Most women can notice signs of a period coming soon. Between the time after ovulation and the commencement of menstrual bleeding, a number of symptoms are experienced by most women, collectively referred to as PMS, or in case you were wondering what PMS stands for, premenstrual syndrome. These symptoms can range from being inconveniences affecting your day-to-day activity to debilitating signs that keep you from leading a normal life. These patterns are cyclical and occur in a very predictable manner before the onset of bleeding. 

Different in each woman, PMS can exhibit different symptoms and vary even based on the timeframe. Since premenstrual syndrome causes significant levels of both mental and physical distress for the women experiencing it, it’s important to address questions such as ‘how early can PMS start?’ & ‘when does PMS occur?’ in a detailed manner. Read on as we provide an in-depth guide to understanding PMS, its potential causes, symptoms, and a few methods on how to reduce PMS symptoms naturally to relieve your discomfort. 

An Overview of PMS

• Women often attribute the symptoms they face during PMS to the signs of a period coming soon. 
• ‘Why do I get depressed before my period?’, wonder several women. The answer lies in the fluctuating levels of hormones before the onset of menstrual bleeding. 
• It often involves both physical and mental symptoms that can cause considerable disruption in daily routines. 
• So, when does PMS occur? PMS can appear anytime following ovulation and before the onset of your period. However, it’s often noticeable just a few days before the start of bleeding. 
• It’s quite consistent and appears each month, indicating the cyclic biological component at play. 
• PMS, however, is fairly manageable and can be dealt with in a variety of ways by making certain lifestyle alterations to reduce the impact of the symptoms it brings with it. 
• However, there also exists a severe, and far more debilitating form of PMS called premenstrual dysphoric disorder or PMDD. PMDD appears in about 5-8% of all women and is often accompanied by severe depressive episodes before the onset of a period. 
• This condition requires professional assistance and is mitigated by antidepressants and oral contraceptives that have been proven to show positive effects in women battling PMDD. 
• The differences between PMDD vs. PMS are outlined by the intensity of the psychological and physical symptoms experienced by the women. While unpredictable and low moods are common in PMS, suicidal thoughts and a severe lack of energy a notable symptom in PMDD. 

The Causes of PMS

Despite no conclusive evidence on the real causes of PMS, there exist several theories and possibilities that can explain why these phenomena occur: 

• Fluctuating levels of both estrogen and progesterone are thought to be linked closely with erratic moods, low energy levels, and irritability. 
• These hormones often reach peak levels during the luteal phase that begins following ovulation. Towards the end of the luteal phase, the levels of these hormones begin declining rapidly, leading to several effects such as low moods. 
• Neurochemistry is also thought to play an essential role in PMS. Neurotransmitters are closely interlinked with estrogen and progesterone, and their release is directed by these hormones. 
• Dopamine and serotonin are two important neurotransmitters that direct the sensations of pleasure, happiness, and fulfillment. On the other hand, other neurotransmitters like norepinephrine and their synthesis cause a reduction in the production of dopamine and serotonin. 
• In case you were asking yourself ‘why do I get depressed before my period?’, reductions in estrogen levels cause secretion of norepinephrine, leading to a drop in the synthesis of serotonin and dopamine.
• In addition to these physiological possibilities, women with a history of depression, bipolar disorder, anxiety, and postpartum depression are more likely to develop PMDD. The core difference between PMDD vs. PMS is that the former is far more severe than the latter. 
• A family history of mental illness also increases your likelihood of encountering PMDD and other related symptoms. Certain women can also undergo premenstrual exacerbation in case they’re suffering from bouts of depression or anxiety. 
• Their symptoms of PMS are markedly worse, and also trigger severe depressive episodes - one of the uncommon PMS symptoms. These flare-ups in mental illness are linked to the complex brain chemistry associated with PMS.  

