What happens in a woman's body during PMS and menstruation?
Premenstrual syndrome (PMS) is a set of physical and psychological symptoms that usually appear 1-2 weeks before menstruation and disappear with the onset of menstruation. It is estimated that PMS regularly affects approximately 80% of menstruating women, with symptoms and their intensity varying greatly from individual to individual¹.
PMS is primarily caused by fluctuations in female hormones (estrogen and progesterone) in the second half of the menstrual cycle, which affect the production of neurotransmitters such as serotonin, leading to fluctuations in mood, emotions and energy².
PMS care can be found here .
What are the most common symptoms of PMS?
Psychological symptoms:
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Sudden mood swings, irritability, anxiety
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Increased sensitivity, crying, or feelings of sadness and self-pity
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Inattention, difficulty concentrating, mild confusion
Physical symptoms:
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Acne and skin problems (due to hormonal fluctuations)
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Back pain, headaches, cramps in the lower abdomen
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Constipation, diarrhea, bloating, indigestion
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Severe fatigue and general exhaustion
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Changes in libido – decreased interest in sex, or conversely, stronger sexual desire³
However, these symptoms do not necessarily mean PMS. They can overlap with other conditions such as hormonal imbalances, thyroid disease or endometriosis. The exact cause of your problems can be revealed by a comprehensive analysis of your health. For this reason, we offer the possibility of individual consultations with women's health experts.
What happens during menstruation?
Menstruation is the regular shedding of the uterine lining (endometrium), which grows each month to allow for the possible implantation of a fertilized egg. If fertilization does not occur, estrogen and progesterone levels drop significantly and the lining is shed in the form of menstrual bleeding⁴.
Menstruation usually lasts 3–7 days. A normal cycle lasts 21–35 days. On average, a woman loses approximately 30–80 ml of blood during one period⁵.
When to look out for ("menstrual red flags")?
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Very heavy menstruation (needing to change a pad or tampon every 1–2 hours)
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Bleeding lasting more than 7 days
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Severe menstrual pain that limits normal daily activities
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Severely irregular or absent cycles
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Presence of large blood clots
If you observe any of these signals, we recommend consulting a gynecologist.
Diagnosis of PMS and menstrual problems includes:
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Symptom consultation with a gynecologist or women's health specialist
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Menstrual cycle and symptom tracking
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Hormonal tests (estrogen, progesterone, thyroid)
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Ultrasound examination (to rule out anatomical abnormalities)
Articles about menstruation and PMS:
- PMS: 5 signs your period is coming soon
- 7 herbs to relieve pain during menstruation
- Menstrual *red flags*: 7 signals to watch out for
- How does the menstrual cycle work? What happens in a woman's body?
- What is vaginal discharge and how does it change during the cycle?
- Blood clots during menstruation
- How to start tracking your menstrual cycle?
Clinical studies and expert resources:
¹ Yonkers, K. A., et al. (2008)
Premenstrual syndrome.
https://pubmed.ncbi.nlm.nih.gov/18271824/
² Ryu, A., & Kim, T.H. (2015)
Premenstrual syndrome: A mini review.
https://pubmed.ncbi.nlm.nih.gov/26357694/
³ Pinkerton, JV, et al. (2010)
Hormonal contraception and libido.
https://pubmed.ncbi.nlm.nih.gov/20944038/
⁴ Reed, BG, & Carr, BR (2018)
The Normal Menstrual Cycle and the Control of Ovulation.
https://pubmed.ncbi.nlm.nih.gov/30252321/
⁵ Hallberg, L., et al. (1966)
Menstrual blood loss—a population study.
https://pubmed.ncbi.nlm.nih.gov/5922481/
