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More than 90% of individuals who menstruate experience some degree of premenstrual syndrome or PMS.[1]  Given the similarity between some PCOS symptoms and many individuals with PCOS experiencing irregular cycles, it may be difficult to distinguish which symptoms are related to PMS and which are from PCOS.

Given the overlapping prevalence between PCOS, ADHD and Autism and Premenstrual Dysmorphic Disorder (PMDD), an extreme form of PMS, individuals with PCOS are more likely to experience PMDD.

In this article we explore the link between PCOS and PMS.

A typical menstrual cycle relies on a complex interplay of chemicals over a cycle of around 28 days and comprised of four key phases:[2]

  • Menses: the uterus sheds its lining if pregnancy hasn’t occurred from day 1 of the cycle for a typical period of 3-7 days;

  • Follicular: overlapping with menses and lasting for 10-14 days, the lining of the uterus is restored and follicles in the ovaries grow to produce (usually) a single mature egg or ovum;

  • Ovulation: at roughly day 14, an eggs is released; and

  • Luteal: from day 15-28 the egg travels to the uterus and, if fertilized by a sperm, implants into the uterine wall.

During the luteal phase, the c. 14 days after ovulation leading up to menstruation, the follicle that released an egg changes in structure to become the corpus luteum.[3]  This corpus luteum produces progesterone and estrogen to prepare the uterus for potential pregnancy and prevent bacteria entering the uterus.[4]  Symptoms of this luteal phase include:[5]

  • Mood changes;

  • Breast tenderness;

  • Bloating;

  • Breaking out or acne: and

  • Changes in appetite.

As the luteal phase comes to a close leading up to menstruation, individuals may experience a range of physical and emotional symptoms associated with both PMS and PCOS:[6]

  • Fatigue, insomnia and frequent napping;

  • Bloating;

  • Cramps;

  • Breaking out or acne;

  • Breast tenderness;

  • Headaches;

  • Mood changes, including irritability, anxiety and/or depression;

  • Difficulty concentrating;

  • Changes in appetite, including cravings and/or increased/decreased appetite; and

  • Diminished interest in activities, including sex.

PMS symptoms can also be exacerbated by a range of other factors including:[7]

  • High levels of stress;

  • Family history of depression;

  • Personal history of postpartum depression (PPD) or depression;

  • Age, with women in their 30s at most risk from experiencing PMS;

  • Depression and/or anxiety disorders may be heightened; 

  • Myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS) may have worsening symptoms;

  • Iritable bowel syndrome (IBS) symptoms (cramping, bloating and gas) may worsen;

  • Bladder pain syndrome may cause more frequent painful cramps; and

  • Other health conditions may be exacerbated such as asthma, allergies and migraines.

Reviewed by Sonia Kalra, CEO of NatureMary, biologist and advocate for women’s health


Welcome to Naturemary, where we're pioneering natural solutions for bodycare & pain relief. Our founder Sonia's expertise in Biology & Neuroscience, coupled with her personal struggle with PMDD, inspired her to pioneer effective natural solutions. Harness the power of nature with Bioterpene™ Technology, a cutting-edge innovation in pain relief and body care. Bioterpene™ Technology is designed to provide fast-acting and targeted relief for skin and body.


Want to learn more about menstrual conditions related to PCOS? Check out the sections on PMDD, menstrual cramps and irregular periods.

Symptoms - Menstrual Health

PCOS and Premenstrual Syndrome (PMS)

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