The Symptoms of PMS

There are a number of both common & uncommon PMS symptoms, as well as emotional/ psychological and physical symptoms. Here’s what they entail: 

• Common & Uncommon PMS Symptoms
• Common Symptoms
• Anger & irritability 
• Anxiety 
• Difficulty in maintaining focus & a short attention span
• Bouts of crying 
• Loss of sex drive 
• Tender and painful breasts 
• Bloating 
• Erratic mood swings 
• Diarrhea 
• Constipation 
• Body pains and musculoskeletal discomfort 

• Uncommon PMS Symptoms
• Depressive moods 
• Feelings of hopelessness
• Extreme fatigue 
• Sleeping too much or too little 
• A lack of interest in usual routines 
• Social withdrawal
• Extremely painful cramps 
• Severe headaches
• Severe breakouts and acne

• Emotional/ Psychological & Physical Symptoms of PMS
• Emotional/ Psychological Symptoms 
• Anxiety 
• Irritability 
• Erratic mood swings 
• Increased cravings for carbohydrate-rich foods 
• Changes in sleep patterns 
• Low moods and bouts of crying 
• Emotional outbursts 
• Low libido
• Trouble paying attention & limited ability to focus 

• Physical Symptoms
• Cramps 
• Bloating 
• Increase in body weight 
• Constipation 
• Diarrhea 
• Musculoskeletal pain & tenderness 
• Swollen and painful breasts 
• Extreme sensitivity to bright lights and loud noises 
• Intolerance to alcohol 
• Appearance of acne 
• Tiredness & fatigue 

PMDD vs. PMS

PMDD is more severe when compared to PMS and occurs in a minority of women. Here are some ways in which the two differ: 

• While researchers don’t understand the exact causes of PMDD, just like PMS, it’s commonly associated with women that have had a history of mental health disturbances. 
• The symptoms of PMDD are debilitating and can even lead to suicidal thoughts in some women - making this a serious concern. Dedicated mental health assistance is necessary to address bouts of severe depression and the lack of motivation to follow through with routine activities. 
• Pre-existing mental health problems are also bound to flare up in the days leading up to the onset of the period - complicating both the existing condition and the physiological process. 
• PMDD and vitamin deficiency have also been linked, with the lack of vitamin B complexes and vitamin D playing a role in women that suffer from the condition. 
• The diagnosis of PMDD involves a detailed medical examination that includes a complete medical, menstrual, and family history. 
• Often, tests such as estrogen profiles are conducted to rule out other causes for your severe symptoms such as fibroids and endometriosis. Doctors will also examine you to rule out other psychological conditions such as major depressive disorder, panic disorder, and seasonal affective disorder. 
• Classical signs of PMDD include the onset of symptoms up to a week before your expected period and the disappearance of these symptoms around the time of the onset of your period. Elimination of other conditions and the confirmation of these traits can help your doctor with a diagnosis.

Why Are My PMS Symptoms Getting Worse with Age?

Most women begin to manage the symptoms of PMS better as they age. However, some women tend to experience worse PMS symptoms in their 30s and early 40s. Are you approaching this age and asking yourself ‘why is my PMS worse this month?’ The answer is connected to menopause and is discussed in brief in the following section:  

Why is PMS Worse in the 30s & 40s?

• Since these years fall under the perimenopausal age group, the body experiences even more erratic fluctuations in the levels of hormones. 
• This leads to extreme changes in the nature of PMS, and can even present with some uncommon PMS symptoms in certain women. 
• Doctors also think the appearance of PMS early on can indicate more complicated menopause, leading to symptoms of PMS worse in the 30s and 40s age group. 

Relieving PMS Symptoms 

You aren’t alone if you’ve thought about how to reduce PMS symptoms naturally. There exist several safe methods to mitigate the effects of PMS. 

• How to Reduce PMS Symptoms Naturally
• Avoid consuming large quantities of caffeine, processed sugars, and alcohol. 
• Do not smoke in case you’re facing flare-ups in your PMS symptoms. 
• Eat a healthy and balanced diet that is rich in all the essential vitamins and nutrients. 
• Ensure you get at least 7 hours of sleep every night when your period is approaching. 
• Include some light to moderate exercise in your daily routine. Activity can help reduce musculoskeletal distress caused by the onset of PMS symptoms. 

Conclusion

Your doctor might prescribe painkillers to help you manage the pain from the cramps. In case you face PMDD symptoms, your gynecologist can suggest psychiatric evaluation and appointments with a therapist to help you deal with symptoms of depression and anxiety. Diuretic drugs help you shed the water weight gained during the approaching period and help you feel less bloated. Do not avoid any severe symptoms you might observe either during PMS or when you’re going through your period. Reach out to your primary care physician and seek the requisite medical help you desire.