PMS symptoms? Why it is not just about hormones
Written by Lotte Boekhout
Perhaps you know the feeling: your partner leaves the towels lying around and, before you know it, you snap. Or you are standing in the kitchen, stirring a pan, and suddenly realise you are crying. Everything feels too much. A few days later, your period starts and you think: ‘Oh… That was it.’
For many women, PMS, or premenstrual syndrome, is a recurring pattern of physical and emotional symptoms. But in my view, PMS involves more than hormones alone.
If you notice yourself changing in the week before your period every month, it can be interesting to look a little further. Not only at what your hormones are doing, but also at how your nervous system responds, how much tension you are holding and what may have been going on within you for some time. That is what I would like to explore with you in this article.
What happens in your body during PMS?
PMS symptoms arise in the second half of your cycle, when your hormones change. After ovulation, oestrogen falls and progesterone rises. Among other things, progesterone affects your mood and can have a calming effect. If you are not pregnant, progesterone then falls again as your period approaches.
These hormonal changes can mean that you respond differently, both physically and emotionally, in the days before your period. Perhaps you recognise it: headaches, tender breasts, bloating or suddenly sleeping less well. You may also feel more emotional, worry more or react much more strongly to things you would usually brush off quite easily.
This varies considerably from woman to woman. One person may mainly feel irritable and angry. Another may feel tired, sad or withdrawn. We all respond slightly differently to the changes taking place in our bodies.
Hormonal fluctuations before your period are therefore involved in PMS symptoms. But that is not the whole story. PMS is not caused by having too little or too much of a hormone. It seems that some women are particularly sensitive to the normal hormonal changes that take place during this phase of the cycle.
That sensitivity is precisely why it can be interesting to consider not only your hormones, but also your nervous system and emotions.
Lifestyle and PMS
One thing I find valuable about your cycle is that it can sometimes show you how you are doing. It can act as a mirror. How have you been living over the past few weeks? Have you slept enough? Taken time to recover? Eaten well? Exercised a lot? Or have you actually been pushing past your own limits for weeks?
Your lifestyle can affect how you feel throughout your cycle. Sleep, food, movement and stress all play a part in how your body responds to change.
A diet that provides enough nutrients, including magnesium and omega-3, for example, can support your body. Movement may also help you feel better. But more is not always better.
The nervous system and PMS
Another aspect of PMS that I find at least as interesting is the role of your nervous system. When you experience a lot of stress over a long period, it can become harder for your body to settle. It is as though you remain somewhat ‘switched on’.
What I often see is that the premenstrual phase can make this more noticeable. Hormonal changes may make you more sensitive to stimulation and emotions. Things you can manage fairly easily during the rest of the month may suddenly affect you much more strongly.
The irritation or restlessness you suddenly feel. The need to be left completely alone for a while. It may seem as though these feelings have come from nowhere. But often, they are not new.
When you feel angry, irritated or restless, it may seem as though your nervous system has its foot constantly on the accelerator. You are more easily upset, have less capacity to cope and may feel that everyone wants something from you.
At the other end of the spectrum, you may withdraw. You feel tired, empty or low and just want to curl up under a blanket. This, too, can be a way your body responds when things have become too much. The PMS phase can sometimes reveal what has been building up during the rest of the month.
What might PMS be telling you?
Perhaps that is an interesting question to ask yourself: what might my body be trying to tell me?
Notice what happens for you during that premenstrual week. Do you mainly feel angry and irritable? Rushed and unable to sit still? Do you snap at people and find everything a little too much? Or do you withdraw? Are you exhausted, sad and no longer interested in anything?
Paying closer attention may help you recognise patterns. Perhaps you discover that you have repeatedly pushed past your own limits in the preceding weeks. That you have said ‘yes’ to everything when you really felt ‘no’. Or that you have been holding tension for weeks without doing anything about it.
Sometimes anger can show you that a boundary has been crossed, perhaps by someone else, or perhaps by you. Sadness may bring you into contact with something you have been trying to put away for a while. This does not mean that every PMS symptom carries a particular message. Of course, it is not that simple.
But it can still be interesting to ask yourself: what am I actually feeling? And why is this affecting me so much now?
I often compare emotions to a beach ball you are trying to hold underwater. You can manage it for a while. You can act as though nothing is wrong and carry on with your day. But it takes constant effort to keep that ball down. As soon as you have a little less strength, it rises to the surface.
Emotions can sometimes work in a similar way. What you have pushed aside during the rest of the month may suddenly take up much more space during your PMS week. Not because the emotion has only just appeared, but perhaps because it is no longer so easy to suppress.
Perhaps the question is therefore not only: how can I get rid of my PMS? But also: which emotions return for me each month, and what might they be telling me?
Why it matters to make time for rest early enough
Something I see often is that we leave too little room for rest and recovery throughout our cycles. We keep going all month. Just one more thing. Then another. Somewhere inside, we may know we are tired, but we carry on anyway.
Until our period approaches. Then we think: now I really need to slow down. Of course, it is good to make a little more space during your period. But perhaps you do not have to wait until symptoms are already there.
Perhaps you can begin much earlier. After ovulation, your body changes. Progesterone rises, and many women notice a greater need for rest and turning inwards during the second half of their cycle.
You might see this as an invitation from your body to ease off a little sooner. Not to turn your entire life upside down, but perhaps to go to bed an hour earlier that evening. Take a gentle walk. Attend a yin yoga class. Leave an evening unplanned. Or simply sit on the sofa without feeling that there is still something you ‘should’ be doing.
If you only rest once PMS is in full swing, you may already have left it rather late.
I notice this myself, too. When I keep going for too long and only rest once my body really asks for it, I feel much more emotional in the days before my period. It can feel as though everything that has built up over the preceding weeks suddenly comes out. But when I listen more closely throughout my cycle, especially by allowing more rest after ovulation, it feels very different for me.
I feel steadier. I have more space in my mind. And my emotions feel less as though they are suddenly taking me by surprise.
A final thought
To me, PMS is about more than hormonal imbalance. It can be a mirror of how you live, relate to your emotions and care for yourself. Exploring this may help you make changes, not by pushing your symptoms away, but by listening to what they might be telling you.
Lotte Boekhout’s practice
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