PMS (Premenstrual Syndrome)
Premenstrual syndrome (PMS) is a cluster of symptoms that can include irritability, mood shifts, breast tenderness, food cravings, fatigue, bloating, and headaches. Too often, women are told this is “normal” or something to simply endure — without being offered real support.
PMS is often one expression of a broader hormone imbalance, which is why we look beyond the menstrual cycle alone when symptoms keep showing up month after month.
Does This Sound Like You?
Do you dread your period because of painful cramps or mood changes that make you feel unlike yourself?
Maybe you notice bloating, acne flares, or food cravings that disrupt your routine or confidence.
Or perhaps headaches, back pain, shoulder tension, or fatigue show up reliably in the days before your cycle.
Often, people are told these changes are “normal,” stress-related, or simply part of being a woman — yet that explanation doesn’t feel complete.
Many people notice these symptoms shift or intensify during perimenopause, when hormone patterns become less predictable and the body’s stress response changes. (Internal link: Perimenopause & Menopause)
While PMS is common — affecting up to 75% of menstruating women — that doesn’t mean it should be ignored or minimized.
Common PMS symptoms include:
- Irritability, anxiety, or mood swings
- Low mood or tearfulness
- Fatigue or low motivation
- Breast tenderness
- Bloating or fluid retention
- Constipation or diarrhea
- Headaches or muscle aches
- Food cravings
- Skin breakouts
These symptoms aren’t random — and they’re not something you just have to “push through.”
What’s Really Driving PMS Symptoms?
PMS is rarely caused by one hormone alone. Symptoms often reflect how multiple systems are interacting throughout the month.
Hormonal shifts related to PMS can be influenced by:
- Blood sugar fluctuations
- Stress and nervous system load
- Gut health and nutrient absorption
- Sleep quality
- Inflammation
- Thyroid function
- Environmental exposures
Because hormones don’t function in isolation, PMS symptoms are often shaped by digestion, metabolism, stress physiology, and thyroid health working together.
The Conventional Approach
When PMS symptoms are discussed in traditional care, treatment often focuses on managing discomfort rather than understanding why symptoms occur.
Common approaches include:
- Anti-inflammatory medications (such as ibuprofen)
- Hormonal birth control
While these may reduce symptoms for some, they don’t always address the underlying drivers — and can sometimes introduce new side effects or concerns.
For many people, this approach treats the timing of symptoms without addressing why the body is struggling to adapt each month.
This is why we take a functional medicine approach that looks at the full hormonal picture, not just cycle-related symptoms.
The Functional Medicine Approach to PMS
In functional medicine, PMS is viewed as a signal — not a flaw.
We start by understanding how your hormones interact with sleep, stress, digestion, nutrition, and daily rhythms. From there, we identify where support will be most effective.
Our approach may include:
- Stabilizing blood sugar with balanced meals
- Supporting gut health and nutrient status
- Improving sleep and stress resilience
- Addressing inflammation
- Thoughtful hormone evaluation when needed
When PMS overlaps with perimenopause or early menopause, symptoms are often shaped by changing estrogen and progesterone patterns alongside stress, sleep, and metabolic shifts.
In some cases — particularly during midlife transitions — bioidentical hormone therapy may be considered and carefully evaluated as part of a broader plan.
PMS doesn’t exist in a vacuum — understanding how your hormones and physiology interact can change how you feel every month.
Safety
Our goal is to help your cycles feel more predictable and less disruptive to daily life. When sleep, meals, stress, and key nutrients are supported, many people notice:
- Less cramping and bloating
- Fewer headaches
- Improved mood stability
- Clearer skin
- More even energy
If medications are part of your care, we coordinate thoughtfully with your prescribing clinician. Your safety comes first. Seek urgent care for:
- Severe or sudden pelvic pain
- Heavy bleeding that soaks a pad or tampon every hour for several hours
- High fever
- Fainting
- New severe headache with vision changes, weakness, or confusion
If you think you may be pregnant, take a test and contact your clinician. All recommendations are tailored to your health history.
Frequently Asked Questions
PMS is common, but suffering every month is not “just the way it is.” There are clear, supportive steps that can reduce symptoms and help your cycle feel smoother.
PMS causes bothersome symptoms before your period. PMDD is a more severe form that significantly affects mood and daily functioning. Both often improve once bleeding begins, but PMDD usually requires additional support.
Not always. Many people improve with better sleep routines, balanced meals with enough protein and fiber, simple stress tools, and key nutrients like magnesium.
Testing is most helpful when PMS symptoms suggest a deeper hormone imbalance or changes related to perimenopause.
Yes. We can still support sleep, nutrition, stress, and micronutrients to reduce breakthrough symptoms, and we coordinate with your prescribing clinician as needed.
Some people notice improvement within one cycle. More consistent changes usually build over two to three cycles as habits and physiology stabilize.
No. We focus on balance — regular meals with protein, fiber-rich carbohydrates, healthy fats, and colorful plants. Extreme restriction usually backfires.
Yes. Low thyroid function and low iron can contribute to fatigue, mood symptoms, and cramping. That’s why thyroid health and iron status are sometimes part of a more complete PMS evaluation.
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