PMS in Your 40s? Here’s Why It Feels More Intense

Dear MHI reader, 

Many women notice changes in their PMS (Premenstrual Syndrome) as they approach perimenopause. Symptoms may feel stronger, last longer, or appear at unexpected times. But are PMS symptoms worsening, or is something else happening?

The Link Between PMS and Perimenopause

PMS and perimenopause are both caused by hormonal changes, so they are closely linked.

While PMS occurs before your period due to shifts in oestrogen and progesterone, causing 

mood swings, bloating, and fatigue; perimenopause, on the other hand, is the transition to menopause, brings similar symptoms—plus irregular periods, hot flashes, and sleep issues. 

The difference? PMS follows a pattern, while perimenopause can feel unpredictable. 

Although, managing both often involves lifestyle changes, stress management, and sometimes medical support.

Why Does Premenstrual Syndrome Feel Worse During Perimenopause? 

During the perimenopausal phase, your hormones become more unpredictable, causing stronger mood swings, cramps, and fatigue. 

Here’s what’s going on:

1. Unstable Hormones

Oestrogen and progesterone levels rise and fall unpredictably, making PMS symptoms worse.

2. Irregular Periods

Your cycle may change, bringing PMS more often or lasting longer.

3. Stronger Mood Swings

You may feel more emotional, anxious, or irritable.

4. More Physical Discomfort

Bloating, cramps, and headaches can feel more intense.

5. Sleep Problems

Poor sleep makes PMS symptoms harder to handle.

How PMS Symptoms Change During Perimenopause

PMS symptoms may not worsen, but they often present differently. Many women experience shifts in timing, with symptoms starting earlier or lasting longer than before.

• Physical discomforts like bloating, headaches, and breast tenderness may persist beyond the usual premenstrual phase, making them seem more pronounced.

• Sleep disturbances are also common, leading to fatigue and irritability, which can heighten the impact of other symptoms

• Mood swings can feel more intense as fluctuating hormone levels affect emotional stability. 

How Can You Manage PMS During Perimenopause 

Although PMS symptoms may feel different, there are ways to manage them effectively. These include: 

• Lifestyle Adjustments: A balanced diet, regular exercise, and stress management help stabilise symptoms.

• Medical Support: Hormonal therapy or supplements like magnesium and vitamin B6 can ease discomfort.

• Tracking Symptoms: Keeping a journal helps identify patterns and triggers.

• Consulting a Doctor: If symptoms severely affect daily life, medical guidance may be needed.

PMS during perimenopause may feel worse, but this is often due to hormonal unpredictability rather than an actual increase in severity. Recognising these changes and adopting strategies can help you navigate this transition smoothly.

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