PMS
What It Is // Symptoms // Progression // Remedies
Do you feel bloated, irritable, or extra hungry right before your period? Maybe you experience cramping or crying spells. If these symptoms are familiar and appear month after month, you may have premenstrual syndrome (PMS).
For most women, the symptoms of PMS are uncomfortable yet manageable. But after a while, many women find their monthly cramping intensifies or their cravings rev out of control. If you’re among them, you’re likely frustrated and seeking answers.
There are a number of reasons why PMS symptoms worsen — fortunately, there are a number of ways you can ease them. Read on to learn why you may be experiencing worsening PMS symptoms all of a sudden as well as some natural remedies that can help with symptoms of PMS.
What Is PMS?
Premenstrual syndrome, or PMS, is a combination of physical, emotional, and/or behavioral symptoms experienced by most women in the days or weeks prior to their period. These symptoms can vary widely in duration and intensity, ranging from brief and mild to protracted and severe.
What Are Common Symptoms of PMS?
The sharp drop in hormones that follows ovulation can impose a wide range of physical and emotional costs. Some of the most common symptoms of PMS include:
- Night sweats
- Cramping
- Decreased sex drive
- Trouble sleeping
- Hot flashes
- Irritability
- Mood swings
- Fatigue
- Weight fluctuations
- Brain fog
- Bloating or gassiness
- Food cravings
- Mild constipation or diarrhea
- Feelings of sadness
- Headache or backache
- Nervousness
For some women, PMS can start up to five days before their period. In most cases, the symptoms stop once menstruation begins and hormone levels start rising again.
Not all women experience PMS, and not all cases of PMS can be self-diagnosed. If you are experiencing symptoms that interfere with your daily life, consult a healthcare professional for evaluation and guidance.
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Does PMS Get Worse With Age?
PMS strikes as many as three in four women at some point in their lives. Usually, the symptoms are mild, but they can compound with age. So, if you experience worsening PMS symptoms all of a sudden, know that women in their 30s are more likely to do so, but it’s still important to consult a healthcare professional for evaluation and guidance.
PMS and perimenopause
Symptoms of PMS also tend to get worse during the transition to menopause — known as perimenopause — thanks to the wide fluctuations of hormones, says Maureen Whelihan, M.D., a board-certified obstetrician-gynecologist with Elite GYN Care in Greenacres, Florida. Perimenopause usually starts when you reach your mid-40s and can last up to 10 years.
You’re more likely to see a surge in PMS symptoms during perimenopause if you’re already sensitive to mood changes during your menstrual cycle. But even women who have encountered only mild symptoms — or who’ve never had PMS before — may experience it once they reach the transition to menopause, Dr. Whelihan says.
PMS and birth control
Research shows that women who use hormonal birth control may also be more likely to experience PMS, with their odds increasing over time. However, other research finds that combination birth control pills that contain both estrogen and progesterone or the hormone drospirenone may actually help with PMS symptoms.
Natural Remedies for PMS
The good news is, you don’t have to suffer from PMS month after month. Mild to moderate symptoms may be eased through lifestyle changes that can boost your physical, hormonal, and mental health.
For those whose symptoms are severe, it’s best to consult a healthcare provider for more aggressive treatment options. For everyone else, here’s how you can help reduce PMS symptoms naturally through healthy eating and activity.
1. Strength and cardio exercise
Regular physical activity is a non-negotiable part of your PMS action plan. Movement helps lower stress and boost mood, which can help tame PMS symptoms like tension, physical discomfort, irritability, fatigue, bloating, anxious feelings, and sadness.
And a recent study found no significant difference between the positive effects of strength training versus aerobic exercise on PMS symptoms like pain, concentration, water retention, and negative affect, making them co-equal contributors to help alleviate many symptoms of PMS.
Exercise also helps shrink bloating by helping decrease hormones that cause water retention while stimulating the release of feel-good brain chemicals that help reduce pain.
If you need to take it easy
Of course, you might not be up for your usual workout if your symptoms include cramping, gassiness, or muscle aches. Aim for some form of movement anyway, even on days you’d rather not.
“Even gentler forms of exercise like walking can help manage PMS symptoms,” says Roshni Patel, DO, a board-certified obstetrician-gynecologist at HerMD in Millburn, New Jersey.
Other gentle activities to consider when you’re PMS-ing include:
Aim to meet the physical activity guidelines set by the Centers for Disease Control and Prevention (CDC). That means getting at least 150 minutes of moderate-intensity aerobic exercise and two full-body strength sessions per week.
2. Eating the right foods
Alleviating PMS symptoms can often be as simple as watching what food you put on your plate. Eating a nutritious, balanced diet throughout the month is a great way to help reduce PMS symptoms (or at least ease their severity).
