Why are my PMS symptoms getting worse?

“I’m not sure if it’s just my PMS making everything feel worse or if I’m just having a really bad week,” I said, thumping my fingers angrily against my keyboard as I vented to my friends about the horrendous day I had at work. I like to think of this episode as the universe’s conspiracy against me. How else do I explain tearing up over a video of a newborn baby holding her father’s finger, losing my mind over chocolate-mint ice cream, or even fighting with my sister because she breathed too loudly? It has to be the universe, right? But wait for the tears to dry, and you’ll see it was just PMS and not some grand conspiracy.

Premenstrual syndrome (PMS) is a group of physical and emotional symptoms that women experience before their period each month. These can range from a full-blown emotional breakdown to uncontrollable food cravings or even a headache that feels like your head is about to explode. Ask any woman, and she’ll tell you more. “Last week I was giggling over a cute dog video, but before I knew it, I was crying because I missed my dog,” a friend shared as we complained about our shared suffering.

But it hasn’t always been this intense. At 16, my PMS symptoms were barely evident. But now, at 22, they’ve become much more pronounced, pivoting between body aches and mood swings. The women around me have been telling me that they’ve experienced the same thing.

Dr Thejaswini J, consultant obstetrician and gynaecologist at Motherhood Hospitals, explains how PMS symptoms can change over time. “PMS can vary significantly from person to person. While some may experience changes in their 20s, for many, symptoms may intensify in their 30s or 40s, often due to perimenopause or even PMDD,” she adds. 

To clarify these terms—perimenopause is the transition period before menopause when your ovaries gradually stop functioning, which begins around your 30s or 40s. PMDD, or Premenstrual Dysphoric Disorder, is a severe form of PMS that significantly disrupts daily life. According to Dr Thejaswini, symptoms of PMDD can include “severe depression, persistent irritability, feelings of despair, even thoughts of suicide, and panic attacks,” among others. 

Your lifestyle could also exacerbate your PMS symptoms. As psychologist Radhika Ramdhave explains, high cortisol levels—the stress hormone—are a major reason for severe symptoms, especially before your period. She adds that PMS symptoms often worsen as we enter our 20s, a time when many people take on consequential responsibilities and persevere to “get their life together.” This increased stress naturally raises cortisol levels, which can intensify PMS symptoms.

If you're working long hours, getting minimal sleep, and preparing for a stressful exam, your lifestyle is likely keeping you anxious, naturally raising your cortisol levels and leading to mood swings.

How do I know if you have PMDD? 

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that anyone with ovaries might experience. The symptoms can be physical or psychological, ranging from headaches, breast tenderness, abdominal bloating, and digestive issues to anxiety, depression, intense emotional sensitivity, and more.

According to a review of global studies published in the Journal of Affective Disorders, around 1.6 per cent of women and girls have symptomatic premenstrual dysphoric disorder. While there is still ongoing research on the cause of PMDD, many experts suggest that it is linked to changes in hormone levels—particularly estrogen and progesterone—and may involve imbalances in neurotransmitters like serotonin.

But Dr Thejaswini advises that if your symptoms are so severe that they interfere with your ability to manage daily chores, it’s essential to seek professional help. A gynaecologist can address the physical effects, while a psychiatrist or therapist can help with the mental impact. They will be able to accurately evaluate your symptoms, determine the cause, and provide appropriate treatment.

Could it be perimenopause?

If you’re in your 30s or 40s, it’s possible. Studies and Dr Thejaswini J indicate that PMS symptoms often worsen as you approach your 40s. Perimenopause is the transitional phase leading up to menopause, characterised by fluctuating and eventually decreasing levels of estrogen and progesterone, which can cause irregular menstrual cycles. While this phase can be challenging, early signs include hot flashes, night sweats, vaginal dryness, sleep disturbances, mood swings, weight gain, decreased libido, and fatigue.

If any of these symptoms sound familiar, consult your gynaecologist. Ramdhave also recommends seeking support from a mental health professional during this transition.

What do I do about my PMS getting worse for now? 

While the reasons for worsening PMS can vary widely (and consulting an expert is strongly recommended), you can start by making some lifestyle and dietary changes. Here are a few things that can help. 

Don’t hate us, but regular physical activity is essential

We know how demanding it can be to stay consistent with your workout routine, especially when you have long working hours. However, Dr Thejaswini J highly recommends maintaining some form of physical activity. It doesn’t necessarily have to be at the gym; it can be anything—from dancing to swimming or even taking a brisk walk. The rationale is that when you engage in physical activity, your body releases endorphins, which can improve mood and reduce discomfort.

You might want to cut down on that caffeine 

Making dietary changes can have an immediate effect on your body, often leading to noticeable improvements. This is why it’s advisable to limit your consumption of caffeine and junk food and aim for a more balanced diet, preferably with Indian home-cooked meals.

Dr Thejaswini suggests that reducing salt intake can help decrease bloating, while limiting caffeine and alcohol consumption may improve mood stability and sleep quality. She also recommends avoiding excessive caffeine, salt, and sugar to help lessen PMS symptoms. Now, we’re all for your occasional cravings, but you must be mindful of how much you indulge and balance it out.

Your mom is right, you need to fix your sleep schedule 

Dr Thejaswini makes a valid point: “Lack of sleep is linked to your mental health,” she says. Put simply, when you get better sleep, you feel less irritable; when you feel less irritable, you think more clearly, and when you think more clearly, you feel better overall. So, you might want to cut down on bedtime doomscrolling and actually get more sleep.

Track your symptoms when you are PMSing. 

Dr Thejaswini suggests keeping track of your symptoms to understand yourself better and be prepared for when you are PMSing. Think about what usually triggers you, how quickly your mood changes, or the cravings you experience. This will allow you to anticipate and manage symptoms when they start appearing.

Tell yourself you are an unstoppable force of nature 

Now, apart from all of this, Ramdhave believes that it is equally important to self-affirmate. You need to be the Baby Tate and Slade da Monsta of your life and tell yourself, “I am healthy, I am wealthy, I am…” You know the drill. The point is, you need to be your biggest cheerleader and give yourself the pep talk. More often than not, your mental health could go for a toss, so this practice is crucial.

Find a way to cope with stress 

With so much happening these days, it’s very easy to become anxious or stressed. Whether it’s your demanding boss, odd thoughts about whether your boyfriend would love you if you were a worm, or concerns about dwindling savings, stress can pile up. You need to find ways to cope with the stress. Engaging in activities such as meditation, yoga, or reading can help you manage stress and PMS more effectively.

 

Lead image credits: Pexels.

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