PMS: What's normal and what's not

Just because it's common does not mean it's normal.

PMS is one of those things most women just accept as part of life. The mood swings. The cramps. The cravings. The acne. The week where everything feels just a little harder.

And we’ve got plenty of solutions for the symptoms:

• Midol for cramps

• Tylenol for headaches

• Heating pads for the bloating and pain

• Acne products for the breakouts

• Prescription brith control as a catch all

But the true cause of most of these symptoms? Low progesterone.

As an integrative health practitioner, I see PMS as communication. It’s our body’s way of saying something’s off. That our hormones need a little more support, not suppression.

I help women figure out the why behind their symptoms and then teach them how to help rebalance what’s off so we can mitigate symptoms from the root of the problem. When symptoms show up, we take a look at everything going on in the body (nutrition, blood sugar, stress, gut issues) and figure out where our body is asking for more help.

What PMS Actually Is

PMS stands for premenstrual syndrome and it refers to the emotional, physical, and behavioral symptoms that occur during the luteal phase (the second half) of the menstrual cycle.

From a functional perspective, PMS isn’t viewed as inevitable or something to be treated. It’s a sign that your hormones are imbalanced and most commonly involves low progesterone or poor estrogen metabolism.

According to The Fifth Vital Sign by Lisa Hendrickson-Jack, mild premenstrual changes (like minor mood shifts or bloating) can be normal. But when symptoms are severe enough to interfere with your daily life, it’s a signal that something deeper needs attention.

What PMS Feels Like (And Why It Happens)

PMS doesn’t look the same for everyone. In fact, research identifies four subtypes, based on which hormones or systems are most affected

• PMT-A (Anxiety): Nervousness, irritability, tension — often linked to low progesterone relative to estrogen.

• PMT-H (Hyperhydration): Bloating, swelling, breast tenderness — associated with high estrogen or fluid retention.

• PMT-C (Cravings): Sugar cravings, headaches, fatigue — related to blood sugar instability and low magnesium or B vitamins.

• PMT-D (Depression): Low mood, tearfulness, brain fog — tied to more significant progesterone drops or thyroid sluggishness.

These variations are your body’s way of flagging which systems need attention.

How to Manage PMS Naturally

Here’s where we flip the script of how these are typically managed. You can support your body’s natural hormone production and reduce PMS by improving the foundations that regulate hormones

Support Ovulation (and Progesterone Production)

• Eat enough. Especially in the second half of your cycle. Under eating gives your body fewer resources to make hormones with.

• Manage stress. Cortisol is the biggest thief of progesterone production.

• Prioritize sleep and rest. Your hormones rely on your circadian rhythm and reset overnight.

• Consider thyroid testing if fatigue and low temps are common. Sluggish thyroid often means lower progesterone.

Support Estrogen Metabolism + Detoxification

• Eat cruciferous veggies (broccoli, kale, cauliflower, cabbage). These support liver enzymes that help process estrogen.

• Add fiber daily (2–3 cups of veggies, seeds, or legumes). Fiber binds estrogen for elimination.

• Sweat and hydrate. Exercise, sauna, and water all support lymphatic flow and hormone clearance.

• Reduce exposure to plastics, conventional cleaners, and fragranced products. These xenoestrogens disrupt hormone signaling.

• Address any underlying gut issues. If you are constantly dealing with IBS-like symptoms, bloating, diarrhea, constipation, gas, etc. you’ll likely have a harder time metabolizing estrogen and absorbing nutrients needed for hormone production.

Balance Blood Sugar

• Never skip breakfast. Eat within 60 minutes of waking.

• Pair protein and fat with carbs at every meal to keep energy and mood stable.

• Limit caffeine. It can spike cortisol and blood sugar and even interfere with sleep.

Replenish Nutrients

• Focus on magnesium, vitamin B6, zinc, selenium and vitamin D.

• Add foods like pumpkin seeds, leafy greens, salmon, and eggs for hormone support.

• Get on a high quality multivitamin to help bridge the gap of any nutrient deficiencies in the diet.

Support Gut Health

• Address constipation. Estrogen is reabsorbed when digestion slows.

• Eat fermented foods (sauerkraut, kefir, yogurt) to support a healthy microbiome.

• Reduce inflammation by limiting ultra-processed foods and adding omega-3s.

PMS Is Not Something You Have to Live With or Manage with Hormones

PMS might be common, but it’s not normal. You don’t have to accept feeling irritable, bloated, or exhausted every month as the price of being a woman.

Your symptoms are signals, and when you understand what your body is saying, you can respond with nourishment instead of quick fixes.

By supporting ovulation, balancing blood sugar, managing stress, and giving your body the nutrients it needs, you can reduce PMS naturally (no pill required).

If you’ve been told your symptoms are “just part of being a woman” or you’re tired of guessing what your body needs, it’s time to look deeper.

Download our free guide, What to Ask for in Your Hormone Panel, or schedule a free consult to learn more about our Cycle Calibration Program. It’s perfect for women with PMS, irregular cycles or trying to conceive. We’ll help you understand your hormones and create a plan that works with your body, not against it.

Information adapted from the Fertility Awareness Mastery Mentorship (FAMM) program © Fertility Friday Publishing Inc.