3 min read
By Dr. Maria K. Jimmy
This International Women’s Day, let’s talk about what really happens before your period: PMS symptoms, period mood swings, premenstrual depression, and the difference between PMS and PMDD.
Have you ever been told your monthly pain, crushing anxiety, or irritability is “just hormones”, something you should simply adjust to because it happens to everyone?
Have you ever felt your own body turn unfamiliar for a week or two each month, leaving you questioning your reactions?
If any of this feels familiar, let this be clear: you are not the problem.
For decades, premenstrual syndrome has been dismissed as a minor inconvenience, rather than recognised as real, disruptive, and deserving of serious attention.
Many women search for answers to questions like:
- “Why am I so emotional before my period?” or
- “Why do I feel depressed before my period?”
They are real premenstrual symptoms that affect mental health and daily functioning.
It is time we stop minimising what women experience every single month and start taking it seriously.
PMS Is Not a Vague Concept
Premenstrual Syndrome (PMS) is often treated like a joke or a casual excuse.
It is neither.
PMS is a real, hormone-driven condition that affects millions of women every month.
In the second half of the menstrual cycle, hormonal shifts can trigger a wide range of symptoms. These include mood swings, anxiety, low mood, irritability, bloating, breast tenderness, headaches, fatigue, and sleep changes.
More than 150 symptoms have been linked to PMS.
Because the definition is broad, people dismiss it easily.
When a woman says she feels deeply sad, unusually angry, or emotionally overwhelmed before her period, the response is often:
“It’s just PMS.”
That phrase closes the conversation instead of taking her experience seriously.
Calling something common does not make it minor. PMS is a biological process with a real impact. These symptoms can affect work, relationships, concentration, and mental health.
No one should feel expected to brush it aside or suffer quietly simply because it happens every month.
The Spectrum of Premenstrual Symptoms
The menstrual cycle affects every woman differently. During the luteal phase — the one to two weeks before a period — some experience mild bloating or slight mood changes.
Others face premenstrual pain, brain fog, anxiety, low mood, irritability, fatigue, and hormonal headaches that disrupt work, relationships, and daily life.
Premenstrual symptoms exist on a spectrum. At one end, symptoms are subtle. At the other, they are severe and debilitating.
Comparing one woman’s symptoms to another’s misses the point. Hormonal health is individual.
Despite this, many women are expected to perform at full capacity while managing intense hormonal shifts. When productivity drops or emotions feel overwhelming, the response is often criticism rather than support.
Premenstrual symptoms can impair concentration, emotional regulation, and physical comfort. That is biology.
PMDD: When Premenstrual Symptoms Become Severe
For some women, premenstrual symptoms go far beyond typical PMS. This is called Premenstrual Dysphoric Disorder (PMDD) — a severe, hormone-linked mood disorder affecting around 5–8% of menstruating women.
While PMS may cause mood swings or irritability, PMDD can trigger intense depression, panic attacks, severe anxiety, rage, hopelessness, and difficulty functioning at work or home.
Some women describe it as feeling like a completely different person in the days before their period.
The difference between PMS and PMDD is severity and impact. PMDD significantly affects mental health, relationships, and daily functioning.
Premenstrual Dysphoric Disorder was only officially recognised as a diagnosis in 2013. This reflects how long women’s severe suffering was ignored.
Stop Blaming Hormones: The Brain’s Role
Here is where it becomes medically fascinating.
Severe premenstrual symptoms are often blamed on a simple “hormone imbalance”.
Research shows that people with severe symptoms usually have normal levels of oestrogen and progesterone.
The current understanding is that the brain has a heightened sensitivity to the normal hormonal fluctuations of the cycle.
In other words, it is not excess hormones. It is an amplified neurological response to expected hormonal shifts in the luteal phase.
Think of hormones as a volume control. For most, the sound rises and falls smoothly. For some, even a small shift triggers emotional and physical overload.
This is a biological sensitivity. It is real, and it is not your fault.
Why Dismissal Hurts
When a young woman struggles to concentrate on her studies for a week every month, it reflects hormonal shifts affecting focus and cognition. When a working professional experiences unexpected tears or irritability before her period, it reflects the powerful interaction between hormones and mood regulation.
It is biology. She deserves understanding and support.
Yet how many of us have hidden our pain, our rage, our tears?
How many of us have smiled through cramps that doubled us over, or apologised for tears we could not explain, because speaking up would invite labels like “dramatic” or “difficult”?
This is the subtle gaslighting that women have endured for generations. Our pain is minimised. Our anger is dismissed as hormonal. Our sadness is seen as weakness.
And when we seek help, we are too often told, “It’s normal. It happens to everyone.”
How to Manage PMS and PMDD: Practical Steps That Help
If the days before your period consistently feel heavier, more emotional, or harder to navigate, your experience matters and it deserves care.
Here are some simple, practical steps:
1. Track Your Menstrual Cycle and Symptoms
Use a period tracking app or a simple diary for at least two full cycles. Record physical symptoms, mood changes, sleep, energy levels, cravings, and productivity. Identifying a clear luteal phase pattern helps with accurate PMS or PMDD diagnosis.
2. Ease Physical Premenstrual Pain
For cramps, bloating, and muscle tension, try heat therapy, gentle stretching, light exercise, or relaxation breathing. These support circulation and reduce stress-related discomfort.
3. Review Supplements Safely
Some evidence supports magnesium and vitamin B6 for PMS symptom relief. Always discuss supplements with your gynaecologist before starting, especially if symptoms are severe.
4. Protect Your Mental Space
During hormonally sensitive days, reduce overstimulation. Limit late-night screen time, prioritise sleep, and create a calm environment. Stable routines support emotional regulation.
5. Seek Medical Support
If premenstrual depression, anxiety, anger, or fatigue affect work or relationships, consult a gynaecologist or mental health professional. Share your symptom tracker. Ask about evidence-based treatments for PMS and PMDD, including lifestyle strategies, therapy, or medication.
A Note to Every Woman
Being a woman means carrying a rhythm that shapes mind and body.
That rhythm deserves attention, research, and compassion.
Always.
Resources & References
- Yonkers, K. A., & Simoni, M. K. (2018). Premenstrual disorders. American Journal of Obstetrics and Gynecology.
- Epperson, C. N., et al. (2012). Premenstrual dysphoric disorder: evidence for a mechanism of serotonergic dysfunction. Psychoneuroendocrinology.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- Sharma, P., & Malhotra, J. (2020). Premenstrual Dysphoric Disorder: Status in India. Journal of Psychosocial Research.
- International Association for Premenstrual Disorders (IAPMD).
Image Note: The illustration used in this essay is AI-generated and does not depict a real individual.
Send this to yourself. Share it with the women in your life. And if you are a man reading this, pass it on to show that you care.
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