Bad PMS Symptoms? A Hormonal Imbalance Might Be to Blame

Bad PMS Symptoms? A Hormonal Imbalance Might Be to Blame

Photo Credit: The Nude Label

With zero judgy undertones, we’d like to ask you: Are you familiar with your female reproductive hormones? Do you know where they come into play throughout your cycle, or the side effects they tend to be associated with? Do you know, for that matter, what the different phases of your cycle are?

Don’t feel bad if you’re a little fuzzy on the details—so much of what we are taught about our bodies centers around our periods when in reality, bleeding is just one symptom of a 28-day hormonal cycle. We know what PMS symptoms to expect; we might even have certain rituals that bring us relief. But if we’re ignoring the other three weeks of our cycle, then we may not be living by the most balanced version of our health. So let’s get better acquainted with our hormones, shall we?

First, a quick refresher on the 4 phases of your menstrual cycle:

The menstrual cycle is typically around 28 days, although this number is different for everyone. (It can also fluctuate depending on your age, life stages like menopause, or external factors like hormonal birth control.) Throughout each of these phases, your hormones send messages back and forth between the brain, ovaries, and uterus.

It consists of 4 phases:

  1. Menstruation, or your period. This is the 3-8 day period when your uterus sheds its lining.
  2. Follicular phase, which actually starts on the first day of your period and lasts for about 2-3 weeks. This is the phase when an egg matures in our ovaries, and it’s also the most fertile time of our cycle—especially in the days leading up to ovulation. During our follicular phase, we tend to feel our most optimistic and energetic. (You have your hormones to thank for that—more in a minute.)
  3. Ovulation, which is the roughly 24-hour period when a mature egg drops from our ovaries, along a fallopian tube toward the uterus.
  4. During the luteal phase, which lasts about 14 days, the uterus lining thickens in preparation for pregnancy. If an egg hasn’t been fertilized, then the luteal phase ends when we get our period. The end of our luteal phase is what we associate with PMS—we might feel irritable and experience symptoms like sore breasts, bloating, and fatigue. (You have your hormones to thank for that, too.)

What are the main reproductive hormones for women?

While we have a chorus of hormones that can impact how we’re feeling day-to-day, the main hormones that drive our menstrual cycle are estrogen and progesterone—along with some other key players.


“Estrogen is the hormone that is released as our egg is maturing, so it dominates the first half of the menstrual cycle, or the follicular phase,” Dr. Caitlin O’Connor, Naturopathic Doctor with a specialty in holistic treatment for women and children, explains. This hormone has some big jobs. “Estrogen helps to lay down the lining of the uterus; it changes the cervical fluid so that conception can occur; and it also has more systemic impact—it helps with brain function, cardiovascular health, and circulation.”


As estrogen levels rise during the follicular phase, follicle-stimulating hormone, or FSH, is produced by the pituitary gland. This hormone essentially tells the ovaries to prepare for ovulation.


When estrogen levels are high enough, a signal is sent to the brain to produce a chemical called Luteinizing Hormone—which in turn triggers the egg to drop down the fallopian tube towards the uterus. This is ovulation.

After the dominant follicle that held the egg release it, it turns into something called the corpus luteum, which makes even more hormones to support pregnancy. If the egg isn’t fertilized by sperm, then the corpus luteum breaks down.


“After ovulation, the follicle where the egg was hanging out starts to produce progesterone, which is the dominant hormone of the second half, or the postovulatory phase of the menstrual cycle,” says Dr. O’Connor. “Progesterone helps to create a more well-nourished uterine lining so that if the egg is fertilized, it has a place to go for implantation.”

And interestingly enough, progesterone is intended to counteract some of the moodiness we associate with PMS. “Progesterone is also a calming hormone, so we see that progesterone helps people produce more GABA, a common neurotransmitter in the brain,” Dr. O’Connor says. Because of this, “oftentimes when people have emotional PMS type symptoms in the second half of their cycle, it can mean that progesterone is not functioning optimally.”

On the flip side, if you notice that you feel particularly relaxed or good-natured during the first week of your luteal phase, you can probably credit the rise in progesterone.


Curious about the mechanics behind period cramps? It’s all thanks to hormones called prostaglandins, which start to rise following ovulation. Rest assured that the purpose of (mild) cramping isn’t to make you miserable—these muscle contractions help to break down the lining of your uterus, starting your period.

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On that note: What are some symptoms of a reproductive hormonal imbalance?

1. Cycle Irregularity 

“One of the greatest hallmarks of a reproductive hormonal imbalance would be menstrual irregularity, or having cycles that vary greater than three to five days from month to month,” Dr. O’Connor says. “Different people can have some variation in the length of their cycle—for example, some people’s normal is a 26-day cycle and some people’s normal is a 32-day cycle—but if we are seeing variation from month to month this may indicate an issue,” Dr. O’Connor explains. It’s also important to take note of “variations in bleeding, like spotting in between menstrual cycles or long or excessive bleeding as those symptoms can also indicate issues with the reproductive hormones.”

2. Severe Cyclical Symptoms

“The other thing that I pay attention to is any symptom that happens cyclically,” says Dr. O’Connor. “So for example, if someone has migraines but they only have them during a specific phase of their menstrual cycle, then that gives us a clue that the symptom may be related to the reproductive cycle. Or, for example with mood, if they’re feeling good three weeks out of the month but one week out of the month feels really terrible, that’s a good indicator.”

Also note that if it’s clear that your symptoms are related to your cycle, and these symptoms tend to be severe, this can be a sign of an underlying imbalance: Believe it or not, really heavy or painful periods (also known as dysmenorrhea), intense mood swings, or really bad hormonal breakouts are not supposed to be status quo, nor something to suffer through. If you have highly irregular periods or your symptoms are consistently disrupting your life, it’s best to check in with your OB/GYN to rule out an underlying condition like PCOS or endometriosis.

How can I support hormonal balance in my daily routine?

“The first step is to track and pay attention to your symptoms,” Dr. Connor says. “I have my patients track symptoms on a tracking app, because oftentimes we can see patterns.”

The second step is to consider our broader routine. “Sometimes our habits related to sleep, stress management, nutrient intake and exercise patterns are a good place to start,” she adds. These foundational habits deeply tied to our hormonal health, after all: Chronic stress, lack of sleep, or low blood sugar can all trigger our cortisol levels, which in turn has an impact on our reproductive hormones. (It’s why when we’re consistently stressed, it can result in an irregular or missed period.)

On the flip side, if these foundational habits are in check but you’re still experiencing intense PMS symptoms, this is probably a good sign to get your hormone levels checked.

Have any specific hormone questions for our experts? Ask away on social or drop us an email. Plus, shop our doctor-founded Women’s Daily Vitamin Trio for full-spectrum nutrition plus added nutrients to support your mood and beauty, too.

Further reading:

  1. The Menstrual Cycle: Menstruation, Ovulation, and How Pregnancy Occurs. ACOG.
  2. Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. National Library of Medicine.

This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.

Written by Jessica Lopez. Jessica Lopez is a freelance writer, digital content creator, and new mother. She has covered all lifestyle topics ranging from bridal to beauty for publications including Brides Magazine, Byrdie, THE/THIRTY, and more. Walking wide-eyed into motherhood has inspired her to connect with other parents through her writing and shared experience. You can follow more of her journey @Jessica.H.Lopez.