by Lisa Hendrickson-Jacks

What is PMS?

Premenstrual syndrome (PMS) is a catch-all term for the mood, behavioral, and physical symptoms women experience during the week or so before menstruation. From anxiety, irritability, and sadness, to sugar cravings, bloating, and sore breasts, most (if not all) women experience some degree of these and other emotional and physical symptoms shortly before their period arrives.

In fact, anywhere from 80 to 90 percent of women experience PMS symptoms the week before their period. That’s most of the women you know — it’s virtually all of us at some point in our lives. But if as many as 90 percent of women experience PMS symptoms the week before their period, can we really call it a “syndrome”?

I mean, seriously, if 90 percent of women felt tired after running a marathon, would we call that a syndrome too? Don’t get me wrong, “post marathon syndrome” does have a certain ring to it. It’s also ridiculous to create a pathology out of a perfectly normal reaction (to marathon running in this case).

Differentiating between normal changes and problematic symptoms

With that said, you and I both know that many women suffer from moderate to severe PMS symptoms. That leaves us with the task of differentiating between the normal changes that occur premenstrually, and the problematic symptoms we associate with PMS.

In my book The Fifth Vital Sign I discuss menstrual molimina. This is an older medical term that refers to the normal symptoms women experience in the second half of the menstrual cycle (after ovulation) such as breast tenderness, fluid retention, and mood changes. These changes happen so consistently that many women use these secondary signs to confirm ovulation.

If you’ve personally experienced PMS symptoms that fall into the emotional category (think anxiety, sadness, teariness, anger, and other mood changes) you’ll appreciate the sense of relief you feel when your period finally arrives. PMS is characterized by a buildup of these symptoms as you approach your menses. They then quickly disappear once your period shows up on the scene. In that way, your period offers both a physical and emotional release of the energy that has built up over the course of your menstrual cycle. But there is a limit to what we can call “normal.”

We can divide PMS into four main categories:

  • Anxiety
  • Hyperhydration/Bloating
  • Carbohydrate cravings, and
  • Depression

If you fall into the anxiety category, you’ll likely feel anxious, nervous, or irritable as your period draws near. You may even experience feelings of mild to moderate depression. These symptoms intensify as you approach your period, but quickly disappear once your period begins.

If you resonate more with the hyperhydration/bloating category, you’ll notice an increase in water retention. This can show up as bloating, weight gain, breast tenderness, and even swelling as your period approaches.

Many of us experience carbohydrate cravings during the week before menstruation. Chocolate, cookies, ice cream, cake, you name it! Unfortunately by giving into your sweet cravings, you’re more likely to worsen your PMS symptoms.

Up to 23 percent of women experience bouts of premenstrual depression. These symptoms range from forgetfulness and lethargy to confusion, tearfulness, insomnia, and suicidal ideation.

As you look at this list, you’ll quickly realize that most women don’t only experience symptoms in one category. There’s quite a bit of overlap, but there tends to be one category that’s more pronounced.

When you think of the menstrual cycle as a vital sign, it makes perfect sense that moderate to severe PMS symptoms (that occur consistently from cycle to cycle) are a sign of a deeper issue. As many as 30 percent of women suffer from moderate to severe PMS symptoms. These women are also more likely to experience a sharp decline in progesterone production during the days leading up to their period.

What can be done to improve PMS symptoms?

Fortunately there are a variety of ways you can improve PMS symptoms naturally. Focus on supporting progesterone during the one to two week period leading up to your period. Here are a few strategies that have been shown to improve PMS symptoms:

  • Reduce refined sugar consumption
  • Reduce caffeine and alcohol consumption
  • Manage stress
  • Get to bed early (and optimize your sleeping habits!)
  • Incorporate specific nutrients that have been shown to improve PMS symptoms including magnesium, calcium, vitamin B6, vitamin D, and vitex.

By regularly consuming refined sugar, caffeine, and alcohol, and failing to manage stress and get sufficient sleep, you’re setting yourself up for more pronounced PMS symptoms. When you address the lifestyle factors listed above, you’re supporting your progesterone production. This is particularly important during the second half of your cycle when PMS symptoms occur.

In addition to addressing lifestyle factors, incorporating the specific nutrients listed above during the 2 weeks prior to menstruation has been shown to reduce a variety of PMS symptoms including irritability, food cravings, fluid retention, weight gain, and menstrual migraines. Vitex has been shown to improve hormone balance, thus reducing a variety of symptoms including irritability, anger, headaches, and breast tenderness.

Tune into your fifth vital sign

The good news is that there are many specific things you can do to improve your PMS symptoms. Though common, moderate to severe PMS symptoms are not normal. Take this opportunity to tune into your fifth vital sign and address the underlying factors head on.


Lisa Hendrickson-Jack is a certified Fertility Awareness Educator and Holistic Reproductive Health Practitioner. She teaches women to chart their menstrual cycles for natural birth control, conception, and monitoring overall health. In her new book The Fifth Vital Sign, Lisa debunks the myth that regular ovulation is only important when you want children by recognizing the menstrual cycle as a vital sign. Drawing heavily from the current scientific literature, Lisa presents an evidence-based approach to fertility awareness and menstrual cycle optimization. She hosts the Fertility Friday Podcast, a weekly radio show devoted to helping women connect to their fifth vital sign by uncovering the connection between menstrual cycle health, fertility, and overall health. Connect with Lisa on Instagram.

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