Debunking menstrual misconceptions: What is premenstrual syndrome (PMS)?
SEPTEMBER 22, 2021
From attempts to degrade women in power positions to your everyday sexist slur, premenstrual syndrome (PMS) has been used to fuel some of the biggest menstrual misconceptions out there. Presenting as over 150 possible symptoms (1), PMS is waaay more than just being ‘in a bad mood’. Let’s debunk some of the biggest myths and find out exactly what is PMS?
About 47% of people with cycles experience some symptoms of PMS each month (2)
PMS includes a huge range of both physiological and psychological symptoms that differ in severity from person to person
The hormonal drop-off of estrogen and progesterone just before our bleeds is thought to bring on most PMS symptoms (2,3)
There are loads of treatments available for all different kinds of PMS symptoms and you should NEVER just put up with pain
Premenstrual dysphoric disorder (PMDD) is a more severe form of the psychological symptoms of PMS
‘It’s her time of the month’.
A classic degrading trope that screams sexism and gender norms at their finest, premenstrual syndrome (PMS) has faced its fair share of stigma.
The typical image of a premenstrual woman is a tearful, bloated, angry dragon—who may, or may not be, on her way home to eat an entire tub of chocolate ice cream.
Although symptoms like high flying emotions, bloating, breast tenderness and period headaches (4), can all be typical for some people who experience PMS, it’s definitely not true of all people with cycles (some people actually experience positive shifts just before their bleed).
There is a lot of contesting scientific evidence and research around PMS—but what is simply a (sexist) social construct and what are the actual biological facts?
As always, we’re here to answer all of these questions (and then some). But first, let’s get familiar with the scientific definitions...
What is PMS?
PMS is basically a whole loaaaad of both physical and psychological symptoms that crop up during the week before our periods and then usually clear up a few days into our bleeds (4).
It’s thought that about 47% of people with cycles suffer with PMS regularly (2) and up to a whopping 75% will experience PMS at some point in their lives (5,6) (that’s a lot of ice cream that’s going to be flying off the shelves).
So what are PMS symptoms? There are thought to be over 150 known PMS symptoms, from minor niggles to completely debilitating emotional and physical changes (1).
Common PMS symptoms include:
Abdominal cramps (period pain)
Bodily aches and pains
Diarrhea and constipation
Food cravings and appetite changes
We could go on (and on)….
It’s important to remember here that whilst many people with cycles will suffer from a handful of symptoms before their bleeds every now and then, this doesn’t necessarily mean they fit the clinical criteria for a diagnosis of PMS.
To be clinically diagnosed with PMS you have to experience at least one symptom 5 days before your bleeding starts, which then clears up by about day 3 of your period, and for this to happen for 3 consecutive cycles (5).
Okay, so what causes PMS?
During the week just before our periods (known as the late luteal phase of the menstrual cycle), both our estrogen and progesterone levels plummet (7). It’s this sudden lack of female sex hormones that are thought to be responsible for most PMS symptoms (7).
The specific hormonal causes vary from symptom to symptom (check out the articles linked in the list above for the deets on each), but mood changes, in particular, are thought to be linked to lower levels of estrogen and serotonin, and their hallmark feel-good factors, premenstrually (8).
Debunking common PMS myths
Okay, so now we’re familiar with the current scientific standpoint, let’s take a look at some of the most common misconceptions about PMS:
Myth: Everyone with a cycle experiences PMS
Although PMS symptoms are very common (experienced by around 47% of people with cycles)(2), definitely not everyone with a cycle will experience PMS nor fit the criteria for a clinical diagnosis of PMS.
Myth: PMS is just mood swings
No, no, no and no. As we’ve seen, there are thought to be up to a whacking 150 symptoms of PMS that span the physiological and psychological. It is true that the majority of people who experience severe PMS are more likely to seek help for mood changes (9), but stigma and social constructs have created this idea of the ‘neurotic’ premenstrual woman. In fact, lots of the bad mood symptoms or feelings of being low may actually be secondary symptoms to other painful physical symptoms—because who’s in a good mood when they’ve got cramps?
Myth: People with cycles make PMS up to blame their bad moods on
Yawn, do we even need to comment on this one?
Myth: PMS is normal and you need to just get on with it
A big, hefty no. Although common, being in pain is definitely not ‘normal’, nor should anyone just put up with it. There are many different treatments for the individual symptoms of PMS (again check out the detailed articles on each of the symptoms above) and these range from getting a good night's sleep to hormonal birth control.
