PMS symptoms: causes and what helps

The week before your period sometimes feels like a different season in your body: you are more irritable, you sleep worse, your trousers fit tighter. And then your period begins and it largely resolves. That pattern, complaints that rise and fade with your cycle, is the core of PMS.

I think it is important not to trivialise this: PMS is not fussing, but also not a condition you must necessarily test away. It is a recognisable pattern you can do a lot about yourself, and where testing only makes sense if the complaints are severe or do not fit the normal picture.

PMS (premenstrual syndrome) is a collection of physical and emotional complaints in the second half of your cycle. An estimated up to 3 in 4 women recognise something of it. The complaints come on after ovulation and fade as soon as your period begins.

Which complaints belong to PMS?

PMS shows up differently in everyone. Often it is a mix of physical and emotional complaints:

• Tense or painful breasts
• A bloated feeling or holding fluid
• Headache or fatigue
• Irritability, low mood or mood swings
• Worse sleep or more appetite

If the emotional complaints are so severe that they disrupt your daily life, it may be the heavier form PMDD. Read about that in our article on recognising PMDD.

What causes PMS?

The exact cause is not fully known, but the sensitivity to the normal swings of oestrogen and progesterone after ovulation seems to be central. So it is usually not about abnormal hormone values, but about how your body responds to the fluctuations. That explains why PMS is so tightly linked to your cycle. If you want to know what a usual progesterone value looks like in the second half of the cycle, see our progesterone reference values per cycle phase.

What helps with PMS?

Many women benefit from lifestyle measures. The table below orders commonly mentioned approaches by how firm the evidence is.

According to Thuisarts and the NHG guideline on PMS, lifestyle measures are often the first step, and for severe complaints there are also medical options you discuss with your GP. The Voedingscentrum (Netherlands Nutrition Centre) emphasises that a varied diet remains the basis, separate from individual supplements.

Track your cycle to see the pattern

The most underrated tool for PMS costs nothing: a simple diary. For a few cycles, note your main complaint each day and how severe it was, on a scale of for example 1 to 3. After two or three cycles you often see a clear pattern: complaints that build in the second half and fade as soon as your period begins.

That pattern is exactly what a doctor wants to see to distinguish PMS from complaints that are not linked to your cycle. If you see that your complaints actually run all month, or that they do not fade after your period, that fits PMS less well and is good information to take to your GP. A diary makes a vague feeling concrete, and that is very useful in the consulting room.

When is a blood test worthwhile with PMS?

You do not establish PMS with a blood test: the pattern in your cycle is leading. A blood test can help rule out other causes if your complaints are unusual, for example a thyroid problem that resembles fatigue or low mood. The Hormones Women panel maps the hormones that steer your cycle, and every result is assessed by a BIG-registered doctor.

Unsure whether your complaints belong to your cycle or to something else? Then read our pillar on irregular periods and which hormones to test.

Frequently asked questions

How do I know if it is PMS or something else?

The hallmark of PMS is the timing: the complaints come in the second half of your cycle and fade with your period. Track your complaints for a few cycles; a doctor can help make the distinction.

Does a supplement help against PMS?

Some women experience benefit from certain supplements, but the evidence is mixed. A varied diet is the basis. If in doubt, discuss supplements with a doctor or pharmacist.

When should I see the GP?

Go if the complaints affect your daily life, if they do not fit the normal picture, or if the emotional complaints are severe. There are more options than many women think.

References

1. NHG. NHG-Standaard Premenstrual syndrome (PMS). Dutch College of General Practitioners. Available via richtlijnen.nhg.org.
2. Thuisarts.nl. I have PMS (complaints before my period). Dutch College of General Practitioners. Available via thuisarts.nl.
3. Voedingscentrum. Healthy eating and a varied diet. Netherlands Nutrition Centre. Available via voedingscentrum.nl.

Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.