Up to 75% of menstruating women experience PMS. Here's every symptom explained — and what actually relieves them.
Premenstrual syndrome (PMS) refers to the physical, emotional, and behavioral symptoms that appear in the days or weeks before your period and disappear shortly after bleeding begins. PMS is caused by the hormonal shifts that happen during the luteal phase — specifically, rising progesterone and falling estrogen levels in the second half of your cycle.
Falling estrogen causes the body to retain sodium and water, making you feel puffy — especially in the abdomen, hands, and feet. This usually peaks 1–3 days before your period.
Progesterone and prolactin cause breast tissue to swell and become sensitive or painful after ovulation. The tenderness typically eases once your period starts.
Estrogen drops sharply before menstruation, which can trigger headaches or menstrual migraines in susceptible women. These are called "menstrual migraines."
Progesterone has a sedative effect on the brain. Combined with disrupted sleep (another PMS symptom), fatigue in the week before your period is extremely common.
Some women experience mild cramping during ovulation and in the days before their period — before prostaglandins from the uterine lining trigger true menstrual cramps.
Testosterone becomes relatively higher as estrogen drops late in the luteal phase, increasing sebum production and triggering breakouts around the chin, jawline, and cheeks.
Fluctuating progesterone disrupts GABA receptors in the brain, lowering your frustration threshold.
Dropping estrogen reduces serotonin, increasing feelings of worry or unease in the week before your period.
Serotonin fluctuations in response to estrogen changes can cause low mood or tearfulness.
Progesterone affects cognitive function and working memory, making it harder to focus pre-period.
Lower serotonin drives cravings for carbohydrates and sweets — your brain seeking a quick mood boost.
Progesterone raises body temperature, which can disrupt sleep quality in the luteal phase.
PMS begins during the luteal phase — typically 1 to 2 weeks before your period. For most women, symptoms are mildest just after ovulation (around day 14–16) and worsen progressively, peaking in the 5–7 days before menstruation begins. Symptoms usually disappear within 4 days of your period starting.
PMDD (premenstrual dysphoric disorder) is a severe form of PMS that affects 3–8% of women. While PMS causes discomfort, PMDD causes significant depression, debilitating anxiety, rage, or suicidal thoughts that substantially interfere with daily functioning. If your premenstrual symptoms are severely impacting your life, relationships, or ability to work, speak to a doctor — PMDD is a recognised medical condition with effective treatments.
See our full guide: PMDD Symptoms & Treatment Options →
Aerobic exercise 3–5 times per week during the luteal phase reduces PMS severity by boosting endorphins and serotonin. Even a 30-minute walk helps. Avoid overtraining, which can worsen fatigue.
If lifestyle changes aren't enough, your doctor may recommend SSRIs (which can be taken only in the luteal phase), hormonal contraceptives to stabilise hormone fluctuations, or other targeted treatments. Don't suffer through severe PMS without getting help.
Log symptoms, mood, and flow every day. WomensPal spots your patterns and predicts your next PMS window so you're never caught off guard.
Start tracking free →PMS symptoms typically begin 1–2 weeks before your period during the luteal phase. Most women notice them most strongly in the 5–7 days before bleeding starts.
PMDD is a severe form of PMS. While PMS causes discomfort, PMDD causes significant depression, anxiety, or rage that interferes with daily life and affects about 3–8% of women.
Yes. PMS commonly causes anxiety and irritability due to fluctuating estrogen and progesterone affecting serotonin — a key mood-regulating neurotransmitter.
Foods rich in magnesium (dark chocolate, nuts, leafy greens), calcium (dairy, fortified foods), and B6 (salmon, bananas, chickpeas) can reduce PMS symptoms. Reducing salt, sugar, caffeine, and alcohol also helps.
Related: PMDD Symptoms · Period Cramps Relief · Hormone Imbalance Symptoms · Period Calculator