Is Premenstrual Syndrome (PMS) Normal?

Premenstrual syndrome is something that many women and their family members are very familiar with. According to the Office on Women’s Health, more than 90% of women say they get some premenstrual symptoms, and as many as three in four report PMS symptoms at some point in their lives.

Some women have to take days off work, miss classes and social events, stay in bed, and take multiple doses of pain medication.

PMS definition

A group of cyclical physical and emotional symptoms that occur 1 or 2 weeks before a woman’s period.

What are PMS symptoms?

Anxiety, depression, irritability, abdominal bloating, fatigue, increased cravings, breast soreness, headaches and migraines.

Believe it or not some women have positive experiences like:

Enhanced creativity and cognitive function, increased libido, a sense of overall happiness and wellbeing.

There are many options out there to help women during their menstrual cycles. Starting with the basics:

Women often find their symptoms ease when they:

Eat a whole-foods diet with little refined sugar, refined carbs, dairy and caffeine; include essential fatty acids from fish, fish oil, nuts and seeds; keep up regular aerobic exercise; and build stress management into daily life.

How to deal with PMS

Cravings

Research suggests women with PMS experience stronger food cravings in the second half of the cycle than women without it (Candan et al., 2025), and those cravings often point toward refined sugar and carbohydrates.

These foods can worsen bloating and water retention and make symptoms feel more intense.

How does this happen?

When you eat sugar it gets absorbed into your bloodstream. When this happens your pancreas releases insulin.

This spike in insulin causes salt and water to stay in the body causing swelling in breast tissue, extremities, and your abdomen (bloating).

Tip: To reduce this, eat more fiber from whole grains. Fiber has been shown to slow the insulin surge that happens after you eat sugar.

Mood changes

Your hormones go through an intricate dance every month that not only involves sex hormones and organs but also neurotransmitters (Serotonin and Dopamine) and brain activity.

This is why some women have mood changes and emotional fluctuations during this time.

One theory states that serotonin levels drop during the second part of your menstrual cycle, inducing sugar cravings.

High sugar foods lead to the production of Tryptophan- the precursor to Serotonin.

Once you have the building blocks for serotonin in your system, it can lead to improved mood and energy.

This is one reason SSRIs (a type of antidepressant) are sometimes prescribed for PMS.

Tip: Vitamin B6 and magnesium may help reduce mood symptoms of PMS. Discuss proper dosing with a qualified medical practitioner when supplementing. Natural sources of Vitamin B6 are found in fatty fish, eggs, spinach, sweet potatoes, and avocados; and Magnesium from nuts, beans, bananas, dark chocolate, and whole grains.

Menstrual pain

Have you ever heard of prostaglandins??

Prostaglandins are compounds that can have hormone-like effects on the body. Depending on the type of prostaglandin, they can create more inflammation or have an anti-inflammatory effect on the body. When we consume diets that are high in sugar, white flour, or vegetable oils, we can increase the levels of inflammatory prostaglandins creating more pain when it comes to menstruation.

Tip: Essential fatty acids that come from fatty fish or fish oil can help to promote anti-inflammatory prostaglandin pathways and provide EPA and DHA to help support your brain and heart.

Hormone testing

Comprehensive hormone testing can help you discover why you have these unwanted symptoms of PMS. Your doctor decides at the first visit whether lab testing is needed to begin treatment, and labs are repeated periodically for monitoring. Lab prices depend on what is tested.

Speak with your doctor about what testing may be appropriate for your symptoms.

You have many options when it comes to investigating and treating your PMS symptoms. Speak with your provider about what you can do about unwanted PMS symptoms, or book a first visit with our care team.