Let the unpacking begin…
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Average read time: 15 minutes
Introduction:
Changes in how you feel before your period can be a natural part of the menstrual cycle, although they’re not always clearly understood.
Definition: Premenstrual syndrome (PMS) refers to a range of physical, emotional and behavioural changes that can occur in the days before menstruation, influenced by the body’s natural hormonal fluctuations throughout the cycle [1,2].
These changes can present differently from person to person and may include shifts in mood, energy, digestion and overall wellbeing. Symptoms can also vary from month to month, with each woman’s experience being unique and evolving over time [1, 2].
As awareness and conversations around women’s health continue to grow, many women are becoming aware of the patterns within their cycle and how these changes may reflect the body’s varying needs at different stages.
Throughout the menstrual cycle, hormonal fluctuations interact with several interconnected systems that contribute to overall wellbeing, including the gut and vaginal microbiome [3, 4].
What does PMS look like? (and how is it different from PMDD?)
- Four in five women aged 18 to 44 years experienced bothersome periods in the last five years
- Three in four of those affected reported these bothersome periods had a substantial impact.
- Bothersome periods made it hard for them to do daily activities such as work, study and exercise with strain on mental and emotional health, relationships with partners, family and friends [5].
Common physical and emotional symptoms of PMS include:
- Bloating, headaches, breast tenderness, fatigue
- Changes in bowel habits: diarrhea and/or constipation
- Mood swings, irritability, anxiety or depression [1, 2, 6]
PMS can cross-over with symptoms of Premenstrual Dysphoric Disorder (PMDD), which is a widely overlooked disorder [7].
Definition: PMDD is a much more severe form of PMS. It is recognised in the DSM-5 as a depressive disorder. Symptoms of PMDD occur at the same time as PMS, starting during the week/s before menstruation and generally end within a few days after your period starts. These symptoms disrupt daily living tasks [8].
Symptoms of PMDD:
- Severe psychological and emotional symptoms such as: mood swings, marked irritability or anger, anxiety, feelings of hopelessness, depression and emotional overwhelm.
- Self-critical thoughts
- Sudden tearfulness
- Changes in appetite, energy levels and sleep patterns [8]
Both PMS and PMDD are diagnosed primarily through symptom tracking across at least two menstrual cycles, as there is currently no single laboratory test available for diagnosis [8] .
PMS - What’s really happening in your body:
PMS may be caused by a range of factors including lifestyle, stress, physical and emotional health. However, symptoms are often due to cyclical hormonal changes throughout the menstrual cycle [1, 2] .
During the luteal phase of the menstrual cycle, the period between ovulation and menstruation, levels of progesterone and oestrogen naturally rise and then decline. These hormonal fluctuations influence brain chemistry and nervous system signalling in ways that contribute to the emotional and physical symptoms associated with premenstrual syndrome (PMS) [9, 10].
One of the key mechanisms involves the interaction between progesterone and neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA), which help regulate mood, stress response and emotional balance. In susceptible individuals, changing sensitivity to these fluctuations may alter the calming effects of GABA signalling, contributing to symptoms such as irritability, anxiety, mood changes and sleep disturbances [9, 10].
Fluctuations in oestrogen during the late luteal phase may also influence serotonin activity. Research suggests that declining oestrogen levels can affect serotonin production, transport and receptor activity, which may contribute to symptoms of low mood, food cravings and heightened emotional sensitivity [9, 10].
Current evidence suggests PMS is not necessarily caused by abnormal hormone levels themselves, but rather by an increased sensitivity to the normal cyclical hormonal changes that occur throughout the menstrual cycle [10].
PMS & Broader Systems Connection
Emerging research suggests that PMS may involve more than hormonal fluctuations alone, with growing interest in the role of the gut-brain axis: the bidirectional communication network linking the gut, brain, immune and nervous systems [11].
During the luteal phase, hormonal fluctuations may not only influence mood and emotional regulation, but can also affect digestion, appetite, bowel habits and inflammation. At the same time, the gut microbiome plays an important role in supporting neurotransmitter production (serotonin & GABA), as well as immune and metabolic function [12].
