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PMS symptoms

By Dr. Sarika Arora, MD

When I ask women how their PMS symptoms affect their lives, they say, “I’m just not ME when I’m PMS-ing.” Or they tell me they’re missing work each month from the headaches, cramps, or irritable bowels that come before their periods.

A woman with pms symptoms

But because so many of us suffer from the symptoms of PMS, we may not search for answers to feel better because we think it’s normal to “feel hormonal.”

Well, let me assure you — chronic symptoms of PMS are not normal. And they may even indicate a larger hormonal imbalance that may affect how your body responds later to perimenopause and menopause.

Our years of experience show there’s simply no reason for you to suffer every month. There are many ways you can reduce the hormonal fluctuations causing your PMS symptoms and set the stage for a healthy, balanced future. Here’s how and why:

“Wired” for PMS: One reason for symptoms

Each of us has a natural, individualized ratio of estrogen and progesterone that surges and recedes to make up our unique menstrual cycle. When this ratio is disrupted, it can cause up to 200 — yes, 200 — known PMS symptoms.

In some women, the disrupted ratio leaves estrogen levels slightly high while progesterone levels are adequate; in others, estrogen levels may be normal but progesterone levels are deficient, and symptoms can simply occur if progesterone levels are lower than the body requires.

PMS includes both physical and emotional symptoms:

  • Mood swings
  • Sadness
  • Irritability
  • Agitation
  • Anxiety
  • Irrational thoughts
  • Altered sleep patterns

In addition, by taking a look at brain chemistry and the influences of our reproductive hormones on our neurotransmitters, we now know some of us are just wired to be more sensitive to fluctuations or changes in our hormones. Women in this category will usually experience more severe physical and emotional distress premenstrually.

Keep in mind endocrine glands within the brain function as master endocrine regulators, sending dominant messages to the other hormone factories in our bodies. Female hormones circulating in the body travel back to the brain to provide feedback. In some premenstrual women, this otherwise normal and minor crosstalk disrupts the function of neurotransmitters, such as serotonin, in the brain — interfering with mood and causing more pronounced symptoms. This confirms that just as there is a recognized “migraine brain,” there is also a “PMS brain.”

Unfortunately, as a result, I’ve seen a surge in prescriptions for antidepressants to treat premenstrual symptoms. However, cutting-edge natural methods also support neurotransmitter health and reduce PMS.

What you can do to reduce — or even eliminate — PMS

Even though we can’t control our hormonal levels 100%, we can have a major influence through lifestyle and nutritional support, as well as by nurturing our bodies and working to handle stress.

Simple lifestyle changes can encourage neurotransmitter health and balance our sex hormones, as well as our adrenal glands and our levels of insulin. Insulin is a key hormone involved in the blood sugar regulation that plays such an important role in PMS symptoms.

For more than 10 years we have seen how adjustments to daily living can transform women and the way they feel in the weeks before their menstrual cycles.

Herbal remedies support hormonal balance and prevent symptoms

Herbal remedies offer specific targeted support for your body, so it can meet the demands being placed on it that lead to hormonal imbalance and PMS. This is especially true with blended herbal therapies that are “adaptogenic” — meaning they allow the body to use just what it needs to create its own hormonal balance.

Do you have a PMS diet?

veggie basket

Our typical American diet is filled with processed food, sugar, and designer coffee that are all hard to resist — until something goes awry. One of the first signs your diet isn’t meeting your body’s needs is worsening PMS symptoms.

It’s critical to remember that a diet high in simple carbohydrates and sugars can lead to insulin resistance and weight gain, so focus first on decreasing carbs. And since fat cells actually produce estrogen, the more fat you have, the higher your estrogen levels may become — throwing off your natural hormonal balance and making PMS symptoms worse. Eating a balanced diet rich in whole foods, nonstarchy vegetables, and healthy proteins and fats may prevent insulin resistance and weight gain.

Potent multivitamins, omega-3 fish oil, B complex vitamins, calcium and magnesium, and vitamin D can all make a huge difference in how we feel You may want to consider a high quality multivitamin, such as our Essential Nutrients.

Finally, be sure to eat regular meals and snacks throughout the day to support balanced blood sugar, which stabilizes your mood.

Exercise for PMS relief


Regular aerobic exercise eases premenstrual symptoms by increasing painkilling, euphoria-producing chemicals. These chemicals are called endorphins and their levels tend to drop in the second half of our cycles.

Exercise likewise boosts our detoxification capabilities, pumping up the cleansing action of the lymph system and ridding our body of toxins and excess hormones through sweat. It also increases our metabolic rate, encouraging the body to burn fat for energy, thereby helping us maintain a healthier hormonal balance.

The role of stress and PMS

Here’s a stress scenario you might recognize:

You rely on caffeine to perform all through the day, then “unwind” after a stressful day with an evening drink. You’re too busy, so exercise drops as a priority. Then your partner announces an out-of-town trip, leaving you with all the family or home responsibilities for several days.


This is what I call the “perfect storm” for PMS! That’s because lots of daily stress forces your stress hormones (cortisol and adrenaline) to remain high all of the time, depleting your adrenal reserves and causing fatigue. While the body can normally handle stress, for a woman with PMS this becomes more difficult during the normal rise and fall of hormones during the menstrual cycle.

If you usually have symptoms, one idea is to allow time for rest before your period starts. Honor your vulnerabilities and don’t overschedule or push too hard through this time. If your body is telling you to hibernate or slow down, listen to those messages. This alone may prevent symptoms.

Quick Start: 4 C’s to Avoid

I urge women to curb the 4 C’s: candy, coffee, cocktails and couch time! A healthy lifestyle that minimizes the 4 C’s helps tremendously to reduce PMS:



Reducing intake of sugar in candy and carbohydrates is critical for health and hormone balance



Cutting down on or eliminating coffee decreases activation of the stress response and promotes more stable blood sugar and mood.



Saying no to daily cocktails and alcohol will improve stamina, reduce cravings, and prevent irritability in most women.

Couch Time


Getting off the couch by pursuing a passionate exercise routine burns off steam, triggers more feel-good brain chemicals, reduces insulin resistance, and improves mood.

You don’t have to live with PMS

I don’t believe any woman should suffer from hormonal symptoms — they’re not natural or necessary.

While it may seem hard to believe that the simple natural approach we propose can have a significant impact on your physical and emotional symptoms of PMS — it can. Our bodies have an incredible ability to heal and adapt. I’ve seen it time and again.

So before you resign yourself to discomfort or a life on medications, consider what you can do today to ease your PMS naturally. With optimal diet, exercise, and nutritional supplementation, you can reduce the frequency and severity of your symptoms, and even free yourself entirely for a “new normal”!

Last Updated: November 27, 2022
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