Cramps, crushing fatigue, mood swings, sore breasts... Every month, it's the same old story. You know it's coming, you count the days, and yet you wonder every time, "Is it normal to be in this much pain? Am I pregnant or is it just my PMS coming back?" PMS affects nearly one in two women, but no one has really explained to you why your body is making you feel this way, how long it will last, and most importantly, how to make it less painful.
This article breaks down everything you need to know about PMS: what it really is, why it happens, how to differentiate it from pregnancy, and practical solutions to better manage it. Because having symptoms every month shouldn't be inevitable.
⚡ The essentials to remember
What Exactly Is Premenstrual Syndrome (PMS)?
Premenstrual syndrome is a group of symptoms that consistently occur during the luteal phase of your menstrual cycle—the period between ovulation and the start of your period. These symptoms can be physical (cramps, breast tenderness, bloating, fatigue), emotional (irritability, anxiety, sadness), or behavioral (food cravings, sleep disturbances).
What's special about PMS? It recurs every month in a cyclical fashion and disappears quickly after the start of your period. It's this recurrence and precise timing that distinguish it from other disorders.
The numbers that speak for themselves
PMS: How Long Before Your Period and How Long Does It Last?
This is THE question everyone is asking. The timing of PMS varies from woman to woman, but it still follows a fairly predictable pattern.
Typical SPM Timeline
📅 Onset of symptoms
Symptoms can appear any time after ovulation (day 14 of a 28-day cycle), but typically start 5 to 7 days before your period. Some women experience them up to 14 days before their period.
⏱️ Total duration
PMS typically lasts from 2-3 days to a maximum of 2 weeks. Symptoms are often most intense 2-3 days just before your period begins.
✅ End of symptoms
Symptoms usually disappear within a few hours of the start of your period, or at most 5 days afterward. If symptoms persist after your period, it's probably not PMS.
💡 The important point: PMS ONLY occurs in cycles with ovulation. If you take a pill that blocks ovulation, you should not experience PMS.
PMS Symptoms: A Complete Catalog
Over 200 different symptoms have been documented for PMS. Every woman experiences PMS differently, with symptoms varying in intensity and nature from cycle to cycle.
🎭 The classic PMS combo
The most common symptoms that come back systematically:
- Tense and painful breasts (mastodynia) - often the first sign
- Irritability - you lose your temper over trifles
- Severe fatigue - feeling like you haven't slept
- bloating - you feel like you've gained 3 kilos all at once
- Cravings - especially sweet and salty
Why Does PMS Exist? (The Real Causes)
Contrary to popular belief, PMS isn't "all in your head." It's a very real phenomenon with identified biological causes, even if the exact mechanisms remain somewhat mysterious.
1. Hormonal fluctuations
After ovulation, your body produces massive amounts of progesterone and estrogen to prepare the uterus for a possible pregnancy. Then, if the egg isn't fertilized, these hormones drop sharply just before your period. It's this hormonal roller coaster that triggers PMS symptoms.
💡 Why some women and not others? Some women are simply more sensitive to these hormonal fluctuations. Their brains and bodies react more intensely to changes in progesterone and estrogen.
2. The GABAergic system and allopregnanolone
Recent studies show that women with PMS have altered sensitivity of the GABAergic system (a neurotransmitter system in the brain) to allopregnanolone, a neurosteroid derived from progesterone. Essentially, their brains do not respond normally to this substance, causing emotional and physical symptoms.
3. Decrease in serotonin
Serotonin is the neurotransmitter responsible for well-being and mood. In women suffering from PMS, serotonin levels drop during the luteal phase, which explains irritability, anxiety, and sadness. This is why SSRI antidepressants (which increase serotonin) are effective in treating severe PMS.
4. Nutritional deficiencies
Some studies point to magnesium, calcium, and vitamin B6 deficiencies in women with severe PMS. These nutrients play a role in regulating mood and muscle contractions.
