PMS: What It Is, Why It Happens, & How To Feel Better During Your Luteal Phase

Premenstrual syndrome (PMS) is something most women will experience at some point in their lives. For some, it’s a few days of bloating or fatigue before a period begins. For others, it may bring mood changes, cramps, or headaches that feel harder to manage. PMS reflects the natural hormonal shifts of the menstrual cycle and the way these shifts interact with nutrition, stress, sleep, and overall health.

In this article, you’ll learn what PMS is, why it happens, what’s considered typical, and how to support your body through the luteal phase.

Premenstrual syndrome (PMS) refers to a collection of physical, emotional, and behavioral symptoms that occur in the days or weeks before menstruation, typically during the luteal phase of the cycle (1). Symptoms usually resolve once bleeding begins. For some, PMS may be as subtle as mild bloating or fatigue. For others, it can include mood swings, headaches, breast tenderness, sleep changes, or cramps that interfere with daily life (1).

While some degree of PMS is common, it is not considered “normal” for your cycle to leave you feeling consistently unwell. In naturopathic medicine, PMS can be viewed as a signal of how your body is responding to hormonal shifts, stress, nutrient status, and overall health.

Before we discuss PMS, we must take a moment to understand the phases of the menstrual cycle (2).

• Menstrual Phase (Days 1-5): The uterine lining is shed, resulting in bleeding. Hormone levels are at their lowest.
• Follicular Phase (Days 1-13): Estrogen rises to stimulate egg development.
• Ovulatory Phase (Days 14-16): A surge in luteinizing hormone (LH) triggers ovulation. Estrogen peaks.
• Luteal Phase (Days 15-28): After ovulation, progesterone rises to support a possible pregnancy, while estrogen falls

PMS happens during the luteal phase of the menstrual cycle, the two weeks after ovulation and before bleeding begins. During this time, your hormones shift in ways that affect the brain, nervous system, and inflammation in the body.

As a note: Some women do not get a period and may not experience PMS during breastfeeding because prolactin, the hormone responsible for milk production, can suppress ovulation. Without ovulation, the hormonal shifts that typically cause PMS symptoms often do not occur.

After ovulation, your body makes more progesterone to prepare for a possible pregnancy. Progesterone usually has a calming effect; it connects with brain pathways that help you relax and sleep (3). But sometimes progesterone is made in smaller amounts, fades earlier than expected, or gets overshadowed by stress hormones like cortisol (4). When that happens, its calming effect is weaker, and you may feel more anxious, restless, or irritable.

At the same time, estrogen drops from its high point at ovulation. Estrogen plays an important role in mood because it helps regulate brain chemicals like serotonin and dopamine. When estrogen levels are lower, it can affect these systems, which is why some women notice more mood swings, irritability, or cravings in the days before their period (5).

Not every woman experiences PMS the same way:

• Differences in estrogen and progesterone levels, as well as how the brain responds to shifts in these hormones, can impact symptoms.
• Some people’s brains are more sensitive to changes in serotonin and calming brain chemicals, like GABA.
• Stress raises cortisol, which interferes with progesterone’s calming role (3).
• Higher inflammation can make cramps, headaches, and mood swings worse (6).
• Adequate levels of nutrients—like magnesium, vitamin B6, vitamin D, and calcium—help the body maintain normal hormone and nervous system function.
• Genetics may make some women naturally more sensitive to hormone fluctuations (7).

Another piece of PMS is prostaglandins. These are natural chemicals that cause the uterus to contract so the lining can be shed (8). They’re necessary for menstruation, but when prostaglandins are too high, they can cause stronger cramps, headaches, and even digestive upset in the days before a period.

The luteal phase also increases the body’s need for certain nutrients (9). If your diet doesn’t supply enough of these, PMS symptoms may sometimes feel worse:

• Magnesium: helps relax occasional tension
• Vitamin B6: supports energy and mood
• Vitamin D: important for hormone signaling and mood regulation
• Calcium: supports muscle relaxation and nerve communication
• Iron: helps prepare for menstrual blood loss

To learn more, read this article: Vitamin D Deficiency & Premenstrual Symptoms

This is one of the most important questions women ask. The short answer: mild PMS is common, but ongoing, severe PMS shouldn’t be accepted as normal.

• Mild PMS is common. Small shifts in mood, appetite, or energy are expected as hormones fluctuate.
• Severe PMS is not ideal. If PMS regularly interferes with your daily life, it may be a sign your body needs more support.
• PMDD (premenstrual dysphoric disorder): A more severe form of PMS with significant mood changes. While rare, PMDD highlights how strongly hormones interact with the brain and nervous system.

Check in with a trusted provider if:

• PMS symptoms regularly disrupt your work, relationships, or sleep.
• Mood swings are severe or include depression or anger.
• Cramps are extreme or do not improve with gentle measures.
• Your cycle suddenly changes in pattern or severity.

While PMS is often triggered by the natural hormone swings that occur after ovulation, some women may also experience underlying imbalances in estrogen and progesterone that make occasional symptoms more noticeable. The good news is that the way you support your body can make a difference in how smoothly you move through the luteal phase each month.

Simple daily choices can help ease occasional PMS symptoms and promote steadier energy, mood, and comfort:

• Balanced meals: Combining protein, fiber, and healthy fats helps keep blood sugar steady, which in turn supports hormone balance and may reduce mood fluctuations.
• Exercise: Gentle, consistent movement encourages circulation, supports mood, and can even help ease cramps. Consider cycle-aware exercise: lighter activities during the luteal phase and more intensive workouts earlier in your cycle.
• Stress management: High cortisol levels can intensify PMS. Practices like breathwork, time in nature, or yoga are just some of the tools that may help calm the nervous system.
• Sleep: Adequate rest can help you feel more balanced emotionally and physically.

Beyond diet and nutrients, these approaches may also help support a smoother cycle:

• Seed Cycling: Rotating flax, pumpkin, sesame, and sunflower seeds during different phases of the cycle provides lignans, minerals, and fatty acids that may support hormone balance. Learn more in our Seed Cycling guide.
• Herbal support: Herbs contain minerals, phytonutrients, and plant compounds that help the body’s natural rhythms without overriding them.
  • Mineral-rich herbs: Nettle and oatstraw are rich minerals like calcium, magnesium, and iron to support muscles, nerves, and energy.
  • Uterine tonics: Raspberry leaf is traditionally used to support uterine comfort and tone.
  • Nervines: Lemon balm, linden, and hawthorn calm the nervous system and support emotional steadiness.
  • Adaptogens: Medicinal mushrooms and kava encourage resilience to stress and overall balance.

PMS reflects the body’s natural hormonal shifts, but symptoms vary widely from person to person. Mild changes in mood, energy, or comfort are common, while more disruptive symptoms may signal a need for additional support. By paying attention to lifestyle, nutrition, and stress management, many women can find greater ease in the luteal phase. If symptoms are severe or interfere with daily life, it’s best to discuss them with a healthcare provider.