Period Symptoms: PMS Explained

Why Do Period Symptoms Happen?

Period symptoms are caused by the hormonal fluctuations that take place during your menstrual cycle. The menstrual cycle is divided into four phases:

1. Menstrual phase: when you get your period.

2. Follicular phase: where the ovaries create small fluid-filled sacs called follicles that can mature into eggs.

3. Ovulation phase: when a mature egg is released from an ovary and travels to the uterus, ready for fertilisation.

4. Luteal phase: when your womb lining thickens in preparation for pregnancy.

Certain hormonal and neurotransmitter changes are thought to be responsible for period symptoms. Symptoms vary between people, not everyone will experience the same symptoms or to the same degree of severity, so don’t worry if you can’t relate to everything we discuss in this article. We are all unique and so are our experiences.

What Causes Period Symptoms?

Throughout your menstrual cycle, hormone levels rise and fall. Increases in progesterone cause the womb lining to thicken in preparation for pregnancy. If this doesn’t happen, then progesterone levels drop just before your period, causing the uterine lining to shed which can result in cramping, also known as period pain.

Fluctuating oestrogen levels, on the other hand, can cause water retention^[1] and mood changes as the hormone interacts with other chemicals in the brain that regulate your emotions.

Changing oestrogen levels during the luteal phase of the menstrual cycle are responsible for mood changes. However, serotonin, a chemical messenger (neurotransmitter) that sends messages between nerve cells in the brain and body, precursors increase between days 7 to 11 and 17 to 19 of the menstrual cycle^[2].

Research also shows that serotonin levels are 30% higher during the luteal phase^[3], suggesting that PMS is closely associated with mood disorders through the regulation of oestrogen and serotonin.

Most Common Symptoms of Periods

Several symptoms are commonly experienced by women during their menstrual cycle.

Period pain is one of the most common symptoms, with 35% of respondents to our survey confirming they experience stomach aches during their period. This is similar to other research which found that period pain was a common feature for 43% of women every month^[4].

Our data shows that the most common period symptoms are:

• Stomach aches – 35%

• Mood swings – 30%

• Breast tenderness – 27%

• Fatigue or low energy – 27%

• Bloating or digestive issues – 26%

• Feeling upset, angry or irritable – 25%

• Backache – 22%

• Headaches/migraines – 22%

• Trouble sleeping – 21%

• Acne or spots – 20%

"I think the big take-home from the data here is how common period related symptoms are. Unfortunately, all too often I see young women who are not listened to when they try and explain the impact that these symptoms can have on their lives. It’s also quite a taboo subject in many circles, but by sharing these experiences, we can normalise the conversation and contribute to changing the culture and attitudes surrounding menstrual symptoms. "

Dr Thom Philips

Physical Symptoms

• Cramps (dysmenorrhea)

• Bloating

• Breast tenderness

• Headaches

• Fatigue

• Back pain

Emotional Symptoms

• Mood swings

• Irritability

• Anxiety

• Feelings of sadness

Other Symptoms

• Acne

• Food cravings

• Sleep disturbances

• Digestive issues (diarrhoea/constipation)

Experiencing period symptoms without a period

There are many reasons why you may experience period-like symptoms, such as cramping, but do not notice any menstrual bleeding. They include:

• Pregnancy

• Hormonal imbalances

• Ovulation

• Stress

• Gas and constipation

• Irritable bowel syndrome (IBS)

• Menopause

• PCOS

• Endometriosis

In many cases, the causes of period symptoms but no period are usually nothing to worry about, but you should discuss your symptoms with your GP to rule out any underlying health conditions and receive any treatment you may need.

What Is PMS (Premenstrual Syndrome)?

Premenstrual syndrome or PMS is the combination of physical and emotional symptoms that many women experience in the weeks leading up to their period, usually during the luteal phase of the menstrual cycle.