5. Genetic factors
There is a genetic predisposition to PMS. If your mother or sister suffers from it, you are more likely to suffer from it too.
PMS or Pregnancy? How to Tell The Difference
It's every woman's dilemma: "Am I having my usual PMS or am I pregnant?" The symptoms are so similar that it's almost impossible to tell them apart at first. Cramps, sore breasts, fatigue, mood swings... it could be either.
🎯 The only way to be sure
It's impossible to differentiate PMS from pregnancy with certainty based on symptoms alone. Both conditions cause hormonal changes that are very similar.
The only reliable indicator: The arrival (or not) of your period + a pregnancy test. If your period doesn't arrive on the expected date and your symptoms persist, take a test.
Severe Premenstrual Syndrome: Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder (PMDD) is the most severe form of PMS. It affects 3 to 8% of women and has been recognized as a true psychiatric disorder in the DSM-5 (Diagnostic Manual of Mental Disorders).
Symptoms of PMDD
PMDD is characterized by emotional and psychological symptoms that are much more intense than classic PMS:
- Severe depression, hopelessness, suicidal thoughts
- Intense anxiety, panic attacks
- Extreme irritability, explosive anger
- Feeling of total loss of control
- Major interpersonal conflicts
- Inability to work or maintain social relationships
⚠️ If you recognize yourself in this description: PMDD isn't "just" a slightly more severe form of PMS. It's a serious disorder that requires medical attention. A gynecologist, general practitioner, or psychiatrist can help you with appropriate treatments (antidepressants, therapy, hormonal contraception).
📋 Symptoms & Solutions to Manage Premenstrual Dysphoric Disorder (PMDD) →
Treatments & Solutions to Manage PMS
PMS is not inevitable. Several approaches exist to reduce the intensity of symptoms, ranging from lifestyle changes to medication.
Healthy lifestyle and natural solutions
🏃♀️ Regular physical activity
Physical exercise helps reduce PMS symptoms by releasing endorphins (feel-good hormones) and reducing stress. Just 30 minutes of moderate activity 3-4 times a week is enough: brisk walking, swimming, yoga, cycling, etc.
🥗 Adapted diet
Certain dietary adjustments can alleviate symptoms:
- Reduce salt : limits water retention and bloating
- Reduce caffeine : reduces anxiety and irritability
- Limit alcohol : worsens mood swings
- Favor complex carbohydrates : whole grains, legumes to stabilize blood sugar
- Increase protein : lean meat, fish, eggs for satiety
😴 Quality sleep
Getting 7-9 hours of sleep a night helps regulate mood and reduce fatigue. Establish a regular sleep routine, avoid screens before bed, and create an environment conducive to rest.
Dietary supplements for PMS
🌿 Other natural solutions
- Herbal teas: chamomile, lemon balm, valerian for anxiety and sleep
- Essential oils : lavender, clary sage (in massage diluted in a vegetable oil)
- Bach flowers: Rescue for stress, Impatiens for irritability
- Homeopathy: Folliculinum, Lachesis, depending on the symptoms (consult a homeopath)
Drug treatments
💊 For physical pain
- Paracetamol : for headaches and minor pain
- Anti-inflammatories (ibuprofen) : for more intense cramps and pain
- Diuretics (spironolactone) : for water retention and bloating
💊 Hormonal contraception
Continuous birth control pills (without breaks) can suppress ovulation and therefore eliminate PMS. Some pills are more effective than others for PMS - talk to your gynecologist.
💊 For severe PMS or PMDD
SSRI antidepressants (fluoxetine, sertraline, paroxetine) : These medications increase serotonin and are very effective for the emotional symptoms of PMS and PMDD. They can be taken continuously or only during the luteal phase.
Note: SSRIs work very quickly in PMS (within a few days), unlike their use in depression.
📋 30 Natural Solutions Under the microscope to manage PMS →
Can You Have PMS and Be Pregnant?
