using an app or writing down the timing of any symptoms you feel can make you more aware of when they start and help you identify useful techniques to manage them moving forward.

Some of the best ways to manage or prevent PMS include:

Exercising might be the last thing you want to do when you’re experiencing bloating and cramps, but research has shown that performing 30 minutes of exercise three times a week can help alleviate symptoms.⁸

You’ll need to do this on a fairly regular basis to notice a difference. But this should happen pretty quickly; when assessing the impact of eight weeks of regular aerobic exercise in non-athletic girls, researchers in Iran discovered a significant reduction in PMS symptoms.⁹

Plus, other studies have shown that the endorphin rush you get when exercising regularly can not only boost your mood but also reduce feelings of fatigue and pain.¹⁰

Changes in oestrogen and progesterone levels can make you crave foods loaded with carbs, sugar or salt. This is perfectly normal – it’s simply your body’s way of dealing with both the increased appetite you get from the hormonal changes, while also trying to boost your mood.

Eating comfort food releases serotonin, nicknamed ‘the happy hormone’ for a reason – it boosts our mood and makes us feel better overall.

However, despite this serotonin boost, eating too many chocolate bars or crisps can make certain PMS symptoms worse, so it’s important to think carefully about which foods to prioritise when you’re PMSing.

It’s also important to drink plenty of water when experiencing PMS. This may help to stop you from feeling bloated or experiencing any headaches caused due to dehydration – a common symptom of PMS.

There are also some foods that you might want to avoid, as they can worsen your symptoms. Spicy food, alcohol, coffee, and foods high in salt or sugar can all leave you feeling much worse.¹¹

If you’re struggling to get many vitamins and minerals in your diet, supplements can also help.

Food supplements like vitamin B6, vitamin D and calcium have all been shown through multiple studies to reduce PMS symptoms and are recommended as a first-line measure in PMS management guidelines set by the Royal College of Obstetricians & Gynaecologists.³

According to the NHS, you should take no more than 10mg of vitamin B6, 100mg of vitamin D, or 1500mg of calcium per day in supplement form, unless advised by your doctor.^12,13,14

Prioritising self-care is important at the best of times but, when experiencing PMS symptoms, it’s even more essential.

If you’re feeling irritable, low or lethargic, don’t force yourself to power on. Give yourself a break – take some time to rest and regenerate.

Try to manage your stress levels by doing something you enjoy, or taking part in relaxing activities. Whether that’s having a massage, acupuncture, meditating, or doing yoga, prioritising both your physical and emotional health can help reduce the impact of your symptoms.

Depending on the type and severity of your symptoms, your doctor may also recommend cognitive behavioural therapy (CBT) – a form of talking therapy that’s been shown to help moderate-to-severe PMS and is also recommended by the Royal College of Gynaecologists.^3,15

Sleep and PMS have a bit of a catch-22 relationship. Not only does having PMS make you twice as likely to experience sleeping problems like insomnia,¹⁶ but sleeping problems can also exacerbate several other symptoms of PMS, leaving you feeling tired and irritable during the day.

A healthy pre-bedtime routine with between seven and nine hours of sleep each night can help improve your sleep quality, reduce your overall symptoms and make PMS easier to cope with.¹⁷

PMS is a very common condition that causes a wide range of symptoms and affects us all in different ways.

However, you can help minimise the impact these symptoms have on your day-to-day life by exercising regularly, maintaining a healthy diet, and taking the time to prioritise both your physical and mental wellbeing.

If you’re particularly concerned about any symptoms you’re currently experiencing, contact your doctor. They’ll be able to work with you to discuss your symptoms, make sure they’re not being brought on by another condition and, if needed, provide you with medical treatment.

PMS symptoms can be difficult to deal with but there’s no need to suffer in silence. Whether it be through medical intervention or small lifestyle changes, there are several things you can do to take control of your symptoms and get back to enjoying your life.