Have you ever felt like you’re not quite yourself in the days before your menstruation – more sensitive, more tired, or more overwhelmed than usual? You’re not alone.
Many people notice changes in mood, energy, or body in the days leading up to menstruation. For some, it might feel like mild irritability or fatigue. For others, it can feel intense, confusing, and hard to manage.
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are clinical conditions used to describe premenstrual symptoms. While PMS is common and often manageable, PMDD is more severe and can significantly affect daily life, relationships, and overall well-being.
In this post, we’ll explain what PMS and PMDD are, how they differ, and share practical strategies that may help you cope and feel more supported during this time of the month.
A Quick Look at the Menstrual Cycle
The menstrual cycle usually lasts around 28 days and has four main phases: menstrual phase, follicular phase, ovulation phase, luteal phase (see image below). Understanding these phases can help you notice patterns in your symptoms and track when PMS or PMDD tends to appear.
Source: https://www.generationnextfertility.com/luteal-phase-stimulation/
PMS – what, when, how?
PMS refers to a combination of emotional, behavioral, and physical symptoms that appear in the late luteal phase of the menstrual cycle and usually ease within the first few days of menstruation. Common symptoms include:
● Emotional symptoms: irritability, mood swings, anxiety, depression, crying, fatigue, restlessness, feeling out of control;
● Behavioral symptoms: sleep problems, appetite changes, social withdrawal, concentration difficulties, decreased interest;
● Physical symptoms: pain (especially in abdomen, lower back, and headache), breast tenderness, nausea, constipation, swelling, bloating/weight gain.
PMS can look different for everyone, and besides the symptoms listed here, some people may notice other PMS-related changes. There’s no strict number of symptoms needed to classify PMS – it’s more about the pattern: when symptoms appear, how long they last, and how much they affect daily life.
PMDD – different from PMS, how?
While PMS symptoms are usually mild and manageable, PMDD is much more severe. For some people, the symptoms can be intense enough to interfere with work, school, social life, family life, and everyday activities.
The timing of symptoms is the same as in PMS: they appear in the week before menstruation, start to improve within a few days after menstruation begins, and are minimal or absent in the week after menstruation. However, for this diagnosis, the symptoms must occur in most menstrual cycles and at least five symptoms must be present in total.
At least one of the following emotional symptoms must occur:
● Strong mood swings (for example, suddenly feeling very sad or tearful, or being unusually sensitive to rejection).
● Strong irritability or anger, or more frequent conflicts with others.
● A clearly depressed mood, feelings of hopelessness, or harsh self-critical thoughts.
● Significant anxiety, tension, or feeling constantly “on edge.”
On top of that, one or more of the following symptoms must be present, to reach a total of at least five symptoms:
● Reduced interest in usual activities (such as work, school, socialising, or hobbies).
● Difficulty concentrating.
● Low energy, unusual tiredness, or feeling slowed down.
● Noticeable changes in appetite, overeating, or strong food cravings.
● Sleeping too much or difficulty sleeping.
● Feeling overwhelmed or out of control.
● Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a feeling of bloating, or weight gain.
These symptoms need to be strong enough to noticeably affect daily life; for example, making it harder to work, study, maintain relationships, or take part in social activities. They are not simply a flare-up of another mental health condition, although they can exist alongside one. The symptoms should also not be explained by medication, substance use, or another medical condition, and they should be tracked daily for at least two menstrual cycles.
Both PMS and PMDD are patterns that repeat with your cycle. Now that we’ve discussed what happens in the days before your period, let’s explore how to cope with these intense hormonal shifts.
What Can Help with PMS and PMDD?
While there is no single solution that works for everyone, it’s important to know that solutions do exist, including: psychological resouces, certain lifestyle choices, and medical solutions. Many people find that small adjustments in daily habits and prioritizing self-care can help ease symptoms.
If you notice recurring PMS symptoms, the first helpful step is becoming more aware of your cycle by tracking it.
Tracking Your Cycle and Symptoms
Tracking your menstrual cycle and symptoms for a few months can provide useful insight. It allows you to notice when symptoms tend to begin, how long they last, and which symptoms appear most often.
This awareness can help you:
- recognise when you may need more rest or support, and plan demanding tasks for times when energy is higher;
- better understand changes in mood or physical symptoms so that you can plan ways to support yourself during that time;
- provide helpful information if you decide to consult a healthcare professional
Tracking can be done using a cycle-tracking app, a calendar, or a simple journal where you briefly note daily symptoms and energy levels.
Lifestyle Habits That May Ease PMS Symptoms
Certain lifestyle habits are associated with milder PMS symptoms for some people. While they probably won’t eliminate symptoms entirely, they can support overall well-being and help reduce some of the intensity.
Sleep
Hormonal changes during the luteal phase can affect sleep quality, which may increase irritability, fatigue, or difficulty concentrating. Many people also experience more fatigue during the luteal phase and first few of days of the period, so it’s helpful to schedule in extra nap-time or more hours for sleep during this phase of the cycle.
