The Science Behind PMS: What Your Body Wants You to Know

PMS can cause great discomfort both physically and mentally. This article will outline the symptoms and causes of PMS and what you can do to help remedy it!

By Mallory Lindahl

Premenstrual syndrome (PMS) is a term that covers the multiple symptoms you can experience in the week or two before your period arrives. The most common symptoms of PMS, according to the Mayo Clinic, are muscle pain, headaches, fatigue, bloating, breast tenderness, anxiety, mood swings, acne breakouts, and more (1). Unfortunately, there is a large stigma around menstruation and period symptoms, and PMS is often ignored or diminished by those who either don’t experience these symptoms or do not menstruate. This is because periods are often considered dirty and taboo. However, this should not be the case. Periods are a completely natural part of life. 

In the past, there have been issues diagnosing people with PMS because some symptoms did not meet the initial criteria defined in the mid 1980’s. These criteria were as follows: There must be the presence of at least five symptoms, one of which must be a mood symptom; there must be two cycles of daily charting to confirm the timing of symptoms; the symptoms must present evidence of functional impairment, and symptoms must not be the result of another psychiatric condition (6). 

However, The American College of Obstetrics and Gynecology (ACOG) has tried to remedy this situation by defining moderate to severe PMS (6). Therefore, more people can have their PMS diagnosed because it’s now measured on a case-by-case basis rather than on the prior conditions listed above. Receiving a diagnosis can help identify the right medication and practices to make PMS more bearable. 

In the week before your period, your body goes through a transitional phase in which the hormones progesterone and estrogen can greatly affect your physical and emotional state. According to Fairview Clinics, estrogen rises during the first half of the menstrual cycle and drops during the second half. Serotonin is a neurotransmitter that regulates mood. In some people, serotonin levels stay mostly steady. But with other cases of PMS, serotonin drops along with estrogen. This means serotonin is lowest in the two weeks before the period (4). Additionally, progesterone can sometimes have a “calming” effect, but during PMS this effect can be reversed and make PMS symptoms worse.

Unfortunately, everything depends on how your body reacts to hormones, and everyone is different! The ovaries are using these hormones to thicken the uterine lining to prepare the body for pregnancy. If a pregnancy does not occur, the thickened uterine lining is shed, which is what we call our period. As the uterine lining thickens, the body experiences PMS symptoms. This means that PMS is undoubtedly a very real medical issue that many will experience. 

When attempting to treat PMS, an article from The Journal for Nurse Practitioners claims that “PMS management is highly individualized and consists of lifestyle changes or medications, or a combination of the two approaches” (3). This journal strongly encourages compassionate counseling for patients experiencing PMS, which makes it an excellent resource for practicing healthcare workers who may often be swayed to ignore PMS symptoms. The article also explains that oral contraceptive pills are often prescribed in order to lessen the effects of PMS and make periods lighter (3). Oral contraceptives are commonly referred to as birth control, and they generally come in two forms: combined pills that contain estrogen and progesterone or progesterone-only pills. To learn more about whether oral contraceptives are right for you, it is best to contact your physician! 

There are also some natural ways to ease the uncomfortable symptoms of PMS. A study in the American Journal of Obstetrics and Gynecology found that patients who took a calcium supplement had a 48% reduction in their total symptoms (5). Approximately 1200 mg of calcium a day is the recommended dosage to aid with symptoms. Foods that are high in calcium include almonds, green vegetables, soy milk, and sesame seeds. If you are feeling up to it, exercise can also help reduce the discomfort caused by PMS and periods. The endorphins released during exercise can help combat the mood swings caused by hormones! Additionally, many different kinds of teas can help with cramps and bloating, including ginger, peppermint, cinnamon, dandelion root, and fennel tea. You can find all of these at a local tea shop or grocery store. You can also invest in hot water bottles and heating pads to relieve cramps and bloating as well. 

Finally, it’s important to let your body rest and get enough sleep during this tumultuous time. Periods affect everyone differently, and the best thing you can do is listen to your body and honor its needs. Don’t let people tell you that PMS is an overreaction or “not real”! Your body is going through intense hormonal changes that cause various symptoms and no one can tell you how to feel about your own health. When in doubt, get in contact with a certified physician or OB-GYN about any concerns or questions you may have about your menstrual cycle. 

Sources: 

[1] “Premenstrual Syndrome (PMS).” Mayo Clinic. Mayo Foundation for Medical Education and Research, February 7, 2020. https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780.

[2] Publishing, Harvard Health. “Premenstrual Syndrome (PMS).” Harvard Health, January 2019. https://www.health.harvard.edu/a_to_z/premenstrual-syndrome-pms-a-to-z.

[3] Raines, Kimberly. “Diagnosing Premenstrual Syndrome.” The Journal for Nurse 

Practitioners 6, no. 3 (March 2010): 224-225. 

https://doi.org/10.1016/j.nurpra.2009.12.013

 [4] “Understanding PMS and Your Cycle.” Fairview. Accessed July 16, 2020. https://www.fairview.org/patient-education/85704.

[5] Wong, Cathy. “Ways to Relieve PMS Symptoms Naturally.” Verywell Health, January 26, 2020. https://www.verywellhealth.com/natural-remedies-for-premenstrual-syndrome-pms-88420.

[6] Yonkers, Kimberly Ann, P. M. Shaughn O'Brien, and Elias Eriksson. “Premenstrual Syndrome.” Lancet (London, England). U.S. National Library of Medicine, April 5, 2008. doi: 10.1016/S0140-6736(08)60527-9