PMS Got You Down? Our Doctor's Guide Will Help


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Premenstrual syndrome is the name given to a variety of physical and emotional symptoms that can affect women during their periods. It typically occurs in the two weeks leading up the start of the cycle, following ovulation, and generally disappears at the end of the period. PMS affects around half of women, but the symptoms, timing and severity vary so wildly from woman to woman that it’s hard to keep track—or to know if what you’re feeling really is PMS and not something else entirely.

While plenty of us don’t suffer or can happily go about our daily lives with just some mild symptoms, according to Professor John Studd, who runs the London PMS & Menopause Clinic, one in 20 women will suffer from symptoms so severe that they temporarily stop living their normal lives. Knowledge is power, so knowing what PMS is and also how to alleviate the symptoms is key. Keep scrolling for your doctor’s guide to PMS, including the four foods you should ditch.

What is PMS?

PMS can occur at any age from the time the menstrual cycle starts. It most commonly affects women aged 30 to 40 years. In one in 20 women, PMS symptoms can be so severe that they greatly affect quality of life and ability to carry out daily tasks. Like many conditions related to hormones, there are both physical and psychological symptoms that occur:


  • Breast tenderness
  • Breast swelling
  • Bloating
  • Abdominal pain
  • Headache
  • Weight gain
  • Swelling of hands and feet
  • Changes in skin and hair


  • Mood swings
  • Irritability
  • Low mood
  • Poor sleep
  • Changes in appetite and food cravings

What Causes PMS?

PMS is thought to be caused by the fluctuation of the female sex hormones, oestrogen and progesterone, that naturally change throughout the menstrual cycle. PMS is not caused by a hormone imbalance or deficiency.

The most widely accepted theory is that it’s due to increased levels of progesterone released into the blood following ovulation. Some women are more sensitive to progesterone than others. The theory goes that increased levels of progesterone in the blood can cause levels of the hormone serotonin in the brain to fall. Serotonin is the hormone that, among many other things, helps to stabilise our mood. It is this decrease in serotonin—secondary to the rise in progesterone—that causes the mood-related symptoms of PMS.


There is no one test that can be carried out to diagnose PMS—it’s determined by a clinical diagnosis based on the collection of symptoms.


PMS is treated case by case to manage symptoms, and, unfortunately, there isn’t one single cure-all. 


Oral contraception: the combined pill

Some women find that using the combined pill can help ease their symptoms. This is likely due to fact that the pill suppresses ovulation, which is thought to lead to the symptoms of PMS. However, you cannot guarantee that all women will experience a positive effect, as hormones affect different women in different ways.

Patches and implants

Oestrogen-only patches can be used to help control the symptoms of PMS. However, it is important to note that although oestrogen will suppress egg production, it is NOT to be used as contraception. The patches need to be used with low-dose progesterone for a minimum of 10 days per month.


Selective serotonin reuptake inhibitors are a group of antidepressant medications which can be used to treat PMS. As the theory goes that women with PMS have low levels of serotonin, SSRIs help to maintain stable levels of serotonin in the brain, which should help reduce the psychological symptoms of PMS, such as low mood, irritability, poor sleep, etc.

As with any medication, it is important to seek advice from your doctor, as they will be able guide you and tailor treatment specifically related to your individual symptoms.


Lifestyle Changes

Medication is only part of the picture. Making positive lifestyle changes, with or without medication, can positively improve and prevent your symptoms of PMS.


Research shows that women who are highly stressed experience more severe symptoms of PMS. Finding ways to manage and relieve stress is an essential first step.

Exercise and weight management

Weight control is another key feature of managing PMS, as research has shown that women who are overweight, especially those who are obese with a BMI (body mass index) over 30, are more likely to suffer from PMS. 

In general, exercise is great stress reliever—it causes a natural high by the release of endorphins, which helps to lift your mood. So whether it’s running, weights or yoga, find what works for you, and get active. Even if you don’t feel like it at the time, you will be glad you did once it’s done!


You can’t go wrong with a healthy, balanced diet. Opt for whole foods with low GI content, as they aid digestion, provide slow release of energy and help avoid the bloat. Eat little and often to avoid dips in your energy levels, which have a negative effect on your mood.


1) Caffeine

2) Alcohol

3) High-salt foods

4) High-sugar foods

These foods can all lead to bloating and send your sugar levels haywire, which, again, has a negative effect on your mood and sleep. Taking a multivitamin and supplements such as B6 and magnesium help stabilise mood, improve sleep and reduce water retention.


A recent study showed that smoking in your teens and early 20s increases the risk of moderate to severe PMS. So if you needed another reason to ditch the cigarettes, this is definitely a good one.

Next up, three doctor-approved ways to get rid of cramps.