PMS: What is it – and why does it feel so intense?
"She's probably just PMS!". The jokes over time are many - but the reality is now quite real. And you may know it:
You notice that you are irritable. You feel irritable. More vulnerable. Definitely tired too (insight: Your sleep is worse than usual). Maybe you cry over something that would not normally affect you. Your body may feel heavy, bloated, sore. You are ready to quit your job, fire your family, everything is in the way.
And then – a few days later: “Ahh, that's why”. You've got your period.
What you have experienced is called PMS.
And you are far from alone.
PMS stands for premenstrual syndrome and covers the physical and psychological symptoms that can occur in the days or weeks leading up to menstruation. Some more bothersome than others, some more serious than others. It is a time when the body can greatly call for calm in order not to be put under further pressure.
But what is actually happening in the body? And when is it “just PMS” – and when is it something more?
Let's dive into it. 
What is PMS?
PMS is a collection of symptoms in the body and mind that occur during the luteal phase – the period after ovulation and before menstruation.
👉 If you want to understand the four phases of the menstrual cycle, read the article here
It is during this phase that the hormone progesterone rises . If you do not become pregnant, both progesterone and estrogen fall again towards menstruation.
This hormonal drop affects the brain's neurotransmitters – including serotonin – which regulate mood, sleep and emotional stability.
That's why PMS doesn't just "stay in your head".
It's real enough - it's pure biology.
How many people experience PMS?
According to a study published in Obstetrics, Gynaecology and Reproductive Medicine, up to 70–80% of menstruating women experience PMS to some degree.
About 20–30% experience symptoms that are so bothersome that they affect everyday life.
It's not a niche experience and think about the fact that we are simultaneously expected to go to work, perform at roughly the same level as last week and otherwise 'keep up appearances' along the way.
Therefore, it is important that workplaces think about how they can make physical conditions better for menstruating women ( with a few measures, you can achieve higher well-being for menstruating women in the workplace - read the article here )
When does PMS start?
It's very individual when PMS starts, but it typically starts:
- After ovulation
- 3–10 days before menstruation
And stops again as soon as the bleeding begins. If the symptoms continue throughout the entire period, there may be other things at play, and therefore you should talk to your doctor.
Typical PMS symptoms
PMS can be experienced both physically and psychologically by the individual and the symptom picture is extremely variable:
Physical symptoms:
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Bloating (suddenly your jeans don't fit?!)
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Sore breasts
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Headache (for some actually migraine)
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Fatigue (1 in 3 experience sleep problems during the luteal phase)
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Lower back pain
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Constipation or loose stomach
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Increased appetite or cravings
Mental symptoms:
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Irritability
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Easy to cry
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Inner turmoil
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Anxiety
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Depression
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Difficulty concentrating
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Shorter fuse
For some, the symptoms are mild.
For others, they can affect relationships, work life, and self-perception.
And it's important to say: It's not weakness. It's hormone sensitivity.
PMS vs. PMDD – what's the difference?
However, for some, symptoms in the luteal phase are significantly more severe.
PMDD (Premenstrual Dysphoric Disorder) is a more severe variant of PMS, where the psychological symptoms are so severe that they can:
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Affect work ability
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Create serious conflicts in relationships
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Cause strong anxiety or depressive thoughts
PMDD affects approximately 3–8%, and according to a recent study from Cambridge, menstruating women with ADHD suffer from PMDD at a significantly higher rate. You can read much more about PMDD, symptoms, treatment and the relationship to ADHD in the article here .
If you experience:
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Suicidal thoughts (if you have suicidal thoughts, call the Lifeline at +45 70 201 201 )
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Panic attack
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Extreme depression every month before menstruation
Then you should contact your doctor, because there is treatment that can help you. No one who is menstruating should feel like this during their cycle.
Why do we react so differently?
Two people can have the same hormone levels – but react very differently. Research suggests that it's not just about hormone levels, but about the brain's sensitivity to hormonal fluctuations .
In addition, these factors come into play:
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Stress level
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Sleep
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ADHD or other neurodivergence
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Previous depression
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Life situation
PMS is not just one thing - and the intensity of how the symptoms are experienced is greatly influenced by the life situation you are in.
What can be done about PMS?
It's little consolation, but the vast majority of menstruating women suffer from PMS. You'll likely meet with a lot of understanding and sympathy if you talk about it out loud.
On the more practical side, there is not just one solution – but several things you can do that can provide relief:
Lifestyle
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Stable sleep ( you will find 7 good tips for good sleep hygiene here )
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Regular movement ( this guide to movement during menstruation will also help you here )
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Protein and fiber-rich diet
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Limited caffeine and alcohol
Medical treatment
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Birth control pills (for some it helps, for others it makes it worse)
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SSRI (for severe PMS or PMDD)
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Hormone-regulating treatment
Cycle awareness
Tracking your cycle can be a huge help.
When you know when the symptoms will come, you can plan accordingly – and face yourself with more understanding.
👉 read our guide to understanding the four phases of your cycle
When should you talk to a doctor?
We'll say it again: No woman who is menstruating should feel so bad during the luteal phase that they can barely function in their daily lives. You should consider seeing a doctor if:
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PMS significantly affects your work or relationships
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You experience depressive symptoms every month
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You get panic attacks before your period.
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Symptoms suddenly worsen
You shouldn't just "live with it" if it's severe. If you're unsure whether your PMS symptoms are normal, check in with the women in your circle. How do they experience the luteal phase? If you have a partner, ask them how they experience you.
And it's really important that you take some of the pressure off yourself. The world isn't designed for half the population - it expects you to perform roughly the same at school, at work, at home, regardless of the day of your cycle. It's designed for a 24-hour cycle, which men are more hormonally designed for.
Take breaks, take care of yourself.
PMS is not hysteria
Let's get back to our starting point: Historically, women's hormonal fluctuations have been used against them, as jokes, memes, in theater, and in movies. But first and foremost, experiencing PMS is no joke - and it's not you who is "hysterical" or unstable.
PMS is a natural, and yes, for some of us, annoying symptom of your body being hormonally active. And for many, increased cycle understanding (both for ourselves and the world around us) can be the first step towards more peace.
FAQ – PMS
What does PMS stand for?
PMS stands for premenstrual syndrome and covers symptoms before menstruation.
How long does PMS last?
Typically 3–10 days before menstruation and stops when bleeding starts.
Is it normal to feel sad before your period?
Yes, mild depression can be part of PMS. If you are experiencing severe depression, you should talk to a doctor.
Can PMS change with age?
Yes. PMS can change after childbirth, during perimenopause, and during stress.
Is PMS the same as PMDD?
No. PMDD is a more severe form with significant psychological symptoms.
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