Premenstrual syndrome (PMS) is an umbrella term for a variety of often uncomfortable changes that many people go through before their period. These symptoms typically disappear at the onset of menstruation.
3 in 4 menstruating people experience symptoms typical of PMS. That’s a lot of people!
For some, PMS symptoms are mild. For others, they’re debilitating. For 1 out of 10 people, PMS means missing school or work, experiencing unbearable emotional distress, and pain that results in nausea or vomiting.
Severe, debilitating cramps can lead to a diagnosis of PMDD, endometriosis, uterine fibroids, adenomyosis, pelvic inflammatory disease, or cervical stenosis. When these conditions are the underlying cause of pain, it’s important to speak to your doctor.
PMS remains somewhat of a mystery to researchers. Many scientists believe that symptoms arise as a result of hormonal changes that happen after you ovulate.
So how to tell if you have PMS? If you experience recurring, consistent symptoms during the luteal phase of your menstrual cycle, and these symptoms interfere with your life, then you have premenstrual syndrome.
What Are The Symptoms of PMS?
Check out this list of commonly reported physical and emotional symptoms. It can be helpful to note which ones you experience during the week before your period.
- Abdominal pain
- Lower back pain
- Joint pain and mastalgia
- Breast soreness
- Sensory sensitivity
- Food cravings
- Change in libido
- Constipation or diarrhea
- Irritability or agitation
- Mood swings
- Lack of concentration
This is just a sliver of the PMS pie. Because there are so many symptoms, PMS can be difficult to diagnose and treat. However, you begin menstruating and noticing patterns, you can develop a personal understanding of how you experience menstruation.
What Are Menstrual Cramps?
Dysmenorrhea, more commonly known as menstrual cramps, is the most complained about PMS symptom. Cramps are uncomfortable at best, and disabling at worst.
Luckily we know a little more about menstrual cramps than we do about the rest of the symptoms.
If you feel your cramps coming and going like contractions, that’s because your uterus is contracting as it sheds its inner lining. Hormone-like substances called prostaglandins are released during this process. They trigger the muscles in your uterus to contract and literally cramp.
Severe cramps are caused by higher levels of prostaglandins in the uterus. As levels decrease, so does pain.
The presence of prostaglandins is also an indication of inflammation throughout your body. This inflammation has not only been linked to cramps, but also to emotional and mental distress.
This kind of cramping is known as primary dysmenorrhea. These cramps are the most common, and pain can range from mild to severe.
Sometimes underlying issues can make period pain far worse. Menstrual pain that is caused by a uterine condition is called secondary dysmenorrhea. Endometriosis, uterine fibroids, and adenomyosis are three of the most common conditions.
And as we know, many diseases that affect womxn are far under-researched. Treatment options are limited and patient advocacy is critical.
Signs of Endometriosis
Endometriosis is a disease caused when cells similar to those in the endometrial lining of the uterus grow elsewhere in the body.
Endometriosis can present itself as pain during menstruation, but unlike primary dysmenorrhea, it doesn’t always go away after the first few days. And because these endometrial-like cells can invade other tissues over time, symptoms frequently get worse with time.
It can also manifest as pain during sexual intercourse, and people with endometriosis are more likely to have IBS.
Symptoms of Uterine Fibroids
Fibroids are large, non-cancerous growths that form in or around the uterus. Heavy bleeding is a common symptom of fibroids. Unusually long periods, constipation, and pain during sex are other common symptoms. And although hundreds of thousands of people are diagnosed with fibroids each year, little is known about why they form.
Adenomyosis is related to endometriosis. It’s also caused by endometrial-like cells growing where they shouldn’t; either in the uterine wall or on the outside of it. For some, pain caused by adenomyosis is mild. For others, it can cause severe pelvic pain during menstruation, pain during sex, and bloating.
Unlike endometriosis, adenomyosis is frequently associated with heavier periods.
There are many lifestyle changes that you can make to alleviate period pain, especially if you’re experiencing primary dysmenorrhea. Let’s look at what you can do to start feeling better during your period.
Period pain is no joke. Some solutions will work better for others, and a little trial and error will be needed to figure out what works best for you. One common denominator of all of these approaches is that they work to lower stress and reduce inflammation.
And because inflammation is so strongly linked to period pain, anything you can do to reduce it is likely to help.
Knowing where you’re at in your cycle at any time is so important. It will inform which approaches you use and at what capacity. Below you’ll find a brief overview of the different phases of your menstrual cycle and how to track them.
Once you know this, you can decide what you need on any given day. On some days you’ll need rigorous exercise. On others, you’ll need rest, water, and unprocessed food. And on some days, you’ll know to expect more emotional sensitivity, which will help you decide how to plan your day.
Know Your Cycle
There are four phases of the menstrual cycle: menstruation, the follicular phase, ovulation, and the luteal phase.
Day 1 of your cycle is the first day of bleeding. This is the beginning of menstruation, and it ends when bleeding stops.
