How Do You Know If Your Period Is Coming?

Bloating, acne, diarrhea or constipation, cramps are just some of the possible signs that your period is coming... Let's explore!

Remember when you got your very first period? (Don't you wish you had period underwear then?) Maybe you noticed yourself feeling a bit more emotional than usual or experiencing tenderness or discomfort in certain body parts. At the time, these new sensations may have surprised or even overwhelmed you. However, as the years (and menstrual cycles) passed, the telltale signs and symptoms that preceded your period became more recognizable and expected.

Regardless of if you’ve experienced 1 period or 100, this article will help you understand why you feel the way you do as your period approaches. But first, let’s take a step back and get a broad understanding of your menstrual cycle as a whole.

The Menstrual Cycle: A Simple Breakdown

The menstrual cycle includes three different uterine phases that occur at the same time as three different ovarian phases. It’s not always obvious which phase you're in, with the exception of the menstruation phase (a.k.a. your period). 

Your menstrual cycle is sometimes referred to as your monthly cycle. The most commonly referenced menstrual cycle is 28 days. However, the normal range for many adult women of reproductive age is 21–35 days. During this time, your body prepares for the possibility of fertilization and pregnancy. Your period is a sign that pregnancy did not occur. 

Many also experience irregular periods or irregular menstrual cycles, which can be caused by a variety of different factors. Tracking the menstrual cycle can be a helpful way to understand the characteristics of your period, i.e., how often it comes, how long it lasts, and what it is associated with, as well as d efficiently detecting any persistent abnormalities or deviations from your normal.

Menstruation + The 3 Ovarian Phases

1. Menstruation (a phase of the uterus that occurs during the follicular phase of the ovary): More popularly referred to as your period, menstruation (or menses) marks the first day of your cycle. If an egg has not been fertilized, the egg disintegrates, and your uterus sheds the lining built from the previous month’s menstrual cycle. This is your period.
2. Follicular Phase: The follicular phase of the ovary is when the egg undergoes a maturation process, and this begins on the first day of your period (day 1 of your cycle) and ends with ovulation (approximately day 13-15 of a cycle of 28 days). At the same time that the ovary is in its follicular phase, the uterus is in its menstruation phase (sloughing of the uterine lining and menstrual blood flow), which then transitions into the proliferative phase which includes reconstruction and regrowth of the endometrium (uterine lining).
3. Ovulation: After the ovarian follicular phase ends, ovulation typically occurs and this is around Days 13-15 of a 28d cycle. The day of ovulation is distinctly defined by the act of the oocyte bursting through the ovarian capsule, out of the ovarian follicle, traveling through the fallopian tube, and becoming available to sperm for fertilization. 
4. Luteal Phase: The luteal phase of the ovary typically lasts for two weeks after ovulation (day 17-28 in a 28d cycle). During this phase, the remnant follicle remodels itself into an enlarged, lipid-rich body known as the corpus luteum. The corpus luteum produces hormones that would be helpful for a developing pregnancy if one were to occur. If no fertilization occurs after 14 days, then the corpus luteum breaks down, which decreases hormonal production, and menstruation begins. During the luteal phase of the ovary, the uterus is in the secretory phase, which means it is using the hormones from the corpus luteum to prioritize the secretion of substances that keep it stable instead of those that cause it to proliferate and grow—all in preparation for implantation of a pregnancy.

If pregnancy doesn’t occur, the corpus luteum dissolves, and the endometrium destabilizes and sloughs off, leading to period flow. If fertilization and implantation (early pregnancy) do occur, the menstrual cycle transitions into a pregnancy cycle, and the endometrium does not need to shed i.e., a missed period occurs.

Hormones play an important role in the menstrual cycle and are responsible for the transition from one phase to the next. These chemical messengers are also suspected to cause certain symptoms in the days leading up to your period, as recorded by The Lancet.

Premenstrual Syndrome 

Premenstrual syndrome (PMS), by definition, is the occurrence of “cyclic physical and behavioral symptoms that appear in the days preceding menses and interfere with work or lifestyle, followed by a symptom-free interval”. 

Symptoms of PMS typically arise during the last 7-10 days of the cycle. PMS symptoms are a combination of physical (e.g., abdominal bloating, extreme fatigue, breast tenderness, and headaches) and behavioral  (e.g., mood lability, irritability, depressed mood, increased appetite, forgetfulness, difficulty with concentration.) 

PMS symptoms are reported by up to 75% of women and thus are commonly reported. However, when strictly defined based on prospective symptom diaries, clinically significant PMS only occurs in 20-30% of those that report it.  

The specific symptoms experienced are less important for diagnosis when compared to the cyclic nature of the symptoms and when they occur in relation to the timing of menstrual flow. Premenstrual Syndrome (PMS) is essentially an abnormal response to normal cyclic menstruation changes.

10 Common Signs Your Period Is Coming

Here are ten common signs your period is coming (premenstrual symptoms), which include both physical and emotional symptoms, meaning you may experience mood-related symptoms.

1. Mild Abdominal Cramps or Pelvic Cramps

Mild abdominal cramps (abdominal pain) or pelvic cramps can be experienced prior to menstruation by some and are a result of the uterine lining destabilizing, releasing prostaglandins and preparing to shed, and the uterus itself contracting in response to the decrease in hormone production from the corpus luteum. 

