Perimenopause and PMS

PMS describes physical or emotional symptoms that appear before a period and ease after bleeding starts. During perimenopause, cycles may become shorter, longer or irregular, and ovulation may not happen in every cycle. That can make breast tenderness, bloating, headaches, cramps, irritability, low mood or sleep changes arrive at unexpected times.

A changing pattern does not prove that every symptom is PMS. Pregnancy, thyroid conditions, medication effects and other health problems can overlap with the menopause transition. Recording symptoms alongside bleeding dates helps a clinician separate a cycle-related pattern from symptoms that continue throughout the month.

Keep a simple diary of bleeding, mood, pain, sleep, food, movement and symptoms. Regular meals, gentle activity, consistent sleep and stress-reduction practices may help some people. Use only pain relief or supplements that are suitable for you, particularly if you have another condition or take regular medicines. A clinician can discuss options when symptoms affect work, relationships or daily activities.

Arrange a review if symptoms are new, severe, present most days, or do not settle after the period. Seek prompt care for very heavy bleeding, bleeding between periods, bleeding after sex, severe pelvic pain, or a missed period with pain or unusual bleeding. Urgent help is needed for thoughts of self-harm or an immediate safety concern.

Ask whether your symptom diary suggests PMS, perimenopause or another cause. Discuss whether contraception, hormone treatment, non-hormonal treatment or mental-health support could help, and explain any change in bleeding pattern, migraine, mood or pain.