Risk Factors

PMS & Risk Factors: What Makes Symptoms Worse?

Premenstrual Syndrome (PMS) risk factors are characteristics or behaviors that increase the likelihood of developing PMS. It’s important to note here that having one or more risk factors doesn’t guarantee that you will develop the condition. However, it may make you more susceptible to PMS.

What are the common risk factors?

Research shows that a combination of biological and environmental factors can contribute to the development and intensity of your PMS symptoms¹. Here are some of the most well-documented risk factors:

1

Age

PMS symptoms typically begin between the ages of 25 and 35 and may worsen with age. Women in their 30s and 40s, particularly those approaching perimenopause, often report increased severity of symptoms due to fluctuating hormone levels.

2

Family history

If PMS runs in your family, you may be more likely to experience it yourself! Genetic predisposition plays a role, so if your mother, sister, or other female relatives have struggled with PMS, your risk may be higher.

3

Psychological factors

Mental health conditions, like depression, anxiety, and mood disorders, can increase the risk factors of PMS.

4

Lifestyle

Certain habits and lifestyle choices can exacerbate PMS symptoms, including:

1. Chronic stress, which can contribute to heightened emotional or physical symptoms.

2. A poor diet, coupled with excess caffeine, sugar, or processed foods.

3. Lack of exercise, as it hinders your hormonal balance and mood.

4. Poor sleep quality, which can intensify fatigue, irritability, and mood swings.

5

Reproductive history

Hormonal fluctuations – caused by past pregnancies (or miscarriages), hormonal contraceptives, birth control, or menstrual irregularities – may impact PMS severity.

6

Obesity & weight gain

Excess body weight is a risk factor for PMS, as it can disrupt hormonal balance and exacerbate inflammation in your body.

What can make PMS worse?

Studies show us that certain influencing factors often exacerbate PMS symptoms.

PMS has been positively correlated with psychological factors, such as depression and stress, sleep disturbances, and poor eating habits or eating disorders². Here is an explanation as to why some of these influencing factors increase PMS symptoms:

1. Stress & Depression

While not direct causes, stress and depression can heighten PMS symptoms as they cause hormonal fluctuations and increased emotional sensitivity.

2. Sleep Disturbances

As a core human need, sleep remains essential in maintaining good health, satisfaction, and overall quality of life³. That is why poor sleep quality, not just sleep duration, is a key determinant of PMS.

3. Unhealthy Eating Habits

Disordered eating, binge-eating, and emotional eating are linked to more severe PMS, with stronger effects in cases of PMDD. This is because imbalanced eating habits can disrupt hormonal regulation and blood sugar, worsening PMS symptoms.

Since PMS affects your physical and emotional wellbeing, healthcare professionals and institutions should focus on personalized interventions that holistically improve stress management, sleep quality, and nutrition.

How does PMS impact your health?

Studies show that hormonal fluctuations during the menstrual cycle may exacerbate mental health disorders and psychiatric symptoms in hormone-sensitive women⁴. In fact, research shows clear evidence of PMS symptom exacerbation during the perimenstrual phase⁴ for:

• Psychotic disorders

• Panic disorder

• Eating disorders

• Depression

• Borderline personality disorder

Although there is less consistent evidence around anxiety-related conditions, certain studies have shown that women dealing with generalized anxiety disorders experience an increase in repetitive negative thinking during the luteal phase of their menstrual cycle⁵.

Each of these facts indicate that our biological processes are more powerful than we think, influencing core cognitive processes!

If you’re experiencing any of these symptoms, don't worry! We recommend speaking to your family doctor or, ideally, a gynaecologist, who can provide more specialized guidance and care.

References

1. Dickerson, LM., Mazyck, PJ., Hunter, MH., (2003). Premenstrual Syndrome. Medical University of South Carolina, Charleston, South Carolina
2. Yi, S.J., Kim, M. & Park, I., (2023). Investigating influencing factors on premenstrual syndrome (PMS) among female college students. BMC Women's Health 23, 592.
3. Garbarino, S., Lanteri, P., Durando, P., Magnavita, N., Sannita, WG., (2016). Co-morbidity, mortality, quality of life and the healthcare/welfare/social costs of disordered sleep: a rapid review. Int J Environ Res Public Health;13:8831.
4. Nolan, L., Hughes, L., (2022). Premenstrual exacerbation of mental health disorders: a systematic review of prospective studies. Archives of Women's Mental Health. 25. 1-22. 10.1007/s00737-022-01246-4.
5. Li, Sophie & Denson, Thomas & Graham, Bronwyn. (2020). Women With Generalized Anxiety Disorder Show Increased Repetitive Negative Thinking During the Luteal Phase of the Menstrual Cycle. Clinical Psychological Science. 8. 216770262092963. 10.1177/2167702620929635.