Premenstrual Syndrome (PMS): understand, manage and relieve symptoms

Irritability, fatigue, aches? “Life’s too short to suffer
according to Judi Dench.

But PMS isn’t inevitable! Reduce inflammation, stabilise your mood, boost your energy. A natural and effective solution exists. Your menstrual well-being, finally accessible.

Right then, let’s have a chat about that monthly visitor, shall we? Not the mother-in-law, but Premenstrual Syndrome (PMS). It’s a common niggle for many women, bringing with it a host of unwelcome guests: mood swings, bloat, and the odd craving. We’ll unpack what PMS really is, looking at those pesky hormonal fluctuations and how they trigger such a kerfuffle.

But, not all PMS is created equal. We’ll distinguish between your run-of-the-mill PMS and its more bothersome cousin, Premenstrual Dysphoric Disorder (PMDD), and why recognising your own PMS pattern is key.

Now, let’s get down to brass tacks: what can be done? Dietary tweaks can make a world of difference – from embracing calcium-rich goodies to dodging sugary temptations. And, of course, we’ll explore how movement as medicine, be it a brisk walk or a calming yoga session, can help restore balance.

Finally, we’ll delve into the world of natural remedies, evidence-based supplements, and soothing essential oils. And, because life throws enough curveballs, we’ll explore stress management and self-care strategies to help you navigate PMS with grace. So, grab a cuppa, settle in, and let’s get started!

Understanding What You’re Up Against

What Is Premenstrual Syndrome (PMS)?

Premenstrual syndrome (PMS) is a common condition that affects many women during the menstrual cycle. It is characterised by a variety of physical, emotional, and behavioural symptoms that occur regularly in the time leading up to menstruation. In British terminology, the hormone involved is called oestrogen (not estrogen), which, along with progesterone, fluctuates during the cycle and influences these symptoms.

Timing Of Symptoms In The Menstrual Cycle

PMS symptoms typically arise during the luteal phase of the menstrual cycle, which is the period about one to two weeks before menstruation begins. This phase starts after ovulation and ends when the period starts. Symptoms usually resolve shortly after menstruation begins.

How Hormonal Fluctuations Trigger Symptoms

The hormonal changes during the luteal phase, especially the fluctuations in oestrogen and progesterone levels, are believed to trigger the symptoms of PMS. These hormonal shifts affect neurotransmitters in the brain, such as serotonin, which can influence mood and physical sensations. For example, a drop in serotonin levels is linked to mood swings, irritability, and anxiety. Additionally, hormonal effects can cause fluid retention, breast tenderness, and headaches.

Distinguishing Between PMS And PMDD

While PMS involves a range of symptoms that can be mild to moderate, there is a more severe form called premenstrual dysphoric disorder (PMDD). PMDD is characterised by intense emotional and physical symptoms that significantly interfere with daily life and functioning. Symptoms of PMDD include severe depression, anxiety, irritability, and emotional instability, often accompanied by suicidal thoughts. Unlike PMS, PMDD symptoms are disabling and require clinical attention.

Normalising PMS To Reduce Stigma And Isolation

It is important to understand that PMS is a common and natural condition experienced by many women. Symptoms can vary widely but are part of the normal hormonal cycle. Recognising PMS as a legitimate health issue helps reduce stigma and feelings of isolation. Women experiencing symptoms should feel supported and know that they are not alone, and that effective management strategies exist.

Recognising Your Personal PMS Pattern

Understanding your personal PMS pattern is essential for managing the symptoms effectively. Premenstrual syndrome manifests through a variety of physical, emotional, and behavioural symptoms that can differ widely among individuals.

Common Physical Symptoms

Many experience breast tenderness, which may present as swelling or soreness in the days leading up to menstruation. Abdominal bloating is another frequent complaint, often accompanied by headaches and joint or muscle pain. Some also report gastrointestinal issues such as constipation or diarrhoea. These physical signs typically arise about one to two weeks before the period begins and usually subside shortly after menstruation starts.