There is also growing recognition of the connection between hormonal health and the vaginal microbiome. Hormonal changes across the menstrual cycle can influence the vaginal environment, including microbial composition, pH balance and vaginal comfort. Research suggests the gut and vaginal microbiomes may also interact through shared immune and metabolic pathways, highlighting the broader relationship between microbial health, hormonal balance and women’s wellbeing [13].
Because of these interconnected systems, changes occurring within the gut and vaginal microbiomes may influence PMS symptoms.
This evolving understanding supports a more holistic approach to women’s health, recognising the close relationship between the brain, gut, vaginal microbiome and overall wellbeing throughout the menstrual cycle [14, 15, 16].
Probiotic support for PMS:
Supporting PMS often involves a holistic approach that includes nutrition, movement, stress management, sleep and targeted nutritional support. Probiotics may play a role within this broader wellbeing strategy by helping to support the gut and vaginal microbiomes [17, 18, 19, 20, 21].
Particularly, during the luteal phase (when PMS occurs), there are significant fluctuations in oestrogen, progesterone and the endometrium, associated with microbial diversity and reduced dynamicity [22, 23]. *see image below
[23]
Probiotics have been reported to support:
- Vaginal lactobacilli concentration
- Bowel function and gut microbiota health
- Immune system health
- Local vaginal immunity
- Female reproductive tract health [19, 20, 21]
Life-Space Probiotic+ PMS Relief provides targeted and clinically studied ingredients including 5 probiotic strains, Vitex agnus-castus and zinc. This formula combines probiotics, herbal and minerals to provide a comprehensive and well-researched support for PMS symptoms.
Health benefits of Life-Space Probiotic+ PMS Relief:
- Relieve symptoms of premenstrual tension
- Supports mood changes and irritability associated with premenstrual tension
- Relieve breast pain/tenderness associated with premenstrual tension
- Supports menstrual cycle regulation
- Helps to restore friendly gut flora
How it works – the ingredients
Probiotics can:
- Support the body’s natural oestrogen metabolism
- Help maintain healthy hormone balance via the gut
- Influence how oestrogen is processed and removed from the body
- Support a healthy vaginal microbiome [18, 24]
Vitex is a traditional herbal medicine widely used for PMS symptom relief.
It works by acting on the brain’s hormone control centre (the pituitary gland), helping to regulate key reproductive hormones.
- Helps reduce prolactin levels (a hormone linked to PMS symptoms)
- Support healthy progesterone balance
- Improve symptoms like mood swings, breast tenderness, and bloating [25, 26]
Zinc is an essential mineral that plays a role:
- Supporting hormone production and regulation
- Maintaining healthy reproductive function
- Supporting brain chemicals involved in mood [27, 28]
Holistic support for PMS:
There are many complementary approaches that aim to improve the experience of menstruation. Some are supported by good evidence while others may simply improve women's sense of wellbeing.
These include: managing diet, exercise and overall lifestyle, yoga and mindfulness meditation, acupuncture & traditional Chinese Medicine, massage and herbal remedies [16, 17, 18].
When to seek further guidance:
Seek support from your healthcare practitioner if symptoms feel severe, impact daily life or go beyond typical PMS [1, 2].
Conclusion:
PMS is a natural and cyclical part of many women’s menstrual experience, although symptoms and severity vary from person to person. Becoming more aware of the patterns and changes that occur throughout the cycle can help support a better understanding of your body’s needs during different phases.
Supporting wellbeing during the premenstrual phase often involves a holistic approach, including balanced lifestyle habits, stress management, nutrition and targeted support such as probiotics. Seeking guidance from a healthcare professional can also help women find the most appropriate support for their individual symptoms and overall health needs.
References:
[1] Services D of H & H. Premenstrual syndrome (PMS) [Internet]. www.betterhealth.vic.gov.au. 2019. Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/premenstrual-syndrome-pms
[2] Australia H. Premenstrual syndrome (PMS) [Internet]. www.healthdirect.gov.au. 2020. Available from: https://www.healthdirect.gov.au/premenstrual-syndrome-pms
[3] Siddiqui R, Makhlouf Z, Alharbi AM, Alfahemi H, Khan NA. The Gut Microbiome and Female Health. Biology [Internet]. 2022 Nov 1;11(11):1683. Available from: https://www.mdpi.com/2079-7737/11/11/1683
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