Mood swings and more: This really helps with PMS!

About half of all people are women. Nevertheless, many symptoms and diseases affecting women are still too rarely discussed. Others are discussed, but often in hushed tones or with a dismissive undertone. A typical example: premenstrual syndrome (PMS).

"Are you on your period?" or "You must have PMS" are unfortunately still typical statements women have to listen to when they struggle with mood swings, irritability and other symptoms before the onset of their monthly bleeding. Added to this is self-doubt: Why am I so strange?

But PMS is not an imagination and has nothing to do with how well you "pull yourself together". Instead, hormonal changes in the second half of the cycle can make the days before the period a real torment for some women. Fortunately, there are ways to address premenstrual syndrome. We explain why one remedy is currently particularly in focus.

The term PMS encompasses various physical and psychological symptoms that typically occur in the second half of the cycle, i.e., after ovulation and before the onset of menstruation. Once bleeding begins, the symptoms usually disappear or become significantly weaker. This timeline is one of the main characteristics of PMS. This is also how the syndrome is usually distinguished from period pain and abdominal cramps that occur during bleeding.

PMS covers a wide range of complaints. Some women notice mainly physical changes such as breast tenderness, water retention in the legs and other body parts, headaches, or digestive problems. Others suffer mainly from emotional symptoms such as irritability, inner restlessness, high sensitivity, depression, or fatigue. For many sufferers, physical and psychological symptoms occur together and reinforce each other. About 20 to 40 percent of all women experience mild PMS symptoms. However, only about 5 percent of all affected individuals experience severe, treatable symptoms.

The cause of PMS is not yet fully understood. However, it is known that it – similar to depression, by the way – is related to the hormone balance during the female cycle. However, not every female body reacts the same way to the changes during the cycle. Two women can have similar hormone levels and still have completely different PMS experiences because the expression of symptoms also depends on the interaction of hormones with the nervous system.

Not every woman experiences PMS the same way – some mainly notice physical changes, others primarily struggle with emotional rollercoasters, and many experience a mix of both. The following symptoms typically occur in the second half of the cycle (about 5-14 days before the period starts) and usually disappear with or shortly after the onset of bleeding. Do you recognize yourself in several of these complaints?

Physical Symptoms:

• Breast tenderness & sensitive breasts
• Abdominal cramps & stomach aches
• Headaches & migraines
• Back pain
• Water retention (swollen legs, hands, feet)
• Bloating & feeling of fullness
• Constipation or diarrhea
• Nausea
• Fatigue & exhaustion
• Cravings (especially for sweets or salty foods)
• Skin blemishes & acne
• Dizziness
• Joint pain
• Muscle pain
• Weight gain (due to water retention)
• Hot flashes
• Increased pulse

Psychological & Emotional Symptoms:

• Mood swings
• Irritability & aggressiveness
• Increased sensitivity
• Inner restlessness & tension
• Depression & sadness
• Lack of drive
• Difficulty concentrating
• Forgetfulness ("Brain Fog")
• Sleep problems (difficulty falling or staying asleep)
• Anxiety
• Panic attacks
• Increased emotionality & weepiness
• Social withdrawal
• Feeling overwhelmed
• Reduced libido
• Self-doubt
• Hopelessness (with PMDD)

When to see a doctor?

• 3+ symptoms severely impact your daily life
• Symptoms last longer than 5 days before your period
• Symptoms worsen month by month
• Work or relationships suffer greatly
• Thoughts of self-harm or suicide (act immediately!)

Hormones thus play a central role in PMS, especially progesterone, estrogen, and serotonin. (1) After ovulation, estrogen levels drop, while progesterone increases. Progesterone generally has calming, sleep-promoting properties, but its breakdown products act on the same receptors in the brain as certain neurotransmitters, including gamma-aminobutyric acid (GABA). In some women, this effect leads to relaxation, while in others it causes inner restlessness, irritability, or depressive moods.

In addition, there is the influence of serotonin, a neurotransmitter that affects our mood, sleep, and appetite, among other things. Studies have shown that serotonin levels in some women drop in the second half of the cycle because more serotonin is transported back into the nerve cells. (2) This decrease can be associated with typical PMS symptoms such as low mood, cravings, and increased sensitivity.

Furthermore, stress can amplify these effects. A demanding everyday life, performance pressure, little sleep, or constant availability can lead to the nervous system being on high alert anyway. The changes in hormone balance thus have an even stronger effect. (3)

About three to eight percent of all menstruating individuals are affected by what is known as premenstrual dysphoric disorder (PMDD). This particularly severe form of PMS is primarily accompanied by pronounced psychological symptoms.

Affected individuals experience intense mood swings, severe irritability, hopelessness, anxiety, or the feeling of completely losing control over their emotions in the second half of the cycle. These symptoms can significantly impair quality of life and heavily burden relationships, work, and self-perception.

Crucially, women with PMDD generally do not have hormone levels that deviate from the "standard." Rather, their brain and nervous system react particularly sensitively to cycle-related changes in estrogen and progesterone balance. The good news: PMDD is now recognized as a distinct illness and is being increasingly researched. Gone are the days when women with PMS and PMDD were simply dismissed as "hysterical" or "too emotional."