The follicular phase also starts on day 1, but ends at ovulation. During this phase, a number of follicles begin to grow in the ovaries. One follicle will mature into an egg, and the others will die.
It’s also during this phase that the lining of the uterus that you shed during menstruation begins to thicken.
Ovulation occurs in the middle of your cycle. Here, the egg is released into the uterus. It survives there for about 24 hours and, unless fertilized by a sperm, dies. Keep in mind that this is when you’re most fertile.
Inflammation levels tend to be lower in the days after you ovulate. This is because your body is priming for a possible pregnancy, and wants to keep the immune system from attacking the fertilized embryo.
Finally, the luteal phase is the time that cramps and other PMS symptoms show up. The lining of the uterus thickens, preparing for an egg to implant. If an egg doesn’t implant, the lining of the uterus will begin to shed, which marks the beginning of menstruation.
It’s also at this point that your body, realizing that you’re not pregnant, allows your immune system to resume its work. And it brings with it inflammation, cramps, and other PMS symptoms.
There are many apps that will track your cycle for you. Flo, Clue, and Natural Cycles are just three apps that will allow you to record your period and other relevant information. From that, they’ll predict when you’re ovulating.
These tracking methods are helpful if you’re trying to get pregnant or trying to avoid pregnancy, but they can also give you a better understanding of the follicular and luteal phase, which aren’t as obvious as the others.
Some of them even let you record your symptoms, and will send you reminders.
But for our purposes, you can always track your cycle the old school way by marking your calendar. By marking your menstruation phase, you can average out your cycle length. From there you can estimate when ovulation typically is (although ovulation does vary) and that will give you an idea of what phase you’re in.
Watch What You Eat
Now that you can tell where you are in your cycle, you can decide when to swing through Taco Bell and when to keep on driving. Focusing on the luteal phase, let’s look at which foods to eat and which to avoid. (Hint: Avoid Taco Bell!).
Eat unprocessed foods to add fiber to your diet. This will stabilize your blood sugar levels, keep your intestine moving at the right speed, and absorb excess estrogen that your body needs to get rid of.
Foods To Stock Up On Before Your Period
The Take-Away: Focus on plant-based, unprocessed food. Hydrate, hydrate, hydrate!
Foods To Minimize or Avoid Before Your Period
- Highly processed foods
- Salty food
- Milk and dairy
- Red Meat
The Take-Away: Foods that have little to no fiber and high fat will not be your friend.
Changing your diet is hard. When making any healthy change, it’s helpful to focus more on what you want to add than what you want to take away. Focus on adding the right foods first, and you’ll find that it’s easier to let go of the wrong ones.
Consistent exercise can provide a huge relief to cramps, bloating, and all the emotional issues that come with premenstrual syndrome. Exercise releases beta-endorphins, the famous mood-reliever. But did you know that they also help to burn prostaglandins faster? That means less period pain for you.
Frequent exercise reduces the inflammation throughout your body, which will lessen the inflammation spike that happens before your period.
Light exercise like walking, gentle yoga, or light jogging is great for times when your energy is low. For some this might be the week leading up to your period, for others this might be while you are bleeding.
During the other phases, exercise that gets your heart rate up can help prevent unwanted pain. Some exercises to consider trying are:
Practice Mindfulness Meditation
Mindfulness meditation is the practice of being present with whatever is happening. It’s simple, but the benefits are many.
Developing this skill can help you handle stress, depression, anxiety, and irritability with more ease. Studies have shown that ongoing meditation also improves brain function.
So if you’re having trouble focusing or are finding that you’re especially reactive when you’re PMSing, you may benefit from a meditation practice.
Meditation can seem complicated, but it’s very simple. All you need to do is follow three simple steps to do it.
- Find a relatively quiet place to sit comfortably, either in a chair or on the floor.
- Close your eyes and bring your attention to your body. Notice the different sensations in your body: your feet touching the floor, your hands touching your lap, your breath moving in your chest, etc.
- When your mind wanders, notice that it has wandered. Simply note, “thinking,” and bring your attention back to the body.
There are so many different styles of meditation, and this is just one very simple approach that you can do anywhere.
See a Pelvic Floor Physical Therapist
Pelvic floor therapy is a holistic solution to dysmenorrhea. It targets the pelvis, which contains the reproductive organs, the bladder, uterus, rectum and all the contents that sit in the abdomen.
A pelvic floor therapist will tell you that pelvic pain is not normal, and early diagnosis and intervention is ideal. Unfortunately, women and menstruating people are often late to contact a physical therapist because their pain is normalized.
What is it like working with a pelvic floor physical therapist? First, your PT will evaluate your lower back, hips and alignment and create a plan to prevent and treat pelvic dysfunction. Together you will set goals, and discuss what you’ll do to achieve those goals.
Your physical therapist may use massage, heat, water, or other stimulating modalities during your session together. They’ll teach you the correct way to do certain stretches and exercises and you’ll leave each session with homework.
