Shop sustainable period care with YourCycle. Ships from NZ.


This section doesn’t currently include any content. Add content to this section using the sidebar.

Image caption appears here

Add your deal, information or promotional text

Premenstrual exacerbation: why your condition can get worse before your period

Most period-havers have experienced PMS at some point. Symptoms can include anxiety, sadness, irritability, and also physical pain such as bloating, cramping, and headaches. But if you have a mental or physical health condition and find your symptoms get worse before your period, you might be experiencing PME.


Hold up, that’s alot of letters. What do they actually mean? 

Premenstrual syndrome (PMS), is a collection of symptoms that can happen in the 1-2 weeks leading up to your period. It can include irritability, sadness, mood swings, or anxiety, as well as physical symptoms like bloating, cramping, and headaches. Generally though, these symptoms are tolerable.

Premenstrual dysphoric disorder (PMDD): If your symptoms are so bad that they significantly impact your quality of life, you may be experiencing PMDD. PMDD is essentially a more severe form of PMS, with a usual emphasis on the emotional symptoms. However, PMDD usually only begins 1-2 weeks before your period, and resolves when your period starts.

Premenstrual exacerbation (PME): Rather than causing new symptoms, PME exacerbates symptoms of an existing condition, like anxiety, depression, eating disorders, or physical health conditions such as chronic pain or seizures. The worse-than-usual symptoms usually resolve at the beginning of your period, but the symptoms you had before are still there. 

Why does PME happen?

While the research on PME is not 100% conclusive, it’s thought to be related to the hormonal changes that happen in the second half of your menstrual cycle. If you have a preexisting condition, it may be that these hormonal changes can make it worse.

If you have a personal or family history of a mental or physical health condition, and extreme PMS symptoms, it may be worth investigating if PME could be the cause.

How to manage PME

How each person manages PMDD will be unique to each person and is a decision that should be made with you and your healthcare provider. What feels right for you might require some testing options and possibly a mixture of natural, lifestyle, and medical solutions. 

Some ways that you can explore to manage premenstrual symptoms include:

  • Tracking symptoms via the YourCycle app. This means you know when you’re likely to experience these symptoms and you can make lifestyle changes in advance to reduce them
  • Calcium and/or B-6 supplementation
  • Regular exercise
  • Focusing on a balanced diet filled with nutritious foods 
  • Maintaining a regular sleep routine and trying to get to sleep before 11pm  or 12pm each night
  • Managing stress through mindfulness or trying to remove the causes of stress in your life

Also, a medication based option that may help some people with PMS symptoms as well as PMDD and PME is hormonal birth control. However, for some people, hormonal birth control can make emotional symptoms worse and have unpleasant side effects (as well as potentially putting you at risk of more serious issues). For all of these reasons, make sure you talk with your healthcare provider(s) to know the full range of possible effects, especially while considering your preexisting condition.


PMS is normal. But, if your PMS is making an existing condition worse, rest assured, there are a broad range of ways that can help you. Firstly, working with your healthcare provider to manage your condition will likely improve your condition in general, and therefore, your PME. However, lifestyle factors, supplementation, and birth control, can all be options to help manage premenstrual symptoms and, hopefully, help to reduce PME. Before trying any of these options, it’s important to talk to your healthcare provider to make sure it’s safe for you to try. Your health is most important. 

Did you find this article helpful?

Download the YourCycle app for personalised information on everything to