Yes and no. If you're pregnant, you can't have PMS in the strict sense of the word, since PMS goes away when your period arrives—and you don't have a period if you're pregnant.
However, early pregnancy symptoms can be very similar to PMS: cramps, sore breasts, fatigue, irritability... This is why you may feel like you have PMS when you are actually pregnant.
💡 The only way to know: If your PMS symptoms persist beyond your expected period, you're probably pregnant. Take a test.
Keeping a Cycle Journal: The Most Useful Tool
If you really want to understand your PMS and find what works to relieve it, keeping a cycle journal is the best thing to do. Record your symptoms every day, their intensity, what you eat, your stress level, how well you sleep, and more.
Why is it useful?
- You identify patterns and can anticipate bad days
- You see what makes your symptoms worse or better
- You have concrete evidence to show your doctor
- You realize it's not "in your head"
You can use a cycle tracking app, a simple journal, or download templates online. The important thing is consistency for at least 2-3 cycles.
Protections Adapted to All Stages of the Cycle
PMS, periods, spotting... Our Period Panties accompany you through every stage of your cycle with comfort and security.
Your PMS Is Not Inevitable
Premenstrual syndrome affects nearly one in two women, with symptoms appearing between 5 and 14 days before their period and disappearing upon its arrival. These symptoms are caused by the natural hormonal fluctuations of the luteal phase. Differentiating PMS from pregnancy is difficult because the symptoms are similar, but the only reliable criterion is duration. PMS stops with your period, while the pregnancy continues. When in doubt, only a pregnancy test can decide.
Solutions exist to alleviate PMS: regular physical activity, a suitable diet (less salt, caffeine, and alcohol), dietary supplements (magnesium, calcium, vitamin B6, chasteberry), and in severe cases, medication. PMDD, a severe form affecting 3-8% of women, requires specific medical monitoring. Keeping a cycle diary for 2-3 months allows you to identify your patterns, anticipate symptoms, and find solutions that work for you. PMS isn't inevitable, and it should never prevent you from living a normal life.
Sources & Scientific References
This article is based on published scientific studies and verified medical data.
Prevalence and epidemiology of PMS
- Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S. (2014). Epidemiology of Premenstrual Syndrome (PMS)-A Systematic Review and Meta-Analysis Study. Journal of Clinical and Diagnostic Research. DOI: 10.7860/JCDR/2014/6788.4021
- Biggs WS, Demuth RH. (2011). Premenstrual syndrome and premenstrual dysphoric disorder. American Family Physician. PMID: 21121563
Biological mechanisms and neurosteroids
- Hantsoo L, Epperson CN. (2015). Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Current Psychiatry Reports. DOI: 10.1007/s11920-015-0628-3
- Martinez PE, Rubinow DR, Nieman LK, et al. (2016). 5α-Reductase Inhibition Prevents the Luteal Phase Increase in Plasma Allopregnanolone Levels and Mitigates Symptoms in Women with Premenstrual Dysphoric Disorder. Neuropsychopharmacology. DOI: 10.1038/npp.2015.246
Treatments and interventions
- Marjoribanks J, Brown J, O'Brien PM, Wyatt K. (2013). Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD001396.pub3
- Yesildere Saglam H, Orsal O. (2020). Effect of exercise on premenstrual symptoms: A systematic review. Complementary Therapies in Medicine. DOI: 10.1016/j.ctim.2019.102272
- Whelan AM, Jurgens TM, Naylor H. (2009). Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Canadian Journal of Clinical Pharmacology. PMID: 19193696
Recent reviews
- Kuczmierczyk J, Antosik AZ, Barczak K, Wirstlein P, Golusinski P. (2024). Premenstrual syndrome: new insights into etiology and review of treatment methods. Frontiers in Psychiatry. DOI: 10.3389/fpsyt.2024.1363875
Note: DOI links provide direct access to the original scientific publications. This article was written in accordance with current medical knowledge.
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If your PMS symptoms are severe or disabling, consult a gynecologist, midwife, or general practitioner.
