Understanding The Hormonal And Neurological Side Of Premenstrual Syndrome
It's a quiet confession many menstruators make before their period – an honest admission of a shift that's hard to explain but deeply felt. Too often, it's brushed off as moodiness or drama, with 'PMS' used casually to discredit what's real.
PMS, known as Premenstrual Syndrome, is far from 'just feeling off." It's a full-body change driven by fluctuating hormones, affecting mood, energy, and mental clarity. According to the National Institutes of Health, nearly 47.8% of women of reproductive age worldwide experience PMS, yet it remains minimised in daily conversations.
'PMS is not in someone's head, it's a genuine physiological and psychological experience," says Dr. Sapna Raina, Senior Consultant, Clinical Lead, Obstetrics & Gynaecology, Narayana Health City, Bengaluru. 'Acknowledging PMS and offering empathy instead of judgment is crucial, because support and simple lifestyle adjustments can significantly improve quality of life during this time," she adds.
The Science Behind PMS
During the luteal phase of the menstrual cycle, estrogen and progesterone levels shift, impacting neurotransmitters like serotonin – the brain's mood regulator. This can cause irritability, sadness, anxiety, or fatigue. For some, symptoms escalate into Premenstrual Dysphoric Disorder (PMDD) – a severe form marked by panic attacks, mood crashes, and emotional overwhelm.
As Swati Sundareswaran, CEO of Mahina, points out, '64% of menstruators say they don't feel like themselves, and 73% say hormonal changes affect them deeply, but they rarely speak up." The Mahina Beyond Blood Report 2025 also found that 97% of menstruators constantly adjust their routines, energy, and expectations during this time, often without anyone noticing.
The Silent Coping
The biggest challenge isn't just the symptoms, but the silence around them. Many continue working, parenting, and caregiving while quietly rearranging their lives to accommodate their cycles. This silence is learned; when discomfort is met with minimisation, shame replaces openness. Over time, menstruators internalise the idea that they're too sensitive, instead of recognising the lack of support around them.
What Needs to Change
The first step is empathy: listening without dismissing and creating space for honesty. Support isn't about doing more; it's about expecting less when someone is unwell. Education is equally vital. Hormonal literacy helps dismantle stigma, fosters understanding, and encourages more compassionate responses from friends, family, and workplaces.
PMS doesn't need to be 'fixed.' It needs to be acknowledged, respected, and met with the same seriousness as any other health concern.
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