This is also an important step for those affected, so they do not view their own experience as an illusion or a personal failing, but rather strive for effective therapy – together with their treating gynecologist.

Lately, the topic of PMS seems to be discussed much more clearly and frequently than just a few decades ago. This could, of course, be due to women being more open about their symptoms and no longer dismissing them as something that only exists in their heads.

At the same time, studies suggest that living conditions for many women today have become more complex than ever. Professional responsibilities, constant psychological stress due to polycrisis, high social expectations, and not least often the desire to master everything simultaneously (and with a smile!) take their toll.

Lack of sleep, irregular meals, and high consumption of caffeine or sugar can also exacerbate PMS symptoms. They put a strain on the body and nervous system, making hormonal changes even more pronounced. PMS can thus also be a sign for you to give your body and soul more attention and care.

Premenstrual syndrome is as individual as the woman who suffers from it. The treatment should be just as individual. Some women specifically seek support through medication, while others consciously choose to avoid it and instead rely on relaxation techniques and natural remedies. However, one insight is paramount in all treatment approaches: PMS is not imaginary and not something you "just have to put up with."

The recognition that PMS is a medical condition and an individual diagnosis is often the first step for many to treat themselves with more kindness. Even this alone can help to perceive the symptoms as less burdensome.

Hormonal contraceptives can alleviate PMS symptoms in some women by stabilizing the natural cycle. However, in some patients, they can exacerbate the symptoms. In addition, the pill can have its own side effects (weight gain, mood and personality changes, risk of thrombosis). Also, for girls just before and during puberty, who are often particularly affected by PMS, it is usually not an option.

However, it is often possible to manage without medication. Approaches from cognitive behavioral therapy and mindfulness practices have proven very effective in keeping symptoms at bay. Regular, moderate physical exercise and sports throughout the entire cycle are also very helpful according to studies. Regular physical activity has been shown to stabilize mood and reduce stress hormones. But here, too, be sure to listen to your body: if you feel unwell, have stomach aches or headaches, you should not overexert yourself. Gentle exercises (e.g., yoga) can help you engage in physical activity while also finding relaxation.

Equally important are fundamental factors such as sleep and nutrition. A balanced diet with sufficient complex carbohydrates, healthy fats (especially omega-3 fatty acids) and micronutrients such as vitamins D and E supports neurotransmitter production and can thus indirectly influence PMS symptoms.

These methods tend to work in the long term as part of a gentler approach to yourself. If you suffer from severe symptoms, please do not hesitate to talk to your doctor. We cannot say it often enough: you don't have to just endure PMS!

In recent years, one active ingredient in particular has increasingly come into focus for PMS: Cannabidiol (CBD). Unlike the pill and similar remedies, it acts entirely naturally on the nervous system and our mood. CBD is a non-intoxicating component of the hemp plant (unlike the more well-known THC). Instead, CBD interacts with the endocannabinoid system, a central regulatory system in the body that is involved in controlling pain, mood, sleep, and stress responses, among other things.

The endocannabinoid system plays an important role in maintaining internal balance, also known as homeostasis. And it is precisely this balance that is often disrupted in PMS.

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Direct, large-scale clinical studies on CBD specifically for PMS are still rare. However, a recent study from Brazil shows that full-spectrum cannabis extracts can particularly help women suffering from chronic pain. The authors also report a significant reduction in symptoms such as sleep disturbances, anxiety, and depressive moods – the classic symptoms of premenstrual syndrome. (4)

Prior to this, there had already been some research investigating mechanisms relevant to PMS. For example, a 2021 review described how the endocannabinoid system interacts with hormonal fluctuations and influences inflammatory processes and pain perception. (5) These processes also play a role in many PMS symptoms.

Further studies also suggest that CBD can have anxiolytic and mood-stabilizing effects. (6) Since anxiety, internal restlessness, and irritability are central components of many premenstrual complaints, CBD could be a real game-changer here.

Regardless of the study situation: women in our product reviews on Trustpilot already report that CBD works very well for PMS, as well as for other problems related to their cycle (e.g., cramps or menstrual irregularities).

Many report overall better emotional stability, more restful sleep, and a reduced feeling of stress and overload. CBD can be used both internally (as drops or spray) and externally. A gentle massage with a CBD-containing balm, for example, helps you relax, warm up, and bring more calm into your day.

Equally important is a regular routine, for example, a gentle evening routine with a mindfulness exercise and your favorite full-spectrum oil, to help you become more resilient to the demands of everyday life in the long term and to take loving care of yourself and your body.

PMS is not an imagined condition or a weakness; it is triggered by complex hormonal and neurobiological processes. An increasingly fast-paced and demanding world also contributes to stress and tension becoming truly overwhelming during certain times of our cycle.

Fortunately, we can gently support our bodies to get through this challenging time. Mindfulness, self-care, and acknowledging that you are not behaving "strangely" are the first steps toward more calm and serenity in dealing with monthly mood swings. You are good just the way you are!

CBD can also help you get through the time before your period in a relaxed way – whether as part of your morning or evening routine or as a warming balm that you can easily use to give yourself a little break in stressful moments.

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