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Premenstrual symptoms
Category: Women's Health · All women's health symptoms
What it can feel like
Premenstrual symptoms are physical and emotional changes in the days before a period — bloating, breast tenderness, headaches, irritability, low mood, anxiety, food cravings and poor sleep — that resolve within a few days of bleeding starting. When mood symptoms are severe and disruptive, the pattern is called premenstrual dysphoric disorder (PMDD).
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Premenstrual symptoms can be associated with the hormonal shifts of the cycle acting on brain chemistry — sensitivity to normal progesterone metabolites rather than abnormal hormone levels — amplified by stress, poor sleep, caffeine and alcohol.
Other possible causes
Severe or atypical patterns can overlap or be confused with thyroid disease, anaemia, depression and anxiety disorders that fluctuate but do not fully lift after periods — a diagnostic diary over two cycles separates them.
Red flags — when to seek help promptly
- Mood symptoms so severe they disrupt work, relationships or safety
- Premenstrual low mood with thoughts of self-harm — seek support promptly
- Symptoms that never fully resolve after periods (suggests another condition running in parallel)
- Physical symptoms that are new and progressive, such as severe headache with visual changes
What a clinician may do
A clinician will usually ask for a two-cycle symptom diary charting symptoms against cycle days — the diagnosis lives in the pattern. Blood tests are used to exclude thyroid disease and anaemia. Management is stepwise, from lifestyle and cycle-targeted strategies to hormonal and mood treatments for severe cases.
Related guides on MedicalVideos.com
Frequently asked questions
Why keep a diary if I'm sure it's my cycle?
Because memory edits the pattern — prospective charting over two cycles shows whether symptoms truly confine themselves to the premenstrual window and vanish after bleeding. That single fact separates PMS and PMDD from depression and anxiety that merely fluctuate.
Is PMDD just bad PMS?
PMDD is a distinct, recognised condition in which the mood symptoms — marked irritability, low mood, anxiety, feeling overwhelmed — dominate and impair functioning. It responds to specific treatments, including cycle-timed antidepressants, so the label is worth establishing properly.
Related symptoms — Women's Health
Browse the P section of the A–Z list or return to the Symptoms A–Z hub.