Cramps due to a menstrual disorder are called dysmenorrhea and can be either called primary dysmenorrhea (without pelvic pathology) or secondary dysmenorrhea (with pelvic pathology). 

If cramps caused by uterine and abdominal contractions are severe, worsening, or affecting the quality of life, this is never normal, and an evaluation with a gynecologist or other qualified reproductive health provider should occur. 

2. Breast Tenderness

Changes in estrogen and progesterone levels can affect how your breasts feel before your period, which can result in tender, sore, achy, or heavy-feeling breasts. This typically resolves once menstrual flow has begun.

3. Bloating Caused by Fluid Retention

It’s not uncommon to feel like you’ve gained weight in the luteal phase prior to the onset of menstruation. But don’t worry! This is temporary bloating caused by fluid retention (a.k.a. ‘water weight’) due to fluctuations in hormone levels.

4. Lower Back Pain

If you experience mild abdominal and pelvic cramps, you may also feel discomfort and soreness in your lower back. As the uterus reacts to the leaky prostaglandins, the surrounding muscles in the pelvic floor, back, and abdomen can as well.

5. Headaches

Menstrual headaches are common, and most are related to changes in hormone levels which lead to vasodilation (larger diameter) of blood vessels, muscle contraction, and/or the physiological stress of menstruation. Many women with PMS also report headaches as part of the cyclic symptoms they experience. If headaches are severe and affecting quality of life, evaluation by a physician or healthcare provider is encouraged.

6. Acne

Some women notice an acne breakout before or during their period. These hormone-related breakouts are often on the chin or jawline but can also be on other body parts, including the back. 

The cause of premenstrual acne is multifactorial, and one possible explanation is decreased levels of progesterone during the luteal phase, which leads to an increase in the effect of androgens on the skin leading to increased sebum production, skin lipids, and skin microflora.

The severity of premenstrual acne flare-ups can change with age. One study published in the Journal of the American Academy of Dermatology found there to be a higher rate of breakouts in women over the age of 33. 

7. Diarrhea or Constipation

Those pesky prostaglandins that cause your uterine muscles to contract can cause bowel muscles to contract as well, resulting in certain gastrointestinal symptoms.

 Contraction of the bowel and other menstrually-related physiologic processes can lead to more frequent (or less frequent) bowel movements and other symptoms related to bowel irritation, like gas. Over time, you might notice that these gastrointestinal symptoms are signs your period is coming.

8. Low Energy and Fatigue/Trouble Sleeping

The luteal phase is often associated with lower energy. PMS would clinically be suspected if this decrease in energy and fatigue was severe. Low energy in the luteal phase can be attributed to a couple of things. 

The menstrual cycle is associated with changes in the serotonin neurotransmitter system, and serotonin is part of the sleep/wake cycle, mood regulation, and bowel movement control. As hormonal levels change and decrease, the serotonin levels, your energy, and your sleep cycle are all affected. Severe serotonin disruption can lead to severe symptoms experienced in PMS and PMDD (premenstrual dysphoric disorder).

9. Mood Swings

The Journal for Psychiatry and Neuroscience explains that “the gonadal steroids (estrogen and progesterone) have been shown to affect brain regions known to be involved in the modulation of mood and behavior.”

As estrogen and progesterone levels decrease during the luteal phase (prior to your period), your mood can fluctuate as well, resulting in mood swings. You may notice you’re more emotionally labile or more prone to shedding some tears in the days leading up to your period. 

If it occurs during the luteal phase in a cyclic manner and improves with the onset of menstrual blood flow, it’s not you - it’s your hormones (it’s OK, ladies, we’ve all been there). If the symptoms are severe and affect the quality of life, seeing a physician or healthcare provider is strongly encouraged.

Early Pregnancy Symptoms vs. Period Symptoms or PMS Symptoms

The signs and symptoms of the luteal phase (breast soreness, nausea, disrupted sleep, change in mood, etc.) can be confused for and/or similar to the signs and symptoms of early pregnancy—so, how can you tell the difference?

There are a few important distinctions to tip you off. If you experience any of the following early pregnancy symptoms, you may be pregnant and should schedule a visit with your doctor:

• Late or missed period 
• Positive pregnancy test
• Food aversions

How to Relieve PMS Symptoms

If you experience PMS, you’re acutely familiar with the discomfort it causes. Luckily, there are some things you can do to alleviate the physical symptoms and pain of period symptoms, as recommended by Planned Parenthood.

• Exercise, meditation, and/or yoga
• A warm bath
• Heating pad for your stomach or lower back
• Over-the-counter pain relievers like ibuprofen
• Acupuncture or acupressure
• A healthy diet rich in iron and calcium and low in sugar, salt, and caffeine
• Hormonal birth control (like birth control pills)

When to See a Doctor Regarding Period Symptoms

Luteal phase symptoms can be severe and can disrupt life. If this occurs, this is likely a sign of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) and warrants medical attention. 

The Mayo Clinic describes premenstrual dysphoric disorder (PMDD) as a severe form (sometimes disabling extension) of premenstrual syndrome (PMS).

If you think you’re suffering from severe PMS signs or PMDD, contact your doctor to discuss potential treatments.

Medically reviewed by Dr. Chimsom T. Oleka, M.D, Written by Jane Flanagan — Updated on January 10, 2023.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.