We often tend to dismiss our premenstrual symptoms. Since we get them every month, it’s easy to brush things off as “normal,” especially according to modern medicine. But how do we know when to be concerned?
While we’d like to imagine a world where our period takes us by surprise (no bloating, no pain, no breakouts, no emotional rollercoaster), we know that may not be realistic. We checked in with Dr. Sherry Ross, OBGYN and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. to learn how to interpret our symptoms and recognize when something is an actual problem.
Dr. Sherry explains that emotional changes, including depression, mood swings, irritability, and anxiety, are common and normal symptoms associated with PMS.
“When these emotional changes become disruptive to work or your personal life, the diagnosis of Premenstrual Dysphoric Disorder (PMDD) is made. Medications that treat depression and anxiety are often given to women suffering from this debilitating diagnosis.”
Just to be clear—PMDD doesn’t cover that unnecessary argument you picked with your partner or the tearful spiral over a dog adoption ad. (We’ve all been there.) PMDD is a clinical diagnosis for when emotional symptoms are intense and disruptive to daily life. If your mood changes continue beyond your period, it could be a sign of something unrelated to hormones, and it’s worth checking in with your healthcare provider.
If you’ve noticed more volatile Number Twos, you’re not alone.
“Bowel changes, including gas and diarrhea, occur during this time of the month and are caused by the hormonal effects on your gastrointestinal tract,” Dr. Sherry explains.
This is likely due to the drop in progesterone, which (unfortunately) decreases GI motility and increases diarrhea. Be sure to consume lots of fiber, and steer clear of irritants like caffeine, alcohol, and excessively spicy foods.
Dr. Sherry confirms that abdominal bloating can be a true nightmare for women and is a common problem, especially pre-menstrual.
It’s primarily caused by pesky fluctuations of estrogen and progesterone that happen in the days before your period, which can lead to increased salt and water retention in the body. Even though you may crave salty snacks, try to limit sodium intake during this time and try using a quality magnesium supplement. Magnesium can help balance electrolytes, encourage gentle fluid release, and relax tense muscles—all of which can help ease premenstrual bloating and water retention.
Right before we shed that hopeful little uterine lining, we literally experience contractions. They may not be as intense as in childbirth, but our body is trying to eliminate something from our uterus. This is triggered by prostaglandins, hormone-like substances produced by the body.
If your cramps are debilitating and last more than a few days, Dr. Sherry warns that it could be a sign of endometriosis—a progressive condition where tissue that normally lines your uterus grows in places it shouldn’t, causing issues that include severe cramps, ovarian cysts, painful sex, lower back and pelvic pain, and even fertility issues.
She encourages us to pay close attention to the severity and length of cramps. Look out for pain that seems unusually intense, interferes with daily activities, or sticks around long after your period ends. If regular pain relievers don’t ease your discomfort, cramps worsen over time, or you’re consistently missing work or important events due to pain, it’s definitely time to talk to your doctor. Early intervention can make all the difference.
The sudden drop in estrogen and progesterone can affect mood-stabilizing chemicals like serotonin, which directly impacts energy levels. Severe fatigue that affects your ability to work or complete basic tasks could be tied to PMDD, according to Dr. Sherry, and warrants a visit to your provider for advice on how to manage it.
Not only does a drop in progesterone cause the sebaceous glands to overproduce, but the drop in estrogen can make testosterone the dominant hormone during the luteal phase. More testosterone makes us more susceptible to breakouts. Eating lots of fiber and antioxidant-rich foods as well as omega-3s can assist with detoxification and reduce oil production.
Although many of these symptoms are considered normal by Dr. Sherry’s standards, prolonged or disruptive experiences should be examined by a medical professional, especially if they prevent you from living your life.
Your body speaks up when something’s urgent, so don’t forget to tune in!
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