PMS vs PMDD
So we couldn’t write an article on PMS without mentioning it’s sinister older sister—premenstrual dysphoric disorder (PMDD). PMDD is a more severe form of PMS and tends to present in much more debilitating psychological symptoms (9).
Only about 5% of people with cycles of childbearing age have (or have been diagnosed with) PMDD (9). It’s often commonly misdiagnosed as bipolar disorder, and there is some debate about whether PMDD should be classed as a mental health disorder or not.
In order to be diagnosed with PMDD your symptoms need to appear a week before your period, clear up a week after and meet a diagnostic criteria.
Here for your hormonal hangups
So there you have it, everything PMSing.
Remember, we’re here to support you with any hormonally-related issues you might be experiencing and help you figure out what the four-letter-word is going on with your hormones.
Come say hi.
Verma RK, Chellappan DK, Pandey AK. Review on treatment of premenstrual syndrome: from conventional to alternative approach. J Basic Clin Physiol Pharmacol. 2014 Mar 12;/j/jbcpp-ahead-of-print/jbcpp-2013-0072/jbcpp-2013-0072.xml.
Roomruangwong C, Carvalho AF, Comhaire F, Maes M. Lowered Plasma Steady-State Levels of Progesterone Combined With Declining Progesterone Levels During the Luteal Phase Predict Peri-Menstrual Syndrome and Its Major Subdomains. Front Psychol. 2019 Oct 30;10:2446
Walf AA, Frye CA. A Review and Update of Mechanisms of Estrogen in the Hippocampus and Amygdala for Anxiety and Depression Behavior. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2006 Jun;31(6):1097–111.
Gudipally PR, Sharma GK. Premenstrual Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Sep 16]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK560698/
Yonkers KA, O’Brien PMS, Eriksson E. Premenstrual syndrome. Lancet. 2008 Apr 5;371(9619):1200–10.
Pearce E, Jolly K, Jones LL, Matthewman G, Zanganeh M, Daley A. Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJGP Open. 4(3):bjgpopen20X101032.
Thiyagarajan DK, Basit H, Jeanmonod R. Physiology, Menstrual Cycle. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Jun 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK500020/
Kikuchi H, Nakatani Y, Seki Y, Yu X, Sekiyama T, Sato-Suzuki I, et al. Decreased blood serotonin in the premenstrual phase enhances negative mood in healthy women. J Psychosom Obstet Gynaecol. 2010 Jun;31(2):83–9.
Hofmeister S, Bodden S. Premenstrual Syndrome and Premenstrual Dysphoric Disorder. Am Fam Physician. 2016 Aug 1;94(3):236–40.
Annalisa Hayes (she/her)
Copywriter at Tuune, Annalisa has worked for various pioneering health-tech startups and healthcare companies with purpose-led missions. Driven by empowering people to take control of their health, she helps make the science behind hormones accessible for our community, so they can make clued-up choices about their healthcare.
Medically reviewed by
Dr. Arushee Prasad, GP, MBBS (she/her)
Dr Arushee Prasad is a GP for NHS England with an MBBS in Medicine and Surgery, and an MRCGP from the Royal College of General Practitioners. Passionate about digital health and algorithmic medicine, Arushee was previously an Algorithmic Medical Doctor for Docly.
Hannah Durrant (she/her)
Hannah is a Biomedical Content Writer at Tuune, with a BSc in Biomedical Sciences from University College London. She is passionate about bringing together the scientific community and the general public by disseminating modern science via digestible, engaging and thought-provoking content.
You may also like
Bloating on your period? Here’s what your hormones have to do with it
We all experience a little (or a lot) of bloating every now and then—but why does it seem to get worse on, or around, our periods? Read on to discover which key hormones kick-start both your bloating AND your bleeding, all at once
Period headaches and menstrual migraines: Are my hormones hurting my head?
As if getting our period isn’t a headache enough, this week we’re taking a deep-dive into hormonally influenced head pains. Read on to learn the difference between a period headache and a menstrual migraine, and how you can track and treat your head splitting symptoms
Beating the breakouts: Skin, the menstrual cycle and hormonal acne
Adult acne is far more common in people with cycles than those without. The saying, ‘it’s just your hormones’, is casually reeled off whenever anyone mentions a bad breakout—but which hormones cause acne? Read on to discover how the menstrual cycle affects our skin and which treatments can help you get a handle on hormonal acne