How perimenopause causes worsening PMS

Every person who’s had a period will tell you that PMS (premenstrual syndrome) is one of the worst side effects. Some have it worse than others, but most experience it to some degree. 

As its name suggests, PMS occurs before the onset of your period. Symptoms include tender breasts, mood swings, fatigue, bloating, food cravings, and even depression. It typically starts 5-10 days before your period begins and dissipates shortly after or at the start of your period. PMS can be a telltale sign of when your period is about to begin. PMDD (premenstrual dysphoric disorder) is a severe form of PMS that occurs in about 5% to 8% of menstruating women

Both PMS and PMDD can worsen during the years of perimenopause and generally resolve when menopause begins. But during perimenopause, when periods are irregular, it can be hard to predict what to expect from your PMS symptoms.

What is PMS and PMDD during perimenopause

Just like during your period, PMS and PMDD can occur with similar symptoms during perimenopause. According to a study published in the British Menopause Society in 2004, “Women seem more prone to PMS symptoms during the perimenopause.” And perimenopause already has its own difficult set of symptoms, so when you add PMS to the mix, your other symptoms might feel worse. So, is PMS really worse during menopause or is it just less manageable as you get older and have other symptoms to manage? 

PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause as your hormones are shifting. If you had challenging symptoms of PMS before perimenopause or if you find that your moods tend to be significantly impacted by your cycle, you’re more likely to feel the impact of the hormone fluctuation that happens during perimenopause and menopause.

Managing PMS during perimenopause

Since PMS typically occurs after ovulation, taking birth control or hormone therapy to suppress ovulation can help you avoid PMS in perimenopause. The same way you’d cope with PMS before perimenopause is similar to how you’d cope with it now. Depending on your symptoms and what your doctor suggests, you can try lifestyle changes and home remedies like getting plenty of sleep, modifying your diet, and taking multivitamins. 

Reviewed by the Ovia Health Clinical Team


“Premenstrual dysphoria disorder: It’s biology, not a behavior choice.” Harvard Health Publishing. Harvard Health Publishing. May 30, 2017.

Perry, Shannon. “PMDD and Menopause: What is it and why is it worse in perimenopause?” Gennev. Gennev. July 17, 2019.

Ismail Hassan 1, Khaled M K Ismail, Shaughn O’Brien. “PMS in the Perimenopause”. British Menopause Society. 10(4):151-6. Web. December 2004.

” Premenstrual Syndrome”. Office on Women’s Health. Office on Women’s Health. February 22, 2021.

Mayo Clinic Staff. “Premenstrual Syndrome”. Mayo Clinic. Mayo Clinic. Feb 25, 2022.

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