PMS Symptoms and 6 Likely Causes of PMS

After a few Google searches, it seems quite a common response to say the cause of PMS is still largely unknown. Now, that information doesn’t help so much does it? With over 200 PMS symptoms, you would think that a little more research would be done on the topic.

Listing the cause as largely unknown leaves women feeling responsible for their symptoms, “if there is no cause, it must be me”. Maybe, I’m putting words into your mouth right now, but with 80% of women suffering at some point with PMS symptoms, why is there not more research going into this? Why are there not better solutions? (Well there are, but we’ll get to that later in the series)

There are over 200 PMS symptoms listed! Yep, you heard me right, 200! I’m pretty sure there is no other condition that has 200 symptoms associated with it. These PMS symptoms fit into two classes: physical and psychological (emotional). I’ve listed a few common symptoms below as no-one’s got time for 200 of them.

Physical PMS symptoms include:

  • Breast tenderness
  • Swollen breasts
  • Bloating, fluid retention
  • Fatigue
  • Changes in appetite
  • Acne
  • Digestive upset (alternating constipation and diarrhoea)
  • Headaches and/ or migraines
  • Hot flashes or sweats
  • Difficulty in sleeping
  • Joint or muscle pain

Emotional PMS symptoms include:

  • Mood swings
  • Irritability
  • Tension
  • Anger
  • Decreased interest in usual activities
  • Feel agitated
  • Drop in self-esteem
  • Feelings of loneliness
  • Teariness
  • Difficulties in concentration
  • Anxiety and/ or depression

If so many symptoms are possible, does it not make sense that there would likely be different causes. I believe that no one cause can explain every case. You are an individual with your own set of causes.

Likely Causes of PMS

We’ve established that there is no one cause. As a naturopath we find it important to find the cause and this is what we treat to heal the symptoms. Treating just the symptoms alone will not change anything biologically and symptoms will continue to occur.

Six likely explanations for you:

  1. Hormonal imbalance

It’s important to get something straight before we talk about hormonal imbalance. It is easy to blame the hormones, they control our menstrual cycle and if something goes wrong with it, then it must be them, right?

Oestrogen and progesterone are the hormones of our menstrual cycle, together along with FSH and LH (refer here for a refresher on these hormones) they signal each other to activate the next step. These hormones are needed for a healthy menstrual cycle.

We LOVE these hormones, we NEED these hormones, but we need them to be in balance with one another.

These hormones are also needed for healthy mood because:

  • Oestrogen boosts serotonin (neurotransmitter contributing to feelings of wellness and happiness) and oxytocin (a hormone that helps with social bonding, trust, contentment and calmness), so when oestrogen is at its highest (as in the follicular phase of their menstrual cycle) women may feel their mood improve.
  • Progesterone soothes and calms mood, by first converting to a neurosteroid called allopregnenolone (refer to reference below), which interacts with GABA receptors causing the following effects: stress-reducing, rewarding, antidepressant, anti-anxiety, prosocial, antiaggressive, prosexual, pro-sleep, cognitive and memory-impairing, sedative etc.

Who wants some more progesterone? Me Please!

So, it is not the hormones themselves that are causing PMS, it could be an imbalance or a sudden drop in the hormones just prior to your period. It’s almost as if you are having withdrawal symptoms from your hormones.

  1. Neurotransmitter imbalance

As discussed above, the hormones have a direct relationship with the production of neurotransmitters such as: serotonin and GABA, if these are affected anxiety and feelings of depression are increased.

  1. Inflammation

All our hormones and neurotransmitters must attach to receptors on the surface of cells in order to exert action. Inflammation throughout the body will affect these receptors and in particular block the GABA receptors. If allopregnenalone cannot interact with the GABA receptor you will not experience all the calming and soothing of the hormone as mentioned above.

  1. Stress

We all experience chronic stress these days. Our never-ending ‘to-do’ lists, life administration, worrying thoughts, illnesses, deadlines, schedules are calling upon our stress hormones cortisol more than it should. When we run short of cortisol, our body will steal the raw materials from progesterone. You see, cortisol is needed to save our life (well, when we used to run or fight wild animals thousands of years ago) and progesterone is needed to make babies. In times of stress, the body chooses survival over baby making and our bodies just haven’t adapted to the amount of stress we now have in our lives.

  1. Nutritional deficiencies

Our hormones are all controlled by our hypothalamus in our brain and first the hypothalamus will be detecting if the body is nourished, healthy and safe. Food quantity signals the hypothalamus and tells it whether the body has enough food and nutrition to make a baby. (Even if you don’t want a baby right now, your healthy menstrual cycle is planning for a baby every single month). So restricting calories or a major food group, such as carbohydrates, can inhibit hormone production or shut down your menstrual cycle.

When you learn more about your menstrual cycle (for a review, click here) you start to understand just how much the ovaries change and how new follicles grow and mature every cycle. This amount of change requires a lot of nutrients for the dynamic ovarian function and ever growing follicles. If you are eating food that does not contain a lot of nutrition, then you are not providing your ovaries with the fuel they need to produce good follicles and a good corpus luteum (once again, if these are terms you aren’t familiar with, please review here).

  1. Environmental toxins

Common environmental toxins that are used in many household and personal products are called endocrine disruptors. These chemicals enter your blood stream and act like hormones within your body. Essentially they mimic oestrogen, which causes a further hormonal imbalance. These obviously play havoc with your own hormonal system, but also disrupt your detoxification pathways necessary for removing hormones each cycle.

If oestrogen isn’t removed from the body, then you have your body producing new oestrogen, you have old oestrogen re-circulating and with added endocrine disruptors, what chance does progesterone have? Now you have an hormonal imbalance.

If you are experiencing a few of the symptoms above, please remember you don’t have to suffer with PMS anymore.


If you need extra support around this ‘time of the month’, please finish reading my ‘PMS series’ and if you feel like naturopathic treatment could be a good fit for you, please contact us here. Look forward to hearing from you.

Amanda xx