Growing up, ‘PMS’ was the reason that my mom was upset with my dad’s joke about her cooking. It was why the women in sitcoms were seemingly randomly sobbing or yelling at their families. It was why a woman could never be President of the United States.

Despite acing both my middle and high school health courses, I didn’t fully understand what PMS—or premenstrual syndrome—was until I was in my mid-20s when I began a holistic course focused on menstrual health. In that class, surrounded by adults at every stage of their menstrual journey, we were able to open up about our own misunderstandings of PMS and the often negative stigma associated with it. The conversations I had in that space inspired my own deep dive into cycle tracking, mood tracking, and researching any coincidences I found—leading me to the question: Is PMS actually affecting my moods?

What is PMS?

Many authoritative sources in the United States, including the Mayo Clinic and the United States Office on Women’s Health, define PMS as a collection of physical and psychological symptoms that take place in the last week of the luteal phase of the menstrual cycle, usually beginning in the five days leading up to menstruation. Common symptoms include but are not limited to depression, anxiety, changes in sleep patterns, breast tenderness, bloating, headaches, and fatigue. 

PMS is a collection of physical and psychological symptoms that take place in the last week of the luteal phase of the menstrual cycle.

The typical menstrual cycle is 21-45 days, with the average being 29 days. Everybody is different, which is why tracking your cycle can be beneficial for understanding your body.

The menstrual cycle has four phases: menstruation, follicular, ovulation, and luteal. While the body cycles through these phases, the levels of the hormones estrogen and progesterone also increase and decrease, contributing to the various symptoms felt not just during PMS but throughout the whole cycle. 

The way these hormones affect the body can vary for each person, but for people with PMS, their serotonin levels—another hormone that is most often attributed as a “happy hormone”—decrease alongside estrogen during the luteal phase (right before menstruation), which can impact mood. The Icahn School of Medicine at Mount Sinai states that the fluctuations in these hormones and brain chemicals may play a role in PMS, but it’s still unclear how or why. They suggest that those with PMS could be more sensitive to the fluctuation of hormones throughout the cycle.

How do I know if I am experiencing PMS?

It’s estimated by researchers that about 75% of people who menstruate will experience PMS symptoms in their lifetime. It’s likely that if you experience different body sensations or thought patterns in the five days leading up to your period and end within four days of starting your period, you’re experiencing PMS. But there isn’t one test or way to prove that any symptoms are or are not related to your menstrual cycle. 

This can make determining if your symptoms are menstruation-related or are signs of unrelated mental health issues challenging. One determining factor between PMS or premenstrual dysphoric disorder—a severe version of PMS, also referred to as PMDD—is if the symptoms are reduced or disappear after menstruation begins. 

“PMS and PMDD tend to be cyclical but anxiety, depression and other mental health disorders are not,” says Dr. Ghazala Aziz-Scott, a specialist in integrative women’s health and bioidentical hormone balancing at the Marion Gluck Clinic. 

“However, many pre-existing mental health conditions can be exacerbated by hormonal fluctuations so will often be worse premenstrual, but there is not dramatic change once the period starts,” ––says Dr. Aziz-Scott, who also explained that the amount of hormones your body does or doesn’t produce can lead to PMS or PMDD as well. 

“…many pre-existing mental health conditions can be exacerbated by hormonal fluctuations…”

– Dr. Aziz-Scott

Each person’s body is different, and an individual’s cycle lengths can vary, but tracking your cycle and learning when you are entering your luteal phase will make it easier to anticipate potential PMS. Once you identify what your cycle looks like, begin to take note of any physical or psychological symptoms that may not be usual for you. This could include changes in sleep, new cravings, increased anxious or depressed thoughts, or fatigue. 

How do I handle potential PMS-related mood swings or mental health issues?

Two studies among small communities of menstruating people in Iran found that attending training in mindfulness-based cognitive-behavioral therapy and receiving talk therapy sessions focused on increased anxiety and depression potentially caused by PMS lowered the overall severity of symptoms. 

Furthermore, another study among a community of people who identified as having PMS showed that receiving lessons in healthy lifestyle habits and behaviors—such as learning the benefits of anaerobic exercise or how to manage increased feelings of anger—decreased their overall symptoms. 

Unfortunately, due to the stigma mentioned earlier against menstruation and PMS, we don’t have much research to refer back to regarding any aspect of PMS, from its direct cause to best practices in treatment.

However, various studies show that those who exercise regularly are less likely to experience PMS, likely because exercise increases serotonin, which can balance out those whose serotonin decreases alongside estrogen. 

Vitamin B6 and magnesium are two supplements that can help alleviate stress and decrease the severity of PMS. B6 increases serotonin and dopamine levels, similar to exercise. Older studies suggest that some with PMS experience magnesium depletion during their luteal phase, so trying to balance out that depletion could potentially help with cramps and constipation. Always consult an expert before beginning supplementation. 

If you believe you might be experiencing PMS, it’s recommended to keep track of your symptoms in relation to your menstrual cycle to try and identify any patterns to share with your OB/GYN or primary care physician. Due to the influence of estrogen and progesterone, you can also reach out to an endocrinologist specializing in hormone imbalances and treatment.  

Whether you’re experiencing PMS or not, understanding your body and how it handles the fluctuations within your menstrual cycle can help deepen your connection to your body and self. 

You are the only person who knows what you are feeling. Check-in with your mind and body when your mood doesn’t feel right. Feel confident in your body’s ability to flag when something isn’t right or goes beyond the standard PMS. 

Remember, you are not going through this journey alone.

And remember, you are not going through this journey alone. There are menstruators across the world who are frustrated, confused, or in love with their body and its reaction to the menstrual cycle.

*If your PMS gets in the way of everyday tasks, consult an OB/GYN or your primary care physician.

Emily Harrison (she/her) is an abortion doula, digital strategist, and author of the self-care newsletter Making Lemonade. She cares deeply about planners, holistic wellness, and discovering the best latte in the Twin Cities.