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Period pain | PMS |Women's Health Concern

Updated: Jan 18, 2022

Have you been wondering the time you are transforming into a hulk when you get angry over small things that you have no ideas about?

Or experiencing crying spells to angry outbursts and anxiety attacks, then back to a stable emotional state all in one day?

Job performance be affected due to headaches, bloating and cramps that would jeopardize your employment?

Feeling depressed, sad, or anxious is very common among women before and during their menstruation. As well as crying, even if you can’t quite figure out what is wrong.

Menstruation and ovulation lead to hormonal changes throughout the month, which explain why your emotions may feel chaotic for weeks before your menstruation. Some women might have cramps before and during their menstruation. These are often part of premenstrual syndrome (PMS) and can be extended into the early days of menstruation.

What is PMS?

PMS refers to the diverse range of physical and psychological symptoms that females experience before their menstrual period, including menstrual cramps- where the uterus contracts, making the lining come off the walls of the uterus and leave the body. When the uterus cramps up, it helps the period blood flow out. About 90% of women report at least one physical or psychiatric symptom during the luteal phase of their menstrual cycle1, however, most do not report significant disturbances in their daily life. The prevalence of PMS is not associated with age, educational achievement or employment status and the symptoms persistence and severity tend to vary from individual to individual.

The exact cause of PMS remains unknown; however, several studies suggest that the fluctuation in estrogen and progesterone levels trigger the symptoms in the week or two before menstruation. The first day of the menstrual cycle is defined as the first day of a monthly period. Ovulation occurs around mid-cycle, which is approximately day 14. The empty follicle that has nurtured the egg forms a corpus luteum, which produces high levels of progesterone and lower levels of estrogen to prepare the womb for pregnancy if conception occurred. If the egg is not fertilized, then the corpus luteum begins to break down and the production of progesterone and estrogen begins to fall. This could play a major role in the development of PMS symptoms. The drop in estrogen levels may affect a person’s serotonin levels, which is a brain chemical that helps regulate mood, sleep and appetite, all which PMS affects.

What are the signs and symptoms of PMS?

There are about up to 150 symptoms have been identified as part of premenstrual syndrome. The most common physical and psychological symptoms of PMS include:

✔ food cravings

✔ tender or swollen breasts

✔ weight gain

✔ abdominal bloating

✔ pain in the lower abdomen or menstrual cramps

✔ acne, pimple breakouts or other skin symptoms

Psychological symptoms of PMS include:

✔ low mood

✔ feeling tearful or crying

✔ irritability or anger

✔ depression

✔ mood swings

✔ insomnia

How do I know it’s PMS?

Usually people may not realize that their symptoms are related to menstruation, especially if they have an irregular cycle.

Keeping a diary when symptoms occur can help person notice patterns and understanding your premenstrual symptoms. If symptoms occur at the same time of each month, this may be due to PMS. Your menstrual diary can help you plan ahead for, prevent, and better cope with your premenstrual symptoms. You can plan to take extra good physical and emotional care of yourself during these difficult days. It also helps others to know that these premenstrual days are not a good time to expect you to be at your best.

What helps with PMS and menstrual cramps?

Lifestyle changes can be a successful part to ease cramps and PMS treatment for many women. For women with severe PMS, seeking medication or doctor’s advice is needed. The following treatment options can stabilize mood swings and improve women’s cramps before menstruation:


It’s believed that the release of endorphins, a feel good brain chemicals released during exercise can help alleviate some of the hormone changes leading to PMS. Exercising such as aerobic exercises, swimming, cycling can help to boost energy and help with cramps and bloating.

Small, frequent meals

Splitting your meals into smaller meals may help to ease PMS symptoms. A large meal comprising high carbohydrates can cause blood sugar swings, worsening PMS. Keeping blood sugar levels steady is the key to reduce PMS.

Nutritional supplements

The consistently changes of calcium and magnesium levels during the menstrual cycle in each women can lead to PMS in certain women. Thus, nutritional supplements such as calcium can helps regulate mood, sleep and food cravings. Whilst fatty acids from fish, nuts and green vegetables can help to reduce abdominal cramps related to PMS.

Besides that, administration supplements containing magnesium was reported to relief PMS as the result from the relaxing effect of magnesium in controlling the neuromuscular stimulations. The magnesium level of women with PMS was found to be lower than that in the women without PMS3.

Herbal remedies

Herbal remedies may play some roles in the treatment of PMS by creating balance. They regulate cortisol and begin to balance your hormones overall while also allowing your body to better manage stress. Examples of herbal remedies that are found to ease PMS includes chasteberry, ashwagandha and maca. A randomized controlled trial using chasteberry4 has been known to be safe, efficacious treatment for PMS. It was shown to be helpful in improving the physical symptoms including cramps, bloating, breast pain and headaches. Whilst the powerful root of maca can balance hormones, relieving hot flashes and night sweats before your menstruation5. On the other hand, Ashwagandha has a calming effect which improves sleep and anxiety that is leading up to your period.

It is essential to listen to what your body needs throughout your menstruation and practice self-love. By doing so, you can lead a happier and healthier life.

References: 1. Wittchen HU, Becker E, Lieb R, Krause P. Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med. 2002;32(1):119–132.

2. Parks, CJ. Premenstrual Syndrome. Pediatric Clinical Advisor (Second Edition), 2007, Page 465, (

3. Salamat S, Ismail KMK, O’ Brien S. Premenstrual syndrome. Obstetrics, Gynaecology and Reproductive Medicine. 2008;18(2):29–52

4. van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013 May;79(7):562-75. doi: 10.1055/s-0032-1327831. Epub 2012 Nov 7. PMID: 23136064.

5. Chacon G. 1st. Lima: Universidad Nacional Mayor de San Marcos; 2001. “Maca” Millenarian Peruvian Food Plant with Highly Nutritional and Medicinal Properties; pp. 1–337

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