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Why are my PMS symptoms so severe?
Premenstrual syndrome (PMS) can affect both your body and your emotional wellbeing during the days or weeks before your period.
For some women these changes are mild and manageable while for others they can significantly affect everyday life.
PMS is linked to the hormonal changes that occur during the menstrual cycle but some women appear to be more sensitive to these changes.
When symptoms are severe it is important to consider whether they may be related to PMS, PMDD or another condition.
What happens before a period?
Hormone levels change naturally during the menstrual cycle, particularly after ovulation and before menstruation.
Some women are more sensitive to these normal hormonal changes and may develop symptoms such as bloating, breast tenderness, headaches, tiredness, irritability or changes in mood.
What symptoms can PMS cause?
PMS can involve both physical and emotional symptoms. These may include bloating, breast tenderness, headaches, fatigue, irritability, anxiety, low mood and changes in appetite or sleep.
Symptoms usually appear during the second half of the cycle and improve once the period begins.
Could it be PMDD?
Premenstrual dysphoric disorder, or PMDD, is a more severe condition in which premenstrual symptoms, particularly emotional symptoms, are intense enough to significantly affect daily life.
Symptoms can include marked irritability, anxiety, depressed mood, difficulty concentrating or feeling overwhelmed. The pattern of symptoms across the menstrual cycle is important when assessing PMDD.
Why is tracking symptoms helpful?
Keeping a record of symptoms across several menstrual cycles can help show whether they consistently occur before your period and improve afterwards.
This can help distinguish PMS or PMDD from conditions such as depression or anxiety that may be present throughout the cycle.
When to see a doctor
If premenstrual symptoms are affecting your relationships, work, study or daily activities it is worth discussing them with your doctor.
Treatment depends on the symptoms and may include lifestyle measures, psychological approaches or medication.
If you experience thoughts of self-harm or suicide seek urgent help by calling 000 or Lifeline on 13 11 14.
Key points
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PMS can cause both physical and emotional symptoms before a period.
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Some women are particularly sensitive to normal menstrual hormone changes.
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PMDD is a more severe condition involving significant premenstrual symptoms.
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Tracking symptoms over several cycles can help clarify the pattern.
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Severe or disruptive symptoms should be assessed rather than simply accepted as normal.
Medically reviewed by Dr Susana Rodriguez, menopause clinician at ClaraSana Women’s Health, Perth.
Our content is based on up-to-date Australian guidelines & may differ from information on other sites.