Many women may experience the more regular symptoms of having a period. PMS typically occurs before your period starts and can feel more intense. Some of the classic PMS signs include:

• Mood swings

• Feelings of depression or irritability

• Feeling anxious, upset, or emotional

• Tiredness and sleep issues

• Sore or tender breasts

• Bloating

• Stomach cramps

• Headaches

• Acne breakouts

• Greasy hair

• Food cravings^[5]

Around 1.6% of women and girls are affected by a more severe form of PMS called Premenstrual Dysmorphic Disorder (PMDD)^[6]. PMDD symptoms are more much more severe than PMS and have a much greater effect on the person’s quality of life. The most concerning symptoms associated with PMDD are anger, depression, and often, suicidal thoughts. Each case of PMDD is unique and is best managed with support from a specialist. If you’re concerned about PMDD then your GP should be able to refer you to your local Sexual and Reproductive Health (SRH) service.

Tips for Managing Period Symptoms

Even though period symptoms may be a natural part of the menstrual cycle, there are things you can do to make them more manageable and help you feel more comfortable.

Lifestyle changes

• Weight loss: Having a high BMI may cause an absence of menstruation, irregular menstruation, heavy or long menstruation and painful menstruation.

• Diet: Following a healthy balanced diet can help to improve your mood, reduce bloating, and boost your energy levels. It’s also common to experience a drop in iron levels, especially if you have a heavy period, which can lead to symptoms like fatigue, lightheadedness, and low energy. Eating iron-rich foods like lean meat, leafy green vegetables (spinach and kale), beans, lentils, and seafood can help to keep your iron levels balanced and manage period symptoms, like cramps, tiredness, and fatigue.

• Exercise: Moderate-intensity exercise may help to reduce pain, improve mood, and promote sleep.

• Stress management: Managing stress with mindfulness, meditation, and deep breathing may help with period symptoms because feeling stressed may make them worse.

• Hydration: Drinking plenty of water will help to prevent bloating and feeling fatigued.

Medication

• Painkillers: Over-the-counter painkillers can help with headaches, cramps, and muscle and joint pain until they go away on their own.

• Contraceptive pill: Although not always the first option, using hormonal products to control your cycle can be an effective way of managing monthly symptoms.

• Antidepressants: Serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) can be prescribed by a medical professional to people who experience mood changes as part of PMS.

Complementary therapies

• Heat therapy: Hot water bottles or heat patches can help soothe period cramps.

• Supplements: Calcium, vitamin B6, magnesium, and evening primrose oil may be of benefit if you experience period symptoms^[7].

• Cognitive behavioural therapy (CBT): If you have been diagnosed with PMS, you may be offered CBT to help you find new ways to manage your symptoms^[8].

"I find that my period symptoms change from month to month, I will always have paracetamol and ibuprofen handy to curb period pain. The months when I need extra help, using hot water bottles or heating pads on my lower back or tummy really helps make me feel more comfortable and having a warm bubble bath and chocolate is always a must."

Rebecca - Forth Customer

When to Seek Medical Help

Although most period symptoms are short-lasting and manageable, sometimes they can indicate an underlying issue. For example, if you experience severe pain, heavy bleeding, emotional distress, or find that your quality of life is severely impaired, it’s important to seek help and advice.

Conditions such as PCOS, endometriosis or fibroids may cause more intense symptoms and it could mean that you’re experiencing more than just common menstrual symptoms.

""These conditions are much more common than people think, with approximately 1 in 8 women meeting the criteria for a diagnosis of Polycystic Ovarian Syndrome. In these instances, it is useful to learn more about your personal hormonal picture through the use of biomarker testing. Unfortunately, there isn’t currently a good biomarker test available for fibroids, but there are some promising developments for endometriosis that will hopefully revolutionise how we identify and manage women who are suffering from this often debilitating condition.""

Dr Thom Philips

Conclusion

Period symptoms are a common and normal part of life, and although not everyone will experience them, they can be managed with the right strategies in place. By understanding what’s ‘normal’ for your body and taking care of your physical and emotional wellbeing, you’ll be better equipped to manage the signs and symptoms of hormone fluctuations.

You can keep track of your menstrual cycle with the MyForm® Female Hormone Mapping Test, so you can gain a better understanding of how your hormones change across your cycle.

It’s important to talk about our menstrual cycles with friends, partners, or family members to help normalise the conversation and help us spot any patterns. Talking about our periods should be a normal and healthy part of life. If you are experiencing symptoms which you find overwhelming or difficult to manage, don’t be afraid to seek medical advice or ask for help. By openly talking about menstrual health, we can all feel more empowered about speaking out and seeking help.