Hormone imbalance can be invisible and is not always measurable

Premenstrual syndrome (PMS) can affect your physical health, emotions and behaviour. It usually causes symptoms during certain days of your menstrual cycle, usually  a few days before your period starts.  Your individual experience may be variable. You may experience changes in your mood, with anxiety, irritability, brain fog, fatigue and insomnia. You may also notice physical symptoms such as period pain, breast discomfort, headaches, carb cravings and acne flares. Symptoms usually ease once your period starts.

PMS symptoms are common. More than 90 percent of women of child bearing age may notice symptoms at some point. But if you are suffering with severe symptoms then you should seek help from your doctor. You may need to be referred to a specialist like me.

Hormone balance and stress

We don’t know the cause of PMS. It is likely to result from imbalances in hormones towards the end of each monthly cycle. This is when your estrogen and progesterone levels start to fall. Your symptoms will usually disappear a few days after the start of your period. If you have very severe symptoms, you may be suffering from a severe form of PMS called premenstrual dysphoric disorder (PMDD). This can be disruptive to your life. Symptoms can overflow into other days of the month, not just the days around your period.

Some research suggests serotonin imbalance (which is also linked with depression) may play a role in PMS and PMDD. Stress hormone imbalance could also explain why symptoms can be worse when you are stressed or going through major life events. High cortisol levels at these times canl tend to suppress other hormones.


There are different types of treatments for PMS/PMDD. You may find a range from lifestyle measures can help, such as a healthy diet, regular daily exercise, stress management and daytime and sleep routine. If these don’t help with your symptoms you may be offered hormone or non-hormone based treatments. These treatments should be decided on an individual basis between you and your doctor, depending on your specific symptoms.

It should also be noted that, depending on your age, PMS symptoms can overlap with perimenopause. This is more likely if you are over the age of 40.

You can find more useful information on the NAPS website;

For more information about PMDD click here

Here is a link to treatments that you can print and discuss with your doctor PMDD Treatments

Hormone Facts & Information