What prolonged PMS might indicate about your hormones

Have you ever experienced mood swings, changes in sleep pattern, breast swelling, or changes in appetite that start 1-2 weeks before menstruation and last for several days after the period begins? If the answer is yes, you are undergoing a condition called prolonged pre-menstrual syndrome (PMS). The  prolonged PMS is frequently linked to hormone levels. In this article you will understand why prolonged PMS might be indicating something about your hormones. Doctify offers experienced gynaecologists that are willing to aid if you ever experience it or have any doubt.

What does “prolonged PMS” actually mean?

According to clinical practice, the pre-menstrual syndrome (PMS) is the combination of physical and emotional symptoms, such as mood swings, fatigue, bloating, and breast tenderness, that occur to many women 1-2 weeks before menstruation, usually disappearing shortly after bleeding begins.

Meanwhile, prolonged PMS is a chronic condition causing severe emotional and physical symptoms, like depression, anxiety, changes in sleep pattern, breast swelling, and weight gain, that start 1-2 weeks before menstruation and last for several days after the period begins.

Is it normal for PMS symptoms to last most of the month?

PMS symptoms may start 1-2 weeks before menstruation and last few days after bleeding begins. Yet, if the symptoms persist for multiple days after the period begins, lasting almost the whole month it is not normal. Oftenly, cycle length, stress, and life stage can affect the PMS duration. For example, chronic stress raises cortisol, leading to delayed ovulation, irregular or missed periods, and  prolonged PMS symptoms. Persistent symptoms should not be automatically dismissed because they might be indicating something else.

How are hormones linked to mood and physical PMS symptoms?

Hormones, such as estrogen and progesterone, play an important role on the emotional and physical PMS symptoms. Estrogen and progesterone levels fluctuate across the different reproductive stages of women: perimenopause, menopause, and postmenopause – each bringing unique physiological changes. 

Some people are more sensitive to hormonal changes because of an abnormal, but often genetic hypersensitivity of brain neurotransmitters to the normal rise and fall of hormones like estrogen and progesterone. This sensitivity affects mood, energy, sleep, and pain due to the changes (ups and downs) of estrogen and progesterone.

When does PMS cross into PMDD?

Premenstrual dysphoric disorder (PMDD) is a more severe and debilitating condition of the PMS. What makes the difference between one and another is that PMDD symptoms disrupt daily living tasks, they are so severe that women have trouble functioning at home, at work, and in relationships during this time.

The most common emotional and psychological symptoms clinicians look for are:

• Mood swings
• Depressed mood, feeling anxious, tense or on edge
• Constant irritability, anger, or both
• Lack of energy or interest in the things you used to enjoy doing
• Breast tenderness or swelling
• Frequent headaches
• Changes in your appetite, such as overeating or having specific food cravings
• Changes in sleep pattern, such as excessive sleeping or difficulty sleeping

PMDD is often under-recognised or misattributed because women tend to normalize these symptoms and overlook them, and don’t consult a doctor for a checkup.

Could prolonged PMS signal another underlying condition?

There are other hormonal and gynaecological conditions that can mimic PMS, but having nothing to do with PMS. These conditions are:

• Uterine fibroids
• Polycystic ovary syndrome (PCOS)
• Endometriosis
• Perimenopause
• Cycle-related mood disorders
• Thyroid issues

It is important to have a full and detailed clinical history in order for the gynaecologist to diagnose and assess the condition the correct way.

What symptoms suggest it’s time to seek medical advice?

If you experience any of the following, don’t hesitate in seeking medical advice:

• Red flags such as: depressed mood, increased anxiety, constant irritability, mood swings, or the feeling of being on edge all the time.
• Changes in appetite and sleep pattern
• Unexplained weight gain or loss
• Worsening symptoms over time
• When symptoms interfere with work, relationships, or wellbeing

How to get the right support and specialist care

Seeing the right clinician can make a difference because they are trained to help diagnose and treat this syndrome interfering with the daily life and wellbeing of the patients. Gynaecologists offer a personalised treatment for each one of their patients and having a personalised treatment rather than “trial and error” is very much valuable. We invite you to use Doctify to find experienced gynaecologists, read verified patient reviews, and book appointments with confidence.

Feel free to consult a gynaecologist through Doctify for personalised advice whenever you want, we will be happy to help you! Find the best gynaecologyists in the United Kingdom or search for the best specialists globally:

• Gynaecologists in the United Arab Emirates
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• Gynaecologists in Australia

Medically Reviewed
Last reviewed on 18/02/2026