Remember when you got your very first period? Perhaps you felt tenderness or pain in new areas? Or maybe you noticed yourself feeling a bit more emotional than usual. At the time, these new sensations may have surprised or even overwhelmed you. However, as the years (and menstrual cycles) pass, the telltale signs and symptoms that precede your period become 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.
A Brief Overview of the Menstrual Cycle
There are four distinct phases of the menstrual cycle. It’s not always obvious which phase you're in, with the exception of the menstrual phase (aka your period).
Your cycle is sometimes referred to as your monthly cycle, although the average cycle lasts around 28 days. During this time, your body prepares for the possibility of fertilization and pregnancy. Your menstrual period is a sign that pregnancy did not occur.
The four phases of your menstrual cycle are:
- Menstruation or Period (~Day 1-7): The uterine lining (endometrium) and unfertilized egg shed through the vagina. This is more commonly referred to as your period.
- Follicular Phase (~Day 1-13): Hormones stimulate a buildup of ovarian follicles and the thickening of your endometrium in preparation for a possible pregnancy.
- Ovulation (~Day14-16): One of the follicles from the previous phase ruptures to release a mature egg into the fallopian tube.
- Luteal Phase (~Day 17-28): The ruptured follicle becomes the corpus luteum, which releases progesterone. If pregnancy doesn’t occur, the corpus luteum withers and dies and the endometrium breaks down. If pregnancy does occur, the cycle is disrupted and menstruation (your period) won’t occur.
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 (PMS) is a condition most women experience about a week or two before their period starts. PMS as a combination of physical and emotional symptoms that can last until a few days into menstruation.
PMS is extremely common and nothing to be concerned about, despite how uncomfortable it may feel. According to the Journal of Reproductive Medicine, over 90% of women experience PMS symptoms. Having said that, if your symptoms are extreme and regularly interfere with your daily life, you may want to consult with your doctor for some medical advice.
PMS is characterized by some very recognizable emotional and physical signs. For some women, those signs can be mild and for others they’re more noticeable. As with so many things regarding your menstrual cycle, every woman is slightly unique!
10 Signs Your Period Is Coming
Here are 10 red flags that let you know your period is about to arrive.
1. Abdominal Cramps
Abdominal cramps are a common symptom of PMS. The medical term for cramps is primary dysmenorrhea. They can range from sharp to dull pain and from general to localized. And some women never experience them at all!
The Mayo Clinic explains that cramps happen when prostaglandins released during the luteal phase trigger your uterine wall to contract. The severity of your cramps will depend on your levels of prostaglandins (hormone-like substances).
2. Breast Tenderness
Rising estrogen and progesterone levels (the gonadal hormones) affect how your breasts feel before your period.
These hormonal changes stimulate the milk ducts (mammary glands) in your breasts. This results in tenderness or lumpy/heavy feeling breasts for some women.
3. Bloating Caused by Fluid Retention
It’s not uncommon to feel like you’ve gained weight while experiencing PMS. But, don’t worry! This is temporary bloating caused by fluid retention (aka ‘water weight’). Fluctuations in the gonadotrophic hormone levels cause your body to retain more water right before your period.
4. Lower Back Pain
If you experience abdominal cramps, you may also feel pain in your lower back. As the uterine wall and abdominal muscles contract, they may also have a domino effect causing your lower back muscles to contract as well.
Hormone fluctuations can also lead to headaches since hormone levels are responsible for your body’s pain response.
In some cases, premenstrual headaches can be very severe. Around 50% of women report a strong association between getting migraines and their period. [Source]
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 severity of premenstrual acne flare-ups can change with age. One study by 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 issues as well. All of your major organs are lined with muscle, so when the muscle lining of one organ contracts, it’s common for other organs to follow suit.
Contractions of the bowels can lead to more frequent (or less frequent) bowel movements as well as other symptoms related to bowel upset like gas.
8. Low Energy and Fatigue
PMS is often associated with lower energy and tiredness. This can be the result of a couple of things. Estrogen is associated with serotonin. So as estrogen levels plummet, your serotonin levels are disrupted as well. Since serotonin is your ‘feel-good’ hormone this can lead to a feeling of fatigue.
Your sleep may also be disrupted during this time which can exacerbate any tiredness.
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.”
So, as estrogen and progesterone levels drop prior to your period, your mood can fluctuate as well. Progesterone is also known to have a ‘calming’ effect so a lack of this hormone can lead to some sensitivity. You may notice you’re more prone to shedding some tears in the days leading up to your period 😢 (it’s ok ladies, we’ve all been there).
10. Trouble Sleeping
These physical and emotional symptoms can cause a lot of discomfort, which can interrupt sleep patterns for many women.
Pregnancy Symptoms vs PMS Symptoms
The signs and symptoms of PMS are very similar to the signs and symptoms of 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, you may be pregnant and should schedule a visit with your doctor:
- You are very late or miss a period
- Milky white vaginal discharge
- Darkening of the areola and nipple area
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 pain, 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 the birth control pill)
When to See a Doctor
In rare cases, PMS is so extreme that it requires medical attention. The Mayo Clinic describes Premenstrual dysphoric disorder (PMDD) as a severe, sometimes disabling extension of premenstrual syndrome (PMS).
If you think you’re suffering from PMDD, contact your doctor to discuss potential treatments.