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Writer's pictureDr. Penny Lane

Premenstrual Syndrome

Updated: Jun 5, 2023

History has long reported that the symptoms of PMS were nothing more than hysteria and although science has well recognized the pathologic changes women suffer when they report PMS for more than sixty years now, it wasn't appreciated as an official medical diagnosis until the 1990s. That's nearly three decades now and physicians are still telling women this is all in their heads and dismiss these concerns, never offering proper treatment. The fact that the mainstay of treatment is an anti-depressant reinforces this misconception.



The list is long with all the signs and symptoms that can be contributed to PMS, with many arguing that these are so common they are just normal and we shouldn't be so dramatic about them. Others recognize that normal physiology doesn't wreck your life, or your couch cushions and car seats, right? Yet the physiologic cause of all this remains a mystery.


We tend to lean into the belief this is a hormonal imbalance, but studies looking at hormone levels in these women aren't overly helpful in offering us real understanding. Maybe it's more about how effective these hormones are within women who suffer, more so than their actual production and presence. There is some thought that our more feminine #hormones potentially don't relate well with our stress hormones and neurotransmitters which then results in the plethora of symptoms that can be associated with premenstrual syndrome. Hence, it is more a combination of events than the hormones themselves.


Since the hormonal birth control pill doesn't correct this phenomenon for many women, this theory seems to hold some merit, and maybe this is why antidepressants have proven a bit more effective. Whatever the underlying cause, we do know this matter is complex and that addressing nutrition, stress, lifestyle, and a number of other modalities has proven helpful. Let's talk though about how you might know if you have PMS and if so, what might be done about it.


Maybe you already know, PMS symptoms often occur the week prior to your flow but for others it begins soon after ovulation. When these symptoms disrupt your life, this isn't normal and shouldn't be ignored. The body gives us some indication of the changing season, or the cycle evolution. We may feel our uterus start to cramp for example as it does the work of releasing our flow, but this physical pain shouldn't manifest itself so that we are doubled over, nauseous, and unable to work. Maybe our breasts are tender, but they shouldn't reduce our activities. Crying can be cleansing, but we shouldn't feel as if we are losing control.


What Symptoms are Considered Part of PMS?


There are more than 150 symptoms here, so the list is long, but the most common emotional symptom is mood swings and the most common physical symptom is abdominal bloating and an extreme feeling of fatigue. Breast tenderness, cravings, headaches, acne, hot flashes, and dizziness are also quite common, as is anger, anxiety, insecurity, irritability, poor memory and concentration, as well as depression. Autoimmune conditions can also flare during this time and this is true too, even if you have had a hysterectomy and still have your ovaries, or even if you have an IUD and aren't experiencing cycles, or if you've had a uterine ablation.


Functional Mindset & PMS


There are a number of nutritional factors associated with PMS, as well as environmental exposures. PMS is often inflammatory and inflammation is a scenario that progresses, with more and more consequence, until resolved. About five percent of women are absolutely incapacitated by severe PMS, every single month. This really isn't sustainable, at least if you want to keep your job or manage your home and family with much effectiveness.


If you identify here, it's time to make an appointment to discuss resolution.

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