Emotional and Behavioural Symptoms

PMS also affects mood and behaviour. Common emotional symptoms include mood swings, irritability, anxiety, and feelings of sadness or tearfulness. Some may experience increased tension, anger, or social withdrawal. Behavioural changes can involve difficulty concentrating, altered sleep patterns, and changes in libido. These symptoms can fluctuate in intensity but tend to follow a consistent pattern for each individual.

Importance of Tracking Symptoms for at Least Two Cycles

To accurately recognise your PMS pattern, it is crucial to track symptoms over at least two menstrual cycles. This tracking helps differentiate PMS symptoms from other health issues and identifies the timing and severity of symptoms. Consistent monitoring provides a clearer picture of your unique experience, enabling better management and communication with healthcare providers.

Practical Guidance on Creating a Symptom Diary

Creating a symptom diary is a practical way to track your PMS. Note daily physical symptoms like breast tenderness or headaches, as well as emotional states such as irritability or anxiety. Record the intensity of each symptom on a scale (for example, 1 to 5) and mark the days of your menstrual cycle. You can use a notebook, a calendar, or digital apps designed for menstrual health tracking. This diary will help you observe patterns and triggers over time.

How Identifying Patterns Helps Develop Targeted Relief Strategies?

Identifying your personal PMS pattern allows you to develop targeted relief strategies. For example, if bloating and breast tenderness are predominant, dietary adjustments and physical activity might be beneficial. If mood swings and irritability are more prominent, stress management techniques, counselling, or medical interventions can be considered. Understanding your symptoms helps tailor lifestyle changes and treatments to your specific needs, improving overall quality of life during the premenstrual phase.

Dietary Changes That Make a Difference

Making thoughtful adjustments to your diet can significantly improve your overall health and well-being. Understanding which foods to embrace and which to limit, along with adopting effective eating patterns, can help you achieve lasting positive results.

Foods To Embrace

Incorporating calcium-rich options into your diet is essential for maintaining strong bones and preventing osteoporosis. Good sources include dairy products like milk, yoghurt, and cheese, as well as leafy green vegetables such as kale and broccoli. Fortified plant-based milks, like almond or soya milk, are excellent alternatives for those who are lactose intolerant or prefer vegan options.

Complex carbohydrates are another important group to include. Unlike simple sugars, complex carbs provide sustained energy and help regulate blood sugar levels. Whole grains such as brown rice, whole wheat bread, oats, and barley are rich in fibre and nutrients. These foods support digestive health and keep you feeling fuller for longer.

In addition, omega-3 fatty acids play a vital role in heart and brain health. Sources rich in omega-3 include oily fish like salmon, mackerel, and sardines. For those who do not consume fish, flaxseeds, chia seeds, and walnuts are plant-based alternatives that provide beneficial omega-3 fats.

Foods to Limit

To optimise your diet, it is important to reduce intake of certain substances that can have negative effects on your health. Caffeine, found in coffee, tea, and some soft drinks, should be consumed in moderation as excessive amounts can disrupt sleep and cause jitteriness.

Alcohol is another ingredient to limit because it can contribute to weight gain, liver problems, and interfere with nutrient absorption. Drinking in moderation or avoiding alcohol altogether is advisable.

High salt intake is linked to increased blood pressure and cardiovascular risk. Processed and packaged foods often contain hidden salt, so opting for fresh ingredients and seasoning meals with herbs and spices instead can help reduce sodium consumption.

Similarly, limiting sugar is crucial for preventing obesity, diabetes, and dental problems. Avoid sugary snacks, desserts, and sweetened beverages, and try to satisfy sweet cravings with natural fruit instead.

Practical Meal Ideas Suitable For British Tastes And Grocery Options

Adapting these dietary principles to familiar British foods makes it easier to maintain healthy habits. For breakfast, consider porridge made with oats and topped with fresh berries and a sprinkle of flaxseeds for omega-3s. Lunch could be a whole wheat sandwich filled with grilled salmon, leafy greens, and a light yoghurt dressing.

