Understanding PMS: What Your Body Is Really Telling You

Article by

Uliana Rogers

Registered Nutritional Therapist

at Elemental Nutrition

Premenstrual Syndrome (PMS) affects the majority of menstruating women at some point in their lives. Symptoms such as irritability, low mood, cravings, bloating, fatigue, or breast tenderness are often considered “normal” — simply something women must tolerate every month.

However, while PMS is common, it is not necessarily normal.

Rather than being a problem with the menstrual cycle itself, PMS often reflects how the body responds to natural hormonal changes.

The Menstrual Cycle: A Brain–Hormone Conversation

The menstrual cycle is not only about periods or fertility. It is a coordinated communication system between the brain, ovaries, uterus, and nervous system.

The cycle begins in the brain, where the hypothalamus and pituitary gland release signalling hormones that instruct the ovaries to produce oestrogen and progesterone.

These hormones do far more than regulate reproduction. They influence:

• mood and emotional resilience
• sleep and energy levels
• appetite and metabolism
• fluid balance
• brain chemistry.

When communication between these systems is smooth, the cycle tends to feel stable. When adaptation becomes more difficult, PMS symptoms may appear.

Why PMS Happens

PMS most commonly occurs in the days before menstruation, during the late luteal phase of the cycle.

At this time, both oestrogen and progesterone naturally decline. Research suggests that many women with PMS do not have abnormal hormone levels — instead, they may have increased sensitivity to hormonal fluctuations.

These hormonal shifts influence key brain messengers called neurotransmitters:

Serotonin, which supports mood stability, sleep, and appetite regulation

GABA, the brain’s primary calming signal, is involved in relaxation and emotional balance.

When hormone support for these systems changes rapidly, symptoms such as anxiety, low mood, cravings, or sleep disturbances can occur.

Different Types of PMS

PMS does not look the same for everyone. Symptoms often follow patterns depending on which body system is most affected:

PMS-A (Anxiety type): irritability, tension, sleep difficulties (may suggest increased nervous system sensitivity to progesterone changes and less stable GABA calming signalling, often amplified by stress, poor sleep, or low magnesium status).

PMS-C (Cravings type): sugar cravings, fatigue, energy dips (may suggest increased metabolic demand in the luteal phase and reduced blood sugar stability, with the brain seeking quick energy and serotonin support).

PMS-D (Depressive type): low mood, tearfulness, withdrawal (may suggest sensitivity of serotonin pathways to falling oestrogen levels and reduced emotional buffering during hormonal withdrawal).

PMS-H (Fluid retention type): bloating, swelling, breast tenderness (may suggest temporary shifts in fluid regulation as progesterone declines, leading to increased sodium and water retention).

Many women experience a combination of these patterns.

Understanding these differences allows support to be more personalised rather than applying one approach to everyone.

Supporting the Body Through PMS

The goal of PMS support is not to suppress hormones, but to help the body adapt more smoothly to normal hormonal change.

Key foundations include:

Nutrition

• Regular, balanced meals with adequate protein
• Fibre-rich plant foods supporting hormone elimination
• Omega-3 fats to reduce inflammation
• Magnesium- and B-vitamin-rich foods supporting nervous system balance
  

Lifestyle

• Consistent sleep routines
• Stress regulation and nervous system support
• Gentle regular movement
• Adequate nourishment, especially in the premenstrual phase
  

Targeted Support

In some cases, additional support may be helpful, such as magnesium, vitamin B6, omega-3 fatty acids, or evening primrose oil — particularly for breast tenderness and fluid-related symptoms. These support how tissues respond to hormonal changes rather than altering hormone levels directly.

When to Seek Professional Support

Occasional mild symptoms may be part of normal cyclical variation. However, professional guidance is recommended if:

• symptoms significantly affect daily functioning
• mood changes become severe
• pain or bleeding is excessive
• symptoms suddenly worsen.
  

A Different Way to View PMS

PMS is not the body working against you. It is often feedback — a signal that the nervous system, metabolism, or nutrient status may need additional support during hormonal transition.

When the underlying systems are supported, many women find that the same hormonal changes feel very different.

Hormones do not need to be controlled — they need to be supported.

BOOK A ONE-TO-ONE COMPLIMENTARY CONSULTATION WITH A UK-REGISTERED NUTRITIONIST (Worth £40)