During perimenopause, or before menopause, apart from mood changes such as anxiety, the menopause blues and mood swings, we may also experience changes in our PMS (premenstrual syndrome).

Perimenopause Hormones

During perimenopause do our hormones declined in a regular fashion?

In Sexual Health & Menopause Online: Changes At Midlife – Changes In Hormone Levels: Estrogen the North American Menopause Society elaborate on:

“Estrogen levels generally decline during perimenopause, but they do so in an irregular fashion. Sometimes there can be more estrogen present during perimenopause than in the past”.

Perimenopause PMS

During perimenopause does our PMS declined in a regular fashion?

Just as our estrogen may not decline in a regular fashion, neither may our PMS. In Premenstrual Syndrome (PMS): Does PMS Change With Age? the Office on Women’s Health,  United States Department of Health and Human Services, Womenshealth.gov explain:


“Yes. PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause.

This is especially true for women whose moods are sensitive to changing hormone levels during the menstrual cycle. In the years leading up to menopause, your hormone levels also go up and down in an unpredictable way as your body slowly transitions to menopause. You may get the same mood changes, or they may get worse.

PMS stops after menopause when you no longer get a period”.

Premenstrual Syndrome (PMS)

What is PMS?

Depending on the Source (DotS), the definition of PMS may vary. In PMDD/PMS the (United States) Massachusetts General Hospital) MGH Center for Women’s Mental Health’s definition is:

“Premenstrual Syndrome, commonly referred to as PMS, is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients”.

Premenstrual Syndrome (PMDD)

What is PMDD?

DotS, the definition of PMDD may vary. In What Is PMDD? the International Association for Premenstrual Disorder’s (IAPMD) definition is:

“Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder with symptoms arising during the premenstrual, or luteal phase of the menstrual cycle and subsiding within a few days of menstruation. It affects an estimated 5.5% of women and AFAB individuals of reproductive age. While PMDD is directly connected to the menstrual cycle, it is not a hormone imbalance. PMDD is a severe negative reaction in the brain to the natural rise and fall of estrogen and progesterone. It is a suspected cellular disorder in the brain. Symptoms can worsen over time and or around reproductive events such as menarche (the first menstrual cycle), pregnancy, birth, miscarriage, and perimenopause”.

How may PMDD be diagnosed?

In Tracking Your Cycle & Symptoms the IAPMD note:

PMDD cannot be diagnosed via blood, hormone, or saliva test. These tests can, however, rule out any underlying disorders including hormone imbalance or thyroid issues. The only way to currently test for PMDD is by tracking symptoms for a span of two more menstrual cycles”.

Monthly Diary

Meno Martha, PMS and PerimenopauseMay keeping a monthly diary help?

In PMDD/PMS: Non-Pharmacologic Treatment for PMS and PMDD – Monthly Mood Charting the MGH Center for Women’s Mental Health elaborate on:

“Keeping a calendar or diary of your symptoms can help you identify the symptoms that are causing you the most trouble. Writing down your symptoms on a calendar can help you understand possible triggers for your symptoms. It can also help your health care provider choose an approach that is most helpful for you”.

In Menstrual Diary the (United Kingdom) National Association for Premenstrual Syndrome explain:

“A completed menstrual chart is the first step towards understanding your own menstrual health. Download the menstrual diary.

Our chart helps you to record accurately your menstrual cycle, to note related symptoms as they occur, to define when you are symptom-free, to plot your days of menstruation and to note the duration of your cycle”.

In Premenstrual Syndrome – Self Care: Keep A Diary of Symptoms the (United States) MedlinePlus explain:

“Keeping a calendar or diary of your symptoms can help you identify the symptoms that are causing you the most trouble. Writing down your symptoms on a calendar can help you understand possible triggers for your symptoms. It can also help your health care provider choose an approach that is most helpful for you. In your diary or calendar, be sure to record:

  • The type of symptoms you are having
  • How severe your symptoms are
  • How long your symptoms last
  • Whether your symptoms respond to a treatment you tried
  • At what point during your cycle your symptoms occur

You may need to try different things to treat PMS. Some things you try may work, and others may not. Keeping track of your symptoms may help you find the treatments that work best for you”.

Monthly Diary Format

Where may I find a monthly diary format so I can record any symptoms I have?

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Health Care Provider

What if I would like help with PMS or PMDD or PME?

If you would like help with PMS or PMDD or PME, it may be in your best interest to choose to talk to your health care provider about this.

In Premenstrual Syndrome (PMS): Symptoms & Causes – Symptoms: When To See A Doctor the (United States) Mayo Clinic explain:

“If you haven’t been able to manage your premenstrual syndrome with lifestyle changes and the symptoms of PMS are affecting your health and daily activities, see your doctor”.

In Premenstrual Syndrome (PMS): Management & Treatment of PMS Symptoms – Things To Keep In Mind the (Australian) Jean Hailes for Women’s Health note:

  • “If symptoms persist and interfere with daily activities, see your doctor or seek referral to a gynaecologist with expertise in PMS”.

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Last Updated: 24 November 2022 – Last Revised: 01 November 2022