Stock Up On Herbs
Make room in your tea cabinet for herbs and spices that will target your cramps.
Many cultures have identified different herbs or extracts that reduce cramping and menstrual pain. Some people swear by ginkgo, chaste berry, evening primrose oil, and St. John’s wort.
More research is needed but studies have shown that there’s hope for many plant extracts in alleviating cramps. Research has begun to show us just exactly how they work for us.
And numerous studies have shown that vitamin and mineral deficiencies are not only correlated with worse period pain, but that alleviating those deficiencies will reduce your pain over time. Researchers have specifically shown that supplementing magnesium and vitamin D3 can reduce period pain.
Other herbal remedies and vitamins that can provide relief:
- Green Tea
- Vitamin D3
Develop Some Self-Care Strategies
Self-care is the wellness trend of today, and all over the world, people are reflecting on what self-care looks like to them. Even though it has become quite trendy, the goal of self-care is for everyone: to step back, ask yourself what you need, and find ways to meet those needs.
To stay grounded, healthy, and balanced during times of stress and chaos.
To balance the work that we do in the world with the work we do within ourselves.
Many people are sharing their discoveries on social media. Others are taking part in a conversation about what it really means to be whole.
How does self-care help PMS? It helps you relax when PMS symptoms are expressing themselves in the form of emotional overload, tension, depression, anxiety, and irritability.
Studies have shown that living in an unpredictable environment has been repeatedly linked with higher levels of stress hormones, and increased chronic inflammation. And because we know that chronic inflammation increases most PMS symptoms and period pain, it’s so important to take time to care for yourself.
Self-care strategies can be simple and inexpensive. Drinking water is a form of self-care. So is eating a nutritious, home-cooked meal. Even disconnecting from social media for one day can be a powerful act of self-care.
Other simple forms of self-care:
- Making a DIY face mask
- Meditating for ten minutes
- Reading a book
But self-care strategies can also be unconventional. Sometimes what you need most when things get tough are some tried and true self-soothing strategies that may not work for anyone else.
Examples of unconventional forms of self-care:
- Drinking seaweed tea with a heating pad watching Friends reruns
- Telling a difficult family member that you won’t be available for the next few days
- Wearing your favorite red flowy dress or pants to acknowledge that you’re menstruating
Self-care is quite fun when you realize that you get to decide what it means to you.
Keep The Essential Products On Hand
Diamond’s were once a girl’s best friend, but today we think it may be the heating pad. Assembling a toolbox of go-to products to help you get through any discomfort you feel during your period is essential. So what to stock up on?
Here are a few ideas:
- Microwavable heating pad with lavender or other calming herbs
- Plant-packed herbal supplements
- Period underwear
- CBD bath bomb
- Period tracker app
Having these things on hand will save you the headache of having to add “grocery run” to your to-do list once PMS hits.
Take Up Yoga
Yoga is an ancient practice of movement and meditation, and it’s practiced around the world for a number of reasons. Yoga can be so helpful for relieving menstrual cramps, and many people report an improved sense of well-being from practicing yoga.
One study showed that cat/cow, fish, reduced period pain after consistent practice.
Other poses to try:
- Forward fold
- Child’s pose
- Legs Up the wall
- Fish pose
- Supine twist
- Knees to chest
Knowing your cycle can help you know when to get more serious about a daily practice. It can also help you decide what kind of yoga class to take.
After menstruation, you may have more energy, so a more vigorous class is appropriate. During the luteal phase, you may opt for a slower, gentler practice.
Implement Some Stress Management Practices
All of the above techniques are tools for stress management as well as pain management. But navigating stress, no matter where you are in your cycle, will help you to have a more enjoyable period.
A study in the Journal of Women’s Health showed that experiencing unrelated stress during the two weeks before their period made women 2-3 times more likely to experience PMS symptoms.
So it pays to reduce your stress in all areas of your life. Just like self-care, there are so many different approaches to stress management. And you’ll need to decide which ones work best for you.
Here are some more stress reduction techniques:
- Get adequate rest
- Listen to music and/or dance
- Learn to manage your time effectively so you don’t become overwhelmed with tasks
- Learn some breathing exercises
- Set boundaries with friends and family
- Talk through things with someone you trust
- Download a mindfulness app
Our Health Is Our Responsibility
When it comes to holistic treatments, it’s up to us to take the lead. Natural premenstrual treatments take more work on our part than conventional treatments do. The good news is, the reward goes beyond reducing our period pain. When we incorporate mental and physical wellness strategies into our life, we get healthier.
For example, picking up meditation is a wonderful relaxation technique, and can help you to deal with emotional distress. It can also help you to navigate difficult relationships with compassion and wisdom.
Learning about a healthy diet can address other, non-PMS related health issues.
Physical therapy can alleviate other kinds of chronic pain, too.
Sometimes a problem leads us to discover solutions to other problems we didn’t know we needed. Don’t give up; you got this!
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