10 Common PMS Symptoms Every Woman Should Know About

Premenstrual syndrome (PMS) refers to a group of physical, emotional, and behavioral symptoms that many women experience in the days or weeks leading up to their menstrual period. Understanding what PMS is and recognizing its symptoms can help you better manage this common condition that affects up to 90% of menstruating women to varying degrees.

PMS symptoms typically begin during the luteal phase of the menstrual cycle (after ovulation) and usually resolve within a few days after menstruation starts. The severity and combination of symptoms vary greatly from woman to woman, with some experiencing mild discomfort while others face significant disruption to their daily lives.

Below, we explore the most common premenstrual symptoms to help you identify and understand what your body may be experiencing.

1. Mood Swings and Emotional Changes

Mood swings are among the most recognizable PMS symptoms. Women may experience sudden shifts in emotions, feeling happy one moment and tearful or angry the next without any apparent trigger. These emotional fluctuations are related to hormonal changes, particularly variations in estrogen and progesterone levels.

During the premenstrual phase, you might find yourself more sensitive to criticism, easily upset by minor inconveniences, or experiencing heightened emotional responses to situations that wouldn’t normally affect you. These mood changes can strain relationships and make it difficult to maintain your usual emotional equilibrium.

The intensity of mood swings varies considerably. Some women experience mild emotional sensitivity, while others may have such severe mood disturbances that they interfere with work, relationships, and daily activities.

2. Abdominal Bloating and Water Retention

Bloating is one of the most physically uncomfortable PMS symptoms. Many women report feeling swollen, tight, and distended in the abdominal area during the week or two before their period. This sensation is caused by hormonal fluctuations that lead to water and salt retention in the body.

The bloating isn’t limited to the abdomen. You may notice:

• Swelling in the hands and feet
• Puffiness in the face
• Tightness of rings and shoes
• Weight gain of 1-5 pounds due to fluid retention
• Feeling of fullness even without eating much

This water retention is temporary and typically resolves once menstruation begins. The discomfort can make clothing feel tighter and contribute to an overall feeling of physical heaviness.

3. Breast Tenderness and Swelling

Breast tenderness, also known as mastalgia, is a hallmark symptom of PMS. During the premenstrual period, hormonal changes cause the breast tissue to retain fluid and become more sensitive. Your breasts may feel:

• Swollen and fuller than usual
• Tender to the touch
• Heavy or achy
• Painful when pressure is applied
• More sensitive during physical activity or when wearing a bra

The discomfort typically affects both breasts and may extend to the underarm area. Some women experience mild sensitivity, while others find the tenderness so severe that even light contact with clothing causes discomfort. This symptom usually peaks just before menstruation begins and improves rapidly once your period starts.

4. Fatigue and Low Energy Levels

Overwhelming fatigue is a common complaint among women experiencing PMS. This isn’t just ordinary tiredness—it’s a profound lack of energy that can make even simple tasks feel exhausting. The fatigue associated with premenstrual syndrome has several contributing factors.

Hormonal fluctuations affect your body’s energy production and can disrupt sleep patterns. Many women with PMS report difficulty sleeping or poor sleep quality in the days before their period, which compounds the feeling of exhaustion. Changes in serotonin levels may also contribute to feelings of lethargy and decreased motivation.

You might find yourself needing more sleep than usual, struggling to wake up in the morning, or experiencing an overwhelming desire to nap during the day. This fatigue can affect your productivity at work, reduce your enthusiasm for social activities, and make it challenging to maintain your regular exercise routine.

5. Irritability and Anger

Increased irritability is one of the most disruptive emotional symptoms of PMS. During the premenstrual phase, you may find yourself becoming annoyed or angry more easily than usual. Small frustrations that you would normally handle calmly can trigger disproportionate reactions.

This irritability manifests in various ways:

• Reduced patience with others
• Heightened sensitivity to noise and disruptions
• Quick temper and snapping at loved ones
• Feeling constantly on edge or agitated
• Difficulty tolerating normal daily stressors

The anger and irritability associated with PMS are driven by the same hormonal changes that affect mood. Fluctuations in estrogen and progesterone influence neurotransmitters in the brain, particularly serotonin, which plays a crucial role in mood regulation. Many women report feeling remorseful after irritable outbursts, recognizing that their reactions were disproportionate to the situation.

6. Food Cravings and Appetite Changes

Changes in appetite and specific food cravings are distinctive PMS symptoms that many women experience. The most commonly reported cravings include chocolate, sweets, salty snacks, and carbohydrate-rich foods. These cravings aren’t simply psychological—they have a biological basis.

Hormonal changes during the premenstrual phase affect insulin sensitivity and blood sugar regulation, which can trigger cravings for quick-energy foods like sugar and refined carbohydrates. Additionally, decreased serotonin levels may drive cravings for carbohydrate-rich foods, as carbohydrates temporarily boost serotonin production in the brain.

Some women experience:

• Intense cravings for specific foods
• Increased overall appetite
• Desire to eat more frequently
• Reduced feeling of fullness after eating
• Late-night snacking or binge eating episodes

While occasionally indulging these cravings is normal, excessive consumption of sugar and processed foods can worsen other PMS symptoms like bloating, mood swings, and fatigue.

7. Headaches and Migraines

Headaches are a frequent physical symptom of PMS, with some women experiencing tension headaches while others suffer from full-blown migraines. These premenstrual headaches are closely linked to hormonal fluctuations, particularly the drop in estrogen that occurs before menstruation.

PMS-related headaches typically:

• Occur in the week before your period
• Range from dull, constant pressure to throbbing pain
• May be accompanied by sensitivity to light and sound
• Can affect one or both sides of the head
• May worsen with physical activity

For women who are prone to migraines, the premenstrual period often triggers more severe or frequent episodes. The combination of hormonal changes, potential sleep disturbances, stress, and dietary changes during PMS can all contribute to headache development. These headaches typically improve once menstruation begins and hormone levels stabilize.

8. Anxiety and Tension

Feelings of anxiety and nervous tension are common emotional symptoms experienced during the premenstrual phase. This anxiety differs from everyday stress—it’s a pervasive feeling of worry, unease, or impending doom that seems disproportionate to your actual circumstances.

Women with PMS-related anxiety may experience:

• Excessive worrying about everyday matters
• Feeling overwhelmed by normal responsibilities
• Restlessness and inability to relax
• Racing thoughts
• Physical symptoms like rapid heartbeat or shallow breathing
• Difficulty concentrating due to anxious thoughts
• Feeling on edge or unable to calm down

The anxiety associated with PMS is linked to hormonal influences on brain chemistry. Progesterone and its metabolites interact with receptors in the brain that affect anxiety levels. When progesterone levels fluctuate during the premenstrual phase, it can trigger or worsen anxiety symptoms. For women with pre-existing anxiety disorders, PMS can significantly intensify symptoms.

9. Depressive Feelings and Sadness

Feelings of sadness, hopelessness, or depression are serious emotional symptoms that some women experience as part of PMS. This goes beyond temporary moodiness—it involves persistent feelings of sadness, loss of interest in activities you normally enjoy, and a generally pessimistic outlook.

Premenstrual depressive symptoms may include:

• Persistent sadness or feeling down
• Crying spells without clear cause
• Loss of interest in hobbies and social activities
• Feelings of worthlessness or hopelessness
• Withdrawal from friends and family
• Difficulty finding joy in normally pleasurable activities
• Negative thoughts and self-criticism

It’s important to distinguish between typical PMS-related sadness and more severe premenstrual dysphoric disorder (PMDD), which involves debilitating depression and mood symptoms. If you experience severe depressive feelings that significantly impair your ability to function, interfere with relationships, or involve thoughts of self-harm, it’s essential to consult with a healthcare provider.

10. Acne and Skin Changes

Skin changes, particularly acne breakouts, are visible physical symptoms that many women notice before their period. Premenstrual acne is driven by hormonal fluctuations that increase oil production in the skin and can trigger inflammatory responses.

During the premenstrual phase, rising progesterone levels stimulate the sebaceous glands to produce more sebum (skin oil). This excess oil can clog pores and create an environment where acne-causing bacteria thrive. The result is often:

• Breakouts along the jawline, chin, and lower face
• Deep, painful cystic acne
• Increased oiliness of the skin
• Worsening of existing acne
• Inflammation and redness

PMS-related acne typically appears about a week before menstruation and may persist until your period starts or shortly thereafter. Some women also notice other skin changes during this time, including increased sensitivity, dryness in some areas, or a dull complexion. The cyclical nature of these breakouts—appearing regularly before each period—is a key indicator that they’re related to PMS rather than other causes.

Main Causes of PMS

While the exact cause of premenstrual syndrome isn’t fully understood, research has identified several factors that contribute to PMS symptoms:

Hormonal Fluctuations: The primary cause of PMS is the cyclical change in hormone levels, particularly estrogen and progesterone, during the menstrual cycle. These hormones peak and drop at different times during the cycle, and the fluctuations appear to trigger PMS symptoms in susceptible women. The drop in estrogen and progesterone that occurs after ovulation seems particularly significant in symptom development.

Chemical Changes in the Brain: Neurotransmitters, especially serotonin, play a crucial role in mood regulation. Fluctuations in ovarian hormones affect serotonin levels in the brain. Insufficient serotonin may contribute to the emotional and physical symptoms of PMS, including depression, anxiety, food cravings, and sleep problems.

Stress Levels: While stress doesn’t cause PMS, it can exacerbate symptoms. High stress levels may worsen both the physical and emotional manifestations of premenstrual syndrome. Women experiencing significant life stress often report more severe PMS symptoms.

Nutritional Factors: Certain nutritional deficiencies or dietary habits may increase susceptibility to PMS. Low levels of vitamins and minerals, including vitamin B6, calcium, magnesium, and vitamin D, have been associated with more severe symptoms. Additionally, excessive consumption of salt, caffeine, and alcohol may worsen bloating, breast tenderness, and mood symptoms.

Genetic Predisposition: Research suggests that genetics may play a role in PMS susceptibility. Women whose mothers or sisters experience PMS are more likely to develop it themselves, indicating a hereditary component to the condition.

Prevention and Management Strategies

While you may not be able to prevent PMS entirely, several lifestyle modifications can help reduce the severity of symptoms:

Dietary Modifications: Eating a balanced diet throughout your menstrual cycle can help minimize PMS symptoms. Focus on:

• Consuming complex carbohydrates like whole grains, fruits, and vegetables
• Reducing salt intake to decrease bloating and fluid retention
• Limiting caffeine and alcohol, especially in the premenstrual phase
• Eating smaller, more frequent meals to maintain stable blood sugar
• Ensuring adequate calcium intake through dairy or fortified foods
• Staying well-hydrated with water throughout the day

Regular Physical Activity: Exercise is one of the most effective ways to reduce PMS symptoms. Regular physical activity helps by releasing endorphins (natural mood elevators), reducing stress, improving sleep quality, and decreasing bloating. Aim for at least 30 minutes of moderate aerobic activity most days of the week, including during the premenstrual phase when you might be tempted to skip exercise.

Stress Management: Since stress can worsen PMS symptoms, incorporating stress-reduction techniques into your routine is beneficial. Consider:

• Practicing meditation or mindfulness exercises
• Trying yoga or tai chi
• Engaging in deep breathing exercises
• Ensuring adequate sleep (7-9 hours per night)
• Setting aside time for relaxation and hobbies you enjoy
• Seeking counseling or therapy if stress feels overwhelming

Tracking Your Symptoms: Keeping a detailed symptom diary for at least two to three menstrual cycles can help you identify patterns and triggers. Note the type and severity of symptoms, when they occur in relation to your period, and any potential contributing factors. This information is valuable for understanding your individual PMS pattern and can be helpful if you decide to consult a healthcare provider.

Nutritional Supplements: Some women find relief from PMS symptoms by taking certain supplements, though you should consult with a healthcare provider before starting any supplementation regimen. Supplements that have shown some promise in research include calcium, magnesium, vitamin B6, and vitamin E. However, it’s always best to discuss appropriate dosages and potential interactions with your doctor.

Sleep Hygiene: Prioritizing good sleep habits can significantly impact PMS symptoms. Maintain a consistent sleep schedule, create a relaxing bedtime routine, keep your bedroom cool and dark, and avoid screens for at least an hour before bed.

Frequently Asked Questions About PMS

What is PMS exactly?

PMS (premenstrual syndrome) is a combination of physical, emotional, and behavioral symptoms that occur during the luteal phase of the menstrual cycle, typically in the week or two before menstruation begins. These symptoms resolve within a few days after the period starts. PMS affects the majority of menstruating women to some degree, though severity varies widely.

How do I know if what I’m experiencing is PMS?

The key indicator of PMS is the cyclical nature of symptoms—they occur predictably in the premenstrual phase and resolve with or shortly after menstruation begins. To confirm PMS, track your symptoms for at least two to three menstrual cycles, noting when they appear and disappear in relation to your period. If symptoms follow this pattern consistently, it’s likely PMS.

At what age does PMS typically start?

PMS can begin at any point after menstruation starts, but it most commonly develops in a woman’s late 20s to early 40s. Some women experience PMS from their first periods, while others develop it later. Symptoms may also change in severity throughout your reproductive years.

Can PMS get worse with age?

Many women report that PMS symptoms worsen as they approach perimenopause (the transition to menopause), typically in their late 30s and 40s. This may be due to more erratic hormonal fluctuations during this time. However, individual experiences vary considerably.

What’s the difference between PMS and PMDD?

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that affects about 3-8% of menstruating women. While PMS symptoms are uncomfortable and disruptive, PMDD symptoms are debilitating and significantly impair daily functioning. PMDD involves severe emotional symptoms, particularly depression, anxiety, and mood swings that interfere with work, relationships, and quality of life. If you suspect you have PMDD, consult a healthcare provider.

Do all women experience PMS?

No, not all women experience PMS. While up to 90% of menstruating women report at least some premenstrual symptoms, only about 20-40% experience symptoms severe enough to be classified as PMS. A small percentage (3-8%) experience PMDD. Some women have minimal or no noticeable premenstrual symptoms.

Can men understand or experience PMS?

Men cannot personally experience PMS since it’s directly related to the menstrual cycle and female hormonal fluctuations. However, men can educate themselves about PMS to better understand and support the women in their lives who experience it. Partners, fathers, and colleagues can benefit from learning about PMS symptoms and their hormonal basis.

When should I see a doctor about PMS?

You should consult a healthcare provider if PMS symptoms significantly interfere with your daily life, work, or relationships; if you experience severe depression or anxiety; if symptoms don’t improve with lifestyle modifications; or if you’re uncertain whether your symptoms are related to PMS or another medical condition. A doctor can help rule out other conditions and discuss management strategies appropriate for your situation.

Can birth control help with PMS symptoms?

Hormonal contraceptives can help some women manage PMS symptoms by regulating hormonal fluctuations throughout the menstrual cycle. However, responses vary—some women find significant relief, while others notice no improvement or even worsening of symptoms. If you’re interested in using birth control to manage PMS, discuss the options with your healthcare provider to determine the best approach for your individual situation.

Is it normal for PMS symptoms to vary from month to month?

Yes, it’s completely normal for PMS symptoms to vary in type and severity from one cycle to another. Factors like stress levels, diet, exercise, sleep quality, and overall health can all influence how you experience PMS in any given month. However, the general pattern of symptoms occurring premenstrually and resolving with menstruation should remain consistent.

References:

• Office on Women’s Health – Premenstrual Syndrome
• Mayo Clinic – Premenstrual Syndrome (PMS)
• American College of Obstetricians and Gynecologists – PMS
• NHS – Pre-menstrual Syndrome
• Johns Hopkins Medicine – Premenstrual Syndrome