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While experts don’t know exactly what causes premenstrual syndrome — or PMS — hormones are likely the main culprit.

Your hormonal balance changes as your estrogen and progesterone levels fall, leading up to your period. Hormones greatly affect mood, digestion, energy, and fluid retention.

On top of that, when your period starts, your uterus contracts to shed its lining, which can cause painful cramps.

PMS symptoms can start anytime in the five days before your period. They typically last for four days after your period starts. Common symptoms of PMS include:

• Anxiety
• Breast tenderness
• Cramps
• Feeling bloated
• Food cravings
• Headaches
• Mood swings
• Sleep problems
• Trouble concentrating

How Can I Manage Menstrual Wellness?

Wondering how to take care of yourself during your period naturally? These steps can help with overall PMS relief.

Avoiding infections, rashes, and odors

Making hygiene a priority during your period can help you avoid infections, rashes, and odors.

Poor hygiene can lead to urinary tract infections (UTIs), yeast infections, or discomfort, all of which can impact daily life and self-confidence. On the other hand, good menstrual hygiene and proper self-care support overall menstrual wellness and help maintain hormonal balance throughout your cycle.

Experts recommend that you:

• Avoid scented pads — These can irritate the skin.
• Avoid tight, non-breathable clothing — Tight, non-breathable fabric can trap moisture and heat, making it easier for bacteria to grow. Cotton fabrics will help you feel more comfortable during your period.
• Change pads often — Change pads every few hours or more frequently, if necessary.
• Change tampons frequently — You should never wear a tampon for more than eight hours. Use the lowest absorbency needed for your level of flow to reduce the risk of toxic shock syndrome, a rare but dangerous complication of a bacterial infection.
• Change period underwear every six to 12 hours — If your flow is heavy, you may need to change period underwear every six hours. Rinse period underwear and then machine wash it.
• Clean menstrual cups or discs often — You should wash and rinse your menstrual cup or disc after each use. At the end of your period, sanitize your cup or disc by placing it in boiling water for one to two minutes.

Best foods to eat during your period

How you eat can improve or worsen your PMS symptoms. Following these healthy guidelines for two weeks before your period can lessen cramps, bloating, fatigue, and moodiness.

• Avoid caffeine and alcohol — You’ll feel more sluggish after the effects wear off.
• Avoid sugary drinks and foods — They can increase bloating and cause your blood sugar to peak and then crash, which worsens mood symptoms.
• Drink plenty of fluids — Staying hydrated can help you flush out sodium, which can make you feel bloated.
• Eat foods high in calcium — Studies show this mineral can reduce PMS symptoms like fatigue and depression. You can find calcium in milk, cheese, and yogurt; manufacturers may add it to cereals and bread. You can also take a calcium supplement.
• Eat smaller meals more often — Eating slightly less at each meal and adding healthy snacks between meals can keep your blood sugar level stable. This will help with symptoms of fatigue and irritability, bringing overall PMS relief.
• Increase your intake of magnesium — Magnesium can help with bloating and cramps. Leafy greens, nuts, whole grains, sweet potatoes, and tofu are high in magnesium. You can also take a supplement.
• Limit processed and fried foods — These are high in sodium.

How Can I Manage Period Pain?

Some women experience hardly any period cramps, while others find period cramps to be excruciating. If you tend to have painful cramps, these period comfort tips can help.

• Try massage — Either standing or lying down, use your fingers to make circular motions in the lower back where you feel pain. Better yet, book a massage on the day your cramps are the worst, or teach a loved one how to massage your back.
• Have a warm bath with Epsom salts — This can help relieve muscle pain.
• Try over-the-counter pain medications — Ibuprofen (Advil or Motrin) or acetaminophen (Tylenol) can help relieve pain.
• Use a hot water bottle, heating pad, or warm compress — These help when placed on your lower abdomen. Heat can help relax muscles and reduce cramps.

Can Exercise Help PMS Symptoms?

Exercising throughout the month, including during your period, can lower your overall PMS symptoms. The American College of Gynecologists recommends that you aim for 30 minutes of exercise on most days, including period days. Even 15 minutes a day does wonders for your health.

On your heaviest flow day, you may not want to exercise vigorously. But yoga, stretching, or walking can lift your mood, increase energy, and help with cramps.

How Can I Take Care of Emotions During My Period?

Some women find that PMS affects their mood and sleep patterns. If you’re more stressed and emotional before and during your period, try these tips:

• Don’t overcommit — If you find you don’t feel like going to a party or volunteering on the first day of your period, try to avoid committing yourself. A period tracker app can tell you when to expect future periods so you can plan accordingly.
• Prioritize sleep — Changing hormones can make it difficult to fall asleep in the days leading up to your period. You may need to take extra steps to boost your sleep hygiene. Avoid screens one hour before bed. Instead, do a wind-down activity at the end of the day, like reading or listening to a podcast. Try to go to bed at the same time every night, as this will help you fall asleep faster.
• Try meditation — Deep breathing can help you cope with the up-and-down emotions that come with PMS.

When Should I See a Doctor About PMS Symptoms?

If you have severe PMS symptoms, a gynecologist can help. Treatments for PMS problems can include medications and lifestyle changes.

See a doctor if you have:

• Extreme mood symptoms — Extreme sadness, anxiety, irritability, or anger leading up to your period could mean premenstrual dysphoric disorder (PMDD). This affects about 3% of women, according to a 2024 systematic review.
• Heavy bleeding — This means soaking through a pad or tampon every two hours or a heavy period that lasts more than seven days. It could be due to a bleeding disorder, problems with your uterus, or a hormonal problem.
• Irregular periods — These may indicate a medical problem that can be improved with treatment.
• Very painful cramps — If over-the-counter pain medications don’t help, your doctor can suggest other treatments.