Research indicates that some of the best foods for PMS are fresh and unprocessed. Here are a few examples:
- Fatty fish: salmon, mackerel, tuna, herring, sardines
- Nuts and seeds: walnuts, cashews, pumpkin seeds, flax
- Dairy products: Greek yogurt, cottage cheese
- Whole grains: oats, barley, quinoa, wild rice, farro
- Lean meats: chicken breast, white fish, pork loin
- Fruits and vegetables: leafy greens, berries, avocado
Foods high in omega-3 fatty acids may help with PMS symptoms that involve inflammation. Research also finds that calcium levels tend to dip after ovulation, which may contribute to PMS symptoms like irritability. Prioritizing calcium-rich foods may help ease mood-related symptoms.
…And avoiding the wrong foods
Unfortunately, the foods worst for PMS tend to be those you crave most. In particular, foods that are high in sugar or starch.
Research suggests that you crave these foods because they offer a quick hit of two mood-boosting brain chemicals: serotonin and dopamine. However, the effects are short-lived. “These foods can cause swings in insulin and glucose that can worsen mood in some women,” Dr. Whelihan says.
Alcohol and salty, high-fat foods are also unhelpful for PMS, per research.
When in doubt, remember: If eating something makes you feel bloated or sluggish at other times during the month, you’d better believe it’s going to make your PMS symptoms worse. So, hold off on eating these foods until you feel better.
3. Targeted dietary supplements
Certain vitamin, mineral, and herbal supplements may help with symptoms of PMS.
- Calcium: One study found that women who took calcium supplements saw improvements in nervousness, sadness, and other emotional changes compared to those who took a placebo.
- Vitamin D: Also known as the “sunshine vitamin,” vitamin D may influence the production of various hormones, including progesterone and testosterone. Plus, it helps your body absorb calcium and is one of the primary building blocks of strong bones.
- Omega-3s: These healthy fats can help reduce inflammation in the body, which may help ease inflammation-related PMS symptoms.
- Magnesium: There’s an increasing body of evidence that supports a link between magnesium deficiency and increased susceptibility to stress.
- Chromium: This mineral may support insulin sensitivity and healthy metabolic function.
- Vitamin B-6: Similarly, among its many functions vitamin B-6 (pyridoxine) may also help with mood-related PMS symptoms like moodiness, irritability, forgetfulness, bloating, and anxiety.
- Ashwaghanda: This herb has been studied to help lower the stress hormone cortisol, which may assist in taming stress-related symptoms of PMS like fatigue and irritability.
- Rhodiola rosea: Another beneficial herb for helping manage PMS symptoms, rhodiola contains stimulant and antioxidant-like properties that research has found to help the body’s resilience to stress.
4. Stress management techniques
Studies show that women with PMS have higher cortisol levels when they wake up than their symptom-free peers. And the higher the cortisol, the worse the symptoms.
When cortisol levels rise and stay elevated for a long time, the body becomes less capable of handling everyday stress, exacerbating PMS symptoms like fatigue and irritability.
Managing stress is key to helping tamp down cortisol, which can, in turn, benefit a host of bodily processes. It can also positively impact blood pressure, blood sugar, and inflammation.
Corralling spikes in cortisol can additionally help boost mood. And anything that improves mood will likely help with PMS, Whelihan notes.
Research backs this up: In one study, women who participated in an eight-week mindfulness stress reduction program saw an improvement in PMS symptoms compared with women in the control group.
There are many stress reduction methods you can try. Here are some ideas:
- Meditation: All the many forms of meditation have the same goal — training our focus on a single thing, be it your breath, your body, or a mantra.
- Massage therapy: Hardly a mere indulgence, massage can help lift mood, reduce pain, and improve sleep.
- Laughing
- Breathing exercises: When we’re feeling anxious, our breath quickens as an instinctual response to danger. When we breathe deeply, we tell our brains that things will be OK.
- Warm baths
- Spending time outdoors: Researchers have found that stress markers like cortisol can fall within 20 to 30 minutes of being outside in nature.
5. Quality sleep
While a solid night’s sleep is a natural mood booster at any point during the menstrual cycle, a poor night of sleep is especially bad for mood during menses.
And, thanks to their symptoms, women with PMS are twice as likely to have trouble sleeping as their period approaches, per research. There’s even a name for it: PMS insomnia.
Focusing on your sleep habits can help you win the fight against PMS insomnia — and the mood drop that comes with it. Here are the daily habits to prioritize:
- Exposure to natural light in the morning. Signaling to your brain that it’s daytime helps suppress production of the sleep hormone melatonin, leading to better sleep at night when darkness naturally triggers its release.
- Waking up/going to bed at the same time. Routinization of your sleep schedule helps promote consistency of sleep quality and duration.
- Cut off caffeine at least eight hours before bedtime. The half-life of caffeine is three to seven hours, meaning it can take your body three to seven hours to eliminate half of it from your system.
- Keeping your sleep space dark, cool, and quiet. Your core body temperature drops slightly in preparation for sleep, and keeping your room cool can help this process.
- Turning off all screens at least an hour before bedtime. Blue light projected by various devices can have negative effects on sleep quality and duration.
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