For dinner, try baked cod with steamed broccoli and new potatoes, seasoned with herbs and a squeeze of lemon. Snacks like natural yoghurt with walnuts or carrot sticks with hummus provide nutritious options between meals.

Shopping at local supermarkets such as Tesco, Sainsbury’s, or Waitrose offers access to a wide range of fresh produce, whole grains, and omega-3 rich fish. Many stores also stock fortified plant-based milks and low-sodium products to support your dietary goals.

Eating Pattern Recommendations

Adopting an eating pattern of smaller, more frequent meals throughout the day can help maintain steady energy levels and prevent overeating. Eating every three to four hours encourages better digestion and keeps blood sugar stable.

This approach might include three main meals and two healthy snacks, such as fruit, nuts, or wholegrain crackers. It also supports metabolism and helps avoid the sluggishness that can follow large, heavy meals.

Hydration Importance And Practical Tips

Staying well-hydrated is a fundamental part of a healthy diet. Water supports digestion, nutrient transport, and temperature regulation. Aim to drink at least 1.5 to 2 litres of water daily, adjusting for activity level and climate.

Practical tips to increase hydration include carrying a reusable water bottle, drinking a glass of water before meals, and consuming water-rich foods like cucumbers, watermelon, and oranges. Herbal teas can also contribute to fluid intake without added caffeine or sugar.

By embracing these dietary changes, you can make meaningful improvements to your health while enjoying familiar and satisfying meals.

Movement As Medicine

Benefits Of Regular Exercise For Hormone Balance And Mood

Regular exercise plays a crucial role in maintaining hormonal balance and improving mood. Physical activity stimulates the release of endorphins, often called the “feel-good” hormones, which help reduce pain perception and promote a sense of well-being. This natural boost can alleviate symptoms of depression and anxiety, contributing to a more positive mood overall. Additionally, exercise regulates cortisol, the stress hormone, preventing its chronic elevation that can lead to weight gain, mood swings, and sleep disturbances. Exercise also enhances insulin sensitivity, which helps stabilise blood sugar levels and reduces the risk of metabolic disorders such as type 2 diabetes and polycystic ovary syndrome (PCOS). By influencing these key hormones, regular physical activity supports both mental and physical health, making it a powerful tool for hormone regulation and emotional stability.

Exercise Recommendations Suitable For Different Intensities Of Symptoms

Exercise intensity should be adapted according to the severity of symptoms and individual energy levels. For those experiencing mild symptoms or high energy, moderate to high-intensity workouts such as brisk walking, running, cycling, or strength training can be beneficial. These activities stimulate the release of growth hormone and testosterone, supporting muscle growth and metabolic health. For individuals facing moderate to severe symptoms, especially during hormonal fluctuations or high stress, gentle exercises like yoga, Pilates, or light swimming are recommended. These activities help reduce cortisol levels and promote relaxation without overtaxing the body. It is important to listen to your body and avoid overtraining, which can increase cortisol and worsen hormonal imbalances. Consistency and balance in exercise routines are key to achieving hormonal benefits without exacerbating symptoms.

Specific Activities That Help With Cramps (Yoga Poses, Swimming)

Certain activities are particularly effective in alleviating menstrual cramps and related discomfort. Yoga is highly recommended due to its combination of gentle stretching, deep breathing, and relaxation techniques. Poses such as Child’s Pose (Balasana), Cat-Cow Stretch (Marjaryasana-Bitilasana), and Supine Twist help relieve tension in the lower back and abdomen, improving blood flow and reducing pain. Swimming is another excellent option, as the buoyancy of water reduces pressure on joints and muscles while providing a full-body, low-impact workout that can ease cramping. These activities not only address physical pain but also help lower stress hormones, contributing to overall hormonal balance during menstruation.

