Even if you’re not sure what it is, there’s a pretty good chance you’ve heard of premenstrual syndrome (i.e. PMS). It’s a special part of the menstrual cycle during which you might feel anywhere from just a little off to so sad that you can’t stop crying for days…and then your period starts and it all kind of makes sense. Read on to find out more about premenstrual syndrome and how it may affect you.
What does PMS stand for?
PMS stands for premenstrual syndrome, which is quite literally a syndrome made up of symptoms you might experience before menstruating. PMS occurs specifically during the luteal phase, which starts around two weeks before your period starts. Although we don’t know precisely why it happens the way it does, hormones are involved.
Approximately two weeks before your period, a peak in oestrogen helps to trigger ovulation, followed by a drop. During the luteal phase oestrogen begins to rise again, while progesterone levels also rise in order to help prepare your uterus to support a potential fertilised egg… or menstruation occurs. But it’s those fluctuations that are thought to cause all the symptoms you might experience. So that’s why it’s called premenstrual syndrome!
Who has PMS?
If you have ovaries, there is a strong chance you will experience PMS as it is linked to the ovarian cycle. It is believed that most women and people with ovaries will experience PMS at some point during their lives. There is also a chance the symptoms will become more severe as you near menopause and your hormonal cycles transition and change. This is thought to quite often begin as you reach your late 30s or 40s.
What are the symptoms of PMS?
As previously mentioned, you might not experience anything at all, let alone anything too severe. Everyone’s experience is different, and you may also get different symptoms during different cycles. Some people may experience a wide range of symptoms to varying levels, and these can include:
- Mood swings
- Exhaustion or fatigue
- Bloating
- Stomach pain
- Headaches or migraines
- Hormonal acne (causing spots or even cysts)
- Changes to your appetite
- Changes to your libido
- Breast tenderness
These can vary from month to month, but might also stay the same. Natasha, 31, says: “Every single month without fail I have a cystic acne flare-up on my jawline. My skin has been fine otherwise since my early 20s, but that’s how I know my period is coming.” Acne flare-ups are a reasonably common warning sign that your period is on the way, but there really is a wide range of ways that your body might react to your fluctuating hormones in the preceding weeks. Jen, 24, says: “I get persistent leg cramps before it starts! No idea why but it happens every time.”
You might not even recognise the signs of PMS as you’re experiencing them. Katie, 34, says “I know I feel rubbish right before it starts but it’s been unpredictable all my life.”
What is PMDD?
Premenstrual dysphoric disorder, or PMDD for short, is often thought of as a more severe version of PMS. Like PMS, it occurs during the luteal phase. It can present with the same symptoms as PMS (though potentially significantly heightened), along with additional and more concerning symptoms such as paranoia, insomnia, vomiting, hot flushes, and more. It is a condition that can be disruptive and damaging to your daily life, personally and professionally. If you think that you might be suffering from PMDD, particularly if it is hindering your ability to carry out your routine, it’s a good idea to speak to your GP about treatment options.
How can we treat PMS/PMDD?
For most people, the physical symptoms of PMS can usually be managed with home remedies including hot water bottles, over the counter painkillers and appropriate rest or exercise depending on what feels right for you. To address the emotional and mental symptoms, it may be helpful to engage in exercise, reduce sugar, caffeine, and alcohol intake, and explore other self-care methods. However, if your symptoms are severe and significantly impair your ability to work, study, or socialise as usual, it might be worth considering discussing stronger treatment options with your GP, which could include hormonal contraception. In severe cases, surgery could be an option.
Does the contraceptive pill affect PMS?
Hormonal contraception can help some people manage PMS symptoms, but it doesn’t work the same for everybody. Contraceptive pills in particular help prevent pregnancy by stopping your ovaries from releasing an egg, thereby preventing ovulation, but people using hormonal contraception can still experience a bleed along with the hormonal fluctuations that cause PMS.
The monthly hormonal fluctuations associated with the menstrual and ovarian cycles can be unpredictable, complex and vary from person to person. So if you are hoping to use hormonal contraception to treat PMS, you should start by working with your GP to come up with a treatment plan, which may involve the combined contraceptive pill – along with a little trial and error.
PMS symptoms vs. pregnancy symptoms
There is some overlap between PMS and pregnancy symptoms. Pregnancy-related bloating can be mistaken for bloating before a period. The two also share in common things like mood swings, cramping, and headaches. There is less chance (although it’s not impossible) of feeling nauseous before your period, so that could indicate that it’s worth taking a pregnancy test.
The biggest sign that you might be experiencing pregnancy symptoms rather than PMS? A missing period. If your period is absent, it’s time to take a test. Your period might also be absent due to other factors including stress, but it’s a good place to start. If you have any further concerns or questions, please contact your GP.
Why is there a stigma around PMS?
Period shaming is real. Have you ever reacted in anger and heard someone rudely chortle “Sounds like it’s your time of the month!” or been brushed off as “hysterical”? It’s frustrating, right? Or when you hear about how women can’t be politicians or run businesses because they get too emotional during their periods, or men accusing each other of having a period when they show any emotion at all. It’s a sad fact of life that PMS is used to put down anyone who might have a period, or even just feelings!
Unfortunately, this stigma also stops people who need treatment from feeling able to seek out the help that they need. Experiencing PMS does not make your feelings any less valid or give anyone the right to treat you badly, and one way that we can combat this is through proper education. If you think you might have PMS or PMDD and are nervous about approaching your GP to discuss what you’re going through, there are loads of resources online that can help to give you the tools you need.
You can also read more about what might happen to your period while you’re on Hana or whether your menstrual cycle really can “sync up” with your friends on our blog.
Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.
ellaOne® 30mg film-coated tablet contains ulipristal acetate and is indicated for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. Always read the label.
