Psychosomatics of PMS
PMS is a set of symptoms that appear a few days before your period and go away once it starts: irritability, tears, swelling, breast pain, headache, food cravings. It affects many women, but if symptoms get in the way of work and relationships, see a gynecologist, who will rule out other causes and choose treatment. The Ladder method adds questions about what builds up in you over a month.
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When to see a doctor
Book a doctor’s appointment if you notice:
- Mood swings, irritability, tears before your period
- Bloating, swelling, breast tenderness and pain
- Headache, tiredness, poor sleep
- Sugar cravings and a change in appetite
- Symptoms start one to two weeks before your period and go away when it starts
- They get in the way of work and relationships
A gynecologist examines and treats PMS, and a psychiatrist joins in if mental symptoms are severe. Start with a gynecologist and bring a symptom diary.
What medicine knows
Premenstrual syndrome, PMS, according to the clinical protocol of the Kazakhstan Ministry of Health (2023), is a set of symptoms before menstruation with neuropsychiatric, vascular and metabolic signs. They are tied to the luteal phase of the cycle: they appear 2 to 14 days before your period and go away after it. PMS can occur at any age.
The NHS names the most common symptoms: mood swings, irritability, low mood, anxiety, tiredness, trouble sleeping, bloating and cramps, breast pain, headaches, spots, food cravings. Symptoms differ from woman to woman and from cycle to cycle. Most women have PMS at some point.
The protocol distinguishes a mild form, when work and life don’t suffer, a moderate one and a severe one. The most severe form is called premenstrual dysphoric disorder: strong symptoms appear a week before your period, go away within a week after it and last for at least a year.
A doctor looks at how symptoms follow your cycle and, if needed, orders hormone tests: prolactin, estradiol and progesterone, twice, in the first and second phase of the cycle. Both the protocol and the NHS advise keeping a symptom diary, and the NHS asks you to record symptoms for at least two cycles.
As non-drug measures the protocol advises physical activity, less stress, and less alcohol and caffeine. Medicines, such as oral contraceptives or antidepressants, are prescribed only by a doctor: antidepressants, according to the protocol, on a psychiatrist’s recommendation.
In the Ladder method
In the Ladder method, PMS becomes a reason to look at what builds up in you all month. It is not an explanation of why the symptoms appear but a question to yourself: what do you put up with in silence, and where are you short of rest and support?
Before their period many women notice that what was “fine” all month suddenly becomes unbearable: noise, other people’s demands, the load of household chores. In these days you want things quieter and gentler, while life still demands that you be convenient for everyone.
On the ladder you can sort this out: which phrases and expectations of other people hold you (“be patient,” “don’t get upset over nothing”) and where you can ask for help. Diagnosis and treatment of PMS stay with the gynecologist.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
Frequently asked questions
Can PMS come from nerves?
The cause of PMS is not fully understood. The NHS thinks it may be linked to changes in hormone levels during the cycle, and some women are more sensitive to these changes than others. Among general advice the protocol of the Kazakhstan Ministry of Health names reducing stress, but PMS is treated by a doctor.
What does PMS mean in psychosomatics?
PMS has no proven “meaning.” In the Ladder method it becomes a reason to look at what builds up over a month: the unspoken “enough,” fatigue, lack of support. These are questions to yourself, not an explanation of why the symptoms appear.
When is PMS a reason to see a doctor?
If symptoms get in the way of work and relationships, lifestyle changes don’t help, or you feel very anxious and low before your period. The NHS advises seeing a doctor in such cases, ideally with a symptom diary for at least two cycles. The protocol of the Kazakhstan Ministry of Health names a gynecologist, and a psychiatrist for severe symptoms, as the doctors who treat PMS.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.