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What Causes PMS Symptoms?

Premenstrual syndrome (PMS) is a common disorder that occurs in up to 3 out of every 4 menstruating individuals. Symptoms typically occur in a predictable monthly pattern, usually after ovulation and before menstruation.

The effects of PMS can range from mild to debilitating and can include common symptoms like mood swings, bloating, headaches, fatigue, food cravings, and irritability. Treatments for these symptoms include supplements, painkillers, antidepressants, diet adjustments, sleep, hydration, and exercise.

The cause of PMS isn’t fully understood yet, but a few different factors likely come into play. Here are a few possible causes of PMS.

Hormonal Changes

Prior to menstruation, hormones tend to fluctuate greatly. After ovulation, estrogen and progesterone levels drop significantly. These hormone changes can cause physical symptoms like changes in appetite, joint and muscle pain, migraines, bloating, weight gain, acne, and problems with digestion.

Many people use hormonal birth control pills as a form of treatment for PMS symptoms. Because hormonal birth control prevents ovulation, it also prevents hormonal changes caused by ovulation.

Chemical Changes in the Brain

The decrease in estrogen and progesterone prior to menstruation affects various chemicals in the brain, like serotonin. This means serotonin is at its lowest levels 1-2 weeks prior to menstruation in people with PMS.

Decreased serotonin levels cause some of the psychological and behavioral symptoms associated with PMS like irritability, anxiety, mood swings, depression, and insomnia.

Untreated Depression

In combination with the drastic drop in serotonin that some people experience prior to their period, having untreated depression can make the mood-related symptoms of PMS even worse. Some people with extreme symptoms are diagnosed with premenstrual dysphoric disorder (PMDD), a more serious psychological form of PMS.

Some people have found their PMS symptoms to improve after treating their depression through a combination of medication (like antidepressants) and therapy. Because PMS affects the whole body, it is important to treat all of its symptoms.