PMS Symptoms Are Common, But Not Normal

Understanding Premenstrual Syndrome

Premenstrual Syndrome (PMS) is a condition that affects approximately 75% of women of reproductive age. It's characterised by a range of emotional and physical symptoms that manifest in the days leading up to the menstrual period. These symptoms, while common, are not a normal or inevitable part of the menstrual cycle.

The Predictability and Variability of PMS

PMS symptoms typically follow a predictable pattern each month. However, the specific symptoms and their severity can vary greatly from woman to woman. For some, these symptoms are mild and barely noticeable, while for others, they can be debilitating, disrupting everyday life.

A Closer Look at PMS Symptoms

PMS can be categorised into emotional and behavioural symptoms as well as physical symptoms. Common emotional symptoms include mood swings, anxiety, depression, and changes in appetite or libido. Physical symptoms might include breast tenderness, headaches, fatigue, and abdominal bloating. Regardless of the type or severity, these symptoms generally resolve within four days of the onset of the menstrual period.

Diagnosing PMS

Diagnosing PMS can be challenging, as there are no specific lab tests or imaging studies for it. The American College of Obstetricians and Gynecologists suggests that a symptom must be present for at least three consecutive menstrual cycles and interfere with normal activities for a diagnosis of PMS. Keeping a monthly symptom journal can be invaluable in aiding an accurate diagnosis.

Understanding the Causes of PMS

  • Hormonal Imbalances
  • One of the reasons behind PMS is hormonal fluctuations. There is often a lack of progesterone in the luteal phase and slightly higher estrogen levels. Maintaining progesterone is crucial because its fluctuation can impact neurotransmitter levels such as serotonin. When estrogen and progesterone levels are out of balance, serotonin levels can be affected, leading to mood disruptions.

  • Low Serotonin Levels
  • Serotonin, a critical neurotransmitter for mood regulation, is often lower in women with PMS. This could explain the depression, fatigue, sleep issues, and food cravings commonly experienced.

  • Nutritional Factors
  • Vitamin and mineral deficiencies, particularly in Calcium, Vitamin D, Thiamine, and Riboflavin, are also known to influence PMS severity. Ensuring optimal levels of these nutrients may help in reducing PMS symptoms.

  • Gut Health
  • Gut microbiome diversity, or the lack thereof, might play a role in PMS. Studies suggest that supplementing with beneficial bacteria can lead to fewer PMS symptoms, highlighting the importance of gut health.

  • Endocrine Disruptors
  • Environmental chemicals known as endocrine disruptors can interfere with hormonal balance and may exacerbate PMS symptoms. Minimising exposure to these disruptors can potentially reduce PMS severity.

    Functional Medicine Approach to PMS

    Functional medicine seeks to address the root causes of PMS rather than just managing symptoms. This approach involves comprehensive testing to understand each individual's unique hormonal, gut, and nutritional status.

  • Hormonal, Adrenal, and Metabolism Testing
  • This easy at-home lab test  can provide insights into hormone imbalances, adrenal health, and metabolic function, all of which can play a role in PMS.

  • Comprehensive Stool Test
  • This test evaluates gut health by analysing the balance of beneficial and pathogenic microorganisms, digestion and absorption efficiency, and overall immune status. Since gut health is closely linked to overall well-being, this test is crucial in understanding and addressing PMS.


    PMS, while common, is not a condition that women should accept as normal. Understanding the underlying causes, whether hormonal imbalances, nutritional deficiencies, gut health issues, or environmental factors, is key to effectively managing and potentially overcoming PMS. By taking a holistic and personalised approach, it's possible to alleviate these symptoms and improve quality of life.

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