Why Is My PMS So Bad?

Severe PMS Symptoms, PMS Rage, PMDD & What Actually Helps

Author: Dr Lauren Holland

Are you searching:

• Why are my PMS symptoms so extreme?
• Why do I get so angry before my period?
• How do I calm PMS rage fast?
• Is this normal PMS or PMDD?
• Why is my PMS getting worse with age?
• What vitamins actually help PMS?

If you feel like a different person before your period, you are not alone.

Premenstrual syndrome (PMS) affects up to 3 in 4 women. However, severe PMS can feel overwhelming, frightening, and exhausting.

This guide explains:

• What causes severe PMS
• Why PMS mood swings happen
• When PMS becomes PMDD
• Natural treatments that work
• Medical treatments that work
• When to see a doctor

Let’s break it down clearly.

What Causes PMS?

PMS occurs after ovulation during the luteal phase of your menstrual cycle.

After ovulation:

• Progesterone rises
• Oestrogen fluctuates
• Serotonin levels may drop
• Inflammation markers may increase

Your brain responds to these hormonal shifts.

For some women, the response is mild. For others, the brain is highly sensitive to normal hormonal changes.

Important: PMS is not caused by “too much hormone.” It is caused by sensitivity to hormonal change.

Why Are My PMS Symptoms So Severe?

If your PMS feels extreme, there are usually contributing factors.

1. Hormone Sensitivity

Some women have increased neurological sensitivity to progesterone shifts.

This can cause:

• Irritability
• Anxiety
• Mood swings
• Brain fog

2. Stress & Cortisol

High stress increases cortisol.

Cortisol disrupts:

• Sleep
• Blood sugar
• Serotonin balance

Chronic stress makes PMS worse.

3. Blood Sugar Imbalance

Skipping meals or eating high sugar diets can:

• Increase irritability
• Increase anxiety
• Worsen fatigue
• Trigger cravings

4. Vitamin Deficiencies

Low levels of:

• Vitamin D
• Magnesium
• Iron
• B vitamins

can intensify PMS symptoms.

5. Thyroid Dysfunction

Many women assume it is PMS when it may be:

• Underactive thyroid
• Iron deficiency
• Early perimenopause

If symptoms are new or worsening, testing may help.

Severe PMS Symptoms Checklist

Emotional PMS Symptoms

• PMS rage
• Snapping at loved ones
• Crying over small things
• Anxiety before period
• Feeling hopeless
• Relationship conflict
• Loss of motivation
• Social withdrawal

Physical PMS Symptoms

• Severe bloating before period
• Breast swelling
• Headaches or migraines
• Extreme tiredness
• Insomnia before period
• Joint pain
• Acne flare-ups
• Food cravings

Symptoms typically improve once your period begins. If symptoms continue all month, it may not be PMS alone.

How Bad Can PMS Mood Swings Be?

Many women search:

“Is it normal to feel depressed before my period?”

Mild mood shifts are common.

However, severe PMS can include:

• Intense anger
• Panic attacks
• Sudden relationship breakdowns
• Feeling out of control
• Thoughts of self-harm (in rare cases)

If this happens, it may be PMDD.

PMS vs PMDD: What’s the Difference?

Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS.

It affects around 3 – 8% of women.

Signs of PMDD:

• Severe depression before period
• Extreme irritability
• Intense anxiety
• Panic attacks
• Suicidal thoughts
• Missing work or cancelling plans
• Feeling relief once period starts

If this sounds familiar, seek medical advice urgently.

PMDD is real, and it is treatable.

Why Is My PMS Getting Worse in My 30s or 40s?

This is one of the most searched PMS questions.

Hormone fluctuations increase during perimenopause.

Ovulation becomes less predictable.

This can cause:

• Heavier periods
• Worse mood swings
• Breast tenderness
• Anxiety spikes
• Sleep disruption

If PMS suddenly worsens after age 35 – 40, hormone testing may be helpfu