Adjusting Your Workout Routine During Different Cycle Phases

Adapting your exercise routine according to the menstrual cycle phases can optimise hormonal benefits and comfort. During the follicular phase (post-menstruation), energy levels tend to rise, making it a good time for more intense workouts such as cardio, strength training, or HIIT. In the ovulatory phase, when oestrogen peaks, performance and endurance often improve, so maintaining a challenging routine is beneficial. During the luteal phase (post-ovulation), when progesterone rises, energy may decrease, and symptoms like bloating or mood swings can appear; thus, shifting to moderate or gentle exercises like yoga or walking is advisable. Finally, during menstruation, focusing on restorative activities such as stretching, light yoga, or swimming can help manage discomfort and fatigue. This cyclical approach respects the body’s hormonal fluctuations and supports sustained exercise adherence.

Quick And Simple Movement Ideas For Low-Energy Days

On days when energy is low, engaging in short, simple movements can still provide hormonal and mood benefits without overwhelming the body. Gentle stretching, a brief walk outdoors, or a few minutes of deep breathing combined with light yoga poses can stimulate endorphin release and reduce cortisol levels. Even 5 to 10 minutes of movement can improve circulation, ease muscle tension, and elevate mood. These low-effort activities help maintain consistency in physical activity, which is essential for long-term hormonal balance and mental well-being. Listening to your body and allowing flexibility in your routine ensures that movement remains a positive and sustainable part of your lifestyle.

Natural Remedies Worth Trying

Evidence-based supplements: calcium, magnesium, vitamin B6
Herbal options with research support: chasteberry, evening primrose oil
Essential oils guide: lavender, clary sage, peppermint (application methods)
Heat therapy techniques for pain relief

Cautions about supplement quality and interactions

Stress Management and Self-Care Strategies for PMS

Connection Between Stress and PMS Symptom Severity

The relationship between stress and premenstrual syndrome (PMS) symptoms is significant and complex. Stress can exacerbate the severity of PMS symptoms, including emotional symptoms like anxiety, irritability, and mood swings, as well as physical symptoms such as headaches and fatigue. This connection is partly explained by the interaction between stress hormones and reproductive hormones. Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol levels, which can disrupt the hypothalamic-pituitary-ovarian (HPO) axis responsible for regulating menstrual hormones like oestrogen and progesterone. These hormonal fluctuations heighten emotional sensitivity and physical discomfort during the luteal phase, intensifying PMS symptoms. Moreover, PMS itself can act as a stressor, creating a feedback loop that worsens symptoms over time.

Practical Relaxation Techniques

To manage stress and alleviate PMS symptoms, incorporating relaxation techniques into daily routines is highly beneficial. Simple methods such as 5-minute meditation sessions can help calm the mind and reduce anxiety quickly. Deep breathing exercises, including diaphragmatic or box breathing, promote relaxation by lowering heart rate and muscle tension. Other effective practices include progressive muscle relaxation, where you systematically tense and relax muscle groups to relieve physical tension, and gentle activities like yoga or massage, which combine physical movement with mindfulness to reduce stress and improve mood.

Sleep Hygiene Tips Tailored for PMS Challenges

Sleep disturbances are common during PMS, often caused by hormonal shifts and heightened stress. To improve sleep hygiene during this time, it is important to establish a consistent sleep schedule by going to bed and waking up at the same times daily. Creating a relaxing pre-sleep routine, such as reading or taking a warm bath, helps signal the body to wind down. Avoiding caffeine, heavy meals, and screen time at least an hour before bed can reduce sleep disruptions. Additionally, keeping the bedroom cool, dark, and quiet supports deeper sleep. Practising relaxation techniques before bedtime can also ease anxiety and promote restful sleep, which is crucial for managing PMS symptoms effectively.

Self-Compassion Practices During Difficult Days

During the days when PMS symptoms are most intense, practising self-compassion can significantly improve emotional well-being. This involves acknowledging that PMS symptoms are a natural part of the menstrual cycle and allowing oneself to experience these feelings without judgement or guilt. Techniques include speaking kindly to oneself, recognising limits, and permitting rest or breaks without self-criticism. Mindfulness meditation focused on acceptance can help reduce negative self-talk and increase resilience. Cultivating self-compassion encourages a gentler approach to coping with PMS, reducing stress and emotional distress.

Creating a Monthly Self-Care Plan That Anticipates PMS

Developing a monthly self-care plan that anticipates the onset of PMS can help mitigate symptoms proactively. This plan might include scheduling relaxation practices, prioritising sleep, and planning lighter workloads or social activities during the luteal phase. Tracking symptoms with a diary or app helps identify patterns and tailor self-care strategies accordingly. Incorporating regular physical activity, balanced nutrition, and stress management techniques throughout the month supports overall hormonal balance and mental health. Preparing for PMS in advance fosters a sense of control and reduces the impact of symptoms on daily life.

When to Seek Professional Support?

Signs That Warrant Medical Attention

Recognising when to seek professional support is essential for managing mental health effectively. Certain signs indicate that medical attention is necessary, especially when symptoms persist and interfere with daily life. These signs include:

Persistent feelings of sadness, anxiety, or hopelessness that last more than two weeks and affect work, school, or relationships.
Significant changes in mood, such as extreme irritability, anger, or mood swings.
Difficulty managing daily responsibilities due to overwhelming stress or fatigue.
Thoughts of self-harm, suicide, or harming others.
Withdrawal from normal activities and social isolation.
Unusual or concerning changes in sleep or eating patterns.
Substance misuse or increased reliance on drugs or alcohol to cope.

If these symptoms are present, it is important to seek help promptly, as untreated mental health issues can worsen and lead to more severe consequences.

Overview Of Treatment Options Available Through The NHS

The NHS offers a range of treatment options for mental health conditions, tailored to the severity and type of disorder. These include:

Primary care support through general practitioners (GPs) who can provide initial assessments and referrals.
Access to psychological therapies such as Cognitive Behavioural Therapy (CBT) through Improving Access to Psychological Therapies (IAPT) services.
Specialist mental health services for more complex cases, including community mental health teams and inpatient care.
Medication prescribed and monitored by GPs or psychiatrists.
Support groups and self-help resources to complement formal treatment.

The NHS aims to provide timely and accessible care, emphasising early intervention to improve outcomes.

Medical Interventions: SSRIs, Hormonal Contraceptives, NSAIDs

Medical treatments commonly used for mental health and related symptoms include:

Selective Serotonin Reuptake Inhibitors (SSRIs): These antidepressants are frequently prescribed for depression and anxiety disorders. They help regulate mood by increasing serotonin levels in the brain.
Hormonal contraceptives: Sometimes used to manage mood symptoms linked to hormonal fluctuations, such as in premenstrual dysphoric disorder (PMDD).
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): While primarily for pain relief, NSAIDs can be prescribed to alleviate physical symptoms like menstrual cramps that may exacerbate mental health symptoms.

These medications are usually part of a broader treatment plan and require medical supervision to manage side effects and effectiveness.

Therapeutic Approaches: CBT And Other Psychological Supports

Psychological therapies are a cornerstone of mental health treatment. The most common and evidence-based approaches include:

Cognitive Behavioural Therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviours. CBT is effective for depression, anxiety, and many other conditions.
Dialectical Behaviour Therapy (DBT): A form of CBT that helps with emotional regulation and is often used for borderline personality disorder and self-harm behaviours.
Counselling and psychotherapy: Provide emotional support and help develop coping strategies.
Group therapy and support groups: Offer peer support and reduce feelings of isolation.

These therapies can be accessed through the NHS or private providers and are often combined with medication for optimal results.

Questions To Prepare Before Your GP Appointment

Preparing questions before seeing your GP can help you get the most from your appointment. Consider asking:

What might be causing my symptoms?
What treatment options are available for my condition?
Are there any side effects of the medications you might prescribe?
How long will it take to see improvements with treatment?
Can you refer me to a specialist or therapy services?
What self-help strategies or lifestyle changes can support my recovery?
How will my progress be monitored?

Having these questions ready ensures a clear and productive conversation, helping you understand your condition and treatment plan better.

Building Your Personal PMS Toolkit

Creating a Personalised Symptom Management Plan

To effectively manage premenstrual syndrome (PMS) symptoms, it is essential to develop a personalised symptom management plan tailored to your unique experiences and needs. Start by tracking your symptoms daily to identify patterns and triggers, which can help in anticipating difficult days. Incorporate lifestyle modifications such as regular exercise, a balanced diet, and stress reduction techniques like meditation or breathwork. Over-the-counter medications such as ibuprofen may be used to alleviate physical symptoms like cramps and headaches, but consult a healthcare provider for advice on suitable treatments. Cognitive behavioural therapy and relaxation therapies can also support emotional symptom management. This personalised approach allows you to proactively address symptoms before they escalate, improving your overall quality of life.

Practical Everyday Items To Keep On Hand

Having certain items readily available can ease the discomfort of PMS symptoms in daily life. Keep pain relievers such as ibuprofen or naproxen to manage cramps and headaches. Stock up on heating pads or hot water bottles to apply warmth to the abdomen, which helps reduce muscle tension and pain. Maintain a supply of nutritious snacks rich in calcium, magnesium, and vitamins B6 and E, which may alleviate symptoms like fatigue and irritability. Consider essential oils like lavender, chamomile, or clary sage for aromatherapy, which can help reduce stress and improve mood. Additionally, keep menstrual products that suit your comfort, such as organic cotton pads or menstrual cups, to avoid irritation.

Communication Strategies For Work And Relationships

Open and honest communication is crucial in managing PMS symptoms within your workplace and personal relationships. Inform trusted colleagues or supervisors about your condition if you feel comfortable, so they understand potential fluctuations in your mood or energy levels. Setting boundaries and requesting flexibility during challenging days can reduce stress and improve productivity. At home, share your experiences with family or partners to foster empathy and support. Using clear, calm language to express your needs and feelings helps prevent misunderstandings and strengthens relationships. Preparing others for your symptom patterns encourages a supportive environment, which is vital for emotional well-being during PMS.

Planning Ahead For Demanding Events Or Deadlines

Planning ahead is key to minimising the impact of PMS during high-stress periods like work deadlines or social events. Use your symptom tracking to anticipate when symptoms might peak and schedule demanding tasks accordingly. Prioritise important activities for times when you typically feel better and allow flexibility for rest when symptoms intensify. Incorporate stress management techniques daily, such as short meditation sessions or light exercise, to maintain balance. Prepare practical aids in advance, like pain relief medication or comfort items, to have on hand during these periods. By proactively managing your schedule and symptoms, you can maintain performance and well-being even during demanding times.

Community Resources And Support Groups In The UK

In the UK, numerous community resources and support groups are available to assist women managing PMS. Organisations such as the National Health Service (NHS) provide information, medical advice, and referrals for specialist care. Charities like Endometriosis UK and The Daisy Network offer support groups and forums where women can share experiences and coping strategies. Local women’s health clinics and mental health services may provide counselling and therapy options tailored to PMS and related conditions. Online communities also serve as valuable platforms for connection and information exchange. Engaging with these resources can empower you with knowledge, emotional support, and practical tools to better manage PMS.

Conclusion

Premenstrual syndrome (PMS) is a common condition that affects many women and is characterised by a variety of physical, emotional and behavioural symptoms that occur regularly before menstruation. It’s essential to understand PMS to reduce stigma and isolation, and to recognise your personal PMS pattern. Dietary changes, regular physical activity, natural remedies, stress management and self-care techniques can help alleviate symptoms.