Movement
Regular physical activity is linked to improvements in mood and reductions in some PMS symptoms. This does not necessarily mean intense workouts. Many people benefit from moderate activities such as walking, yoga, stretching, or light strength training. High intensity training is best saved for the follicular and ovulation phases of the cycle.
Nutrition
Dietary needs vary between individuals, but here are some suggestions you can try if they’re aligned with your diet.
· Choose complex carbohydrates such as whole grains, oats, legumes, and vegetables for steady blood sugar levels.
· Drink more water: Don’t underestimate this simple life hack; staying hydrated soothes the nervous system.
· Include protein and healthy fats (for example eggs, fish, nuts, flaxseeds, chia seeds, yogurt, or avocado) to support satiety and balanced energy.
· Add magnesium- and calcium-rich foods, such as leafy greens, nuts, broccoli, kale, or yogurt.
· Avoid excessive sugar: Too much sugar can increase the intensity of PMS symptoms. However, if you have sweet cravings, dark chocolate (70%+) or bananas are recommended.
· Reduce excessive caffeine and alcohol, as these affect sleep and make emotional regulation more difficult. Instead, hot drinks like chamomile or ginger tea or turmeric latte can be beneficial.
It’s normal to consume more calories during this phase. You can use cycle tracking to observe which foods help you feel more balanced.
Emotional Self-Care During the Premenstrual Phase
For many people, the days before menstruation bring increased emotional sensitivity. Irritation, sadness, anger or anxiety may become heightened, making everyday stressors harder to manage. If you’re dealing with self-critical thoughts during this time, remember it’s not you and it’s not the truth – it’s hormones.
It’s so important to approach yourself with extra patience and care during this phase. Some people benefit from reducing unnecessary commitments, allowing more rest, or planning calming activities.
Practices such as journaling, breathing exercises, spending time in nature, or engaging in relaxing hobbies may support emotional balance. Communicating with close friends, partners, or family members about what you are experiencing can also help create understanding and support.
When to Seek Professional Support
If premenstrual symptoms begin to significantly interfere with daily life, relationships, or overall well-being, it may be helpful to seek professional support.
A psychologist can help you deal with the emotional and cognitive aspects of PMS or PMDD, treat sleep difficulties and help you design a self-care plan that supports a healthy lifestyle.
If you suspect you might have PMDD or experience physical symptoms like cramps or migraines, it’s recommended to also seek out a gynecologist or medical professional. For example, you can get your hormone levels tested, and discuss medical treatment options.
Understanding Your Cycle
Learning about your menstrual cycle can provide valuable insight into how your body and mind change throughout the month. Women’s health has been neglected for a long time, but it’s important to speak about these issues openly. Premenstrual symptoms are a common experience, and they are not a personal failure. With greater awareness, healthy habits, and the right support when needed, many people find ways to navigate this phase of the cycle more comfortably.
Written by: Magdalena Caputa and Kim Seppälä
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Freeman, E. W. (2003). Premenstrual syndrome and premenstrual dysphoric disorder: Definitions and diagnosis. Psychoneuroendocrinology, 28, 25–37. doi:10.1016/s0306-4530(03)00099-4
Freeman, E.W. (2007). The clinical presentation and course of premenstrual symptoms. In P. M. S. O’Brien, A.J., Rapkin, & P. J. Schmidt (Eds.), The premenstrual syndromes:PMS and PMDD (pp. 55–61). London, UK: Informa Healthcare.
Generation Next Fertility. (2025, September 29). Luteal phase stimulation – generation next fertility.
https://www.generationnextfertility.com/luteal-phase-stimulation/
Granda, D., Szmidt, M. K., Jarmuzek-Orska, P., & Kaluza, J. (2025). Dietary predictors of premenstrual syndrome: Protective role of nuts, seeds, and legumes, and adverse role of sugar and sweets. Nutrition, 138, 112835. https://doi.org
Robinson, R. L., & Swindle, R. W. (2000). Premenstrual symptom severity: Impact on social
functioning and treatment-seeking behaviors. Journal of Women’s Health & Gender-
Based Medicine, 9(7), 757–768. doi:10.1089/15246090050147736
Rogan MM, Black KE. Dietary energy intake across the menstrual cycle: a narrative review. Nutr Rev. 2023 Jun 9;81(7):869-886. doi: 10.1093/nutrit/nuac094. PMID: 36367830; PMCID: PMC10251302.
Saglam, H. Y., & Orsal, O. (2020). Effect of exercise on premenstrual symptoms: A
systematic review. Complementary Therapies in Medicine, 48,
102272. doi:10.1016/j.ctim.2019.102272
Yonkers, K. A., O’Brien, P. M. S., & Eriksson, E. (2008). Premenstrual syndrome. The
Lancet, 371(9619), 1200–1210. doi:10.1016/s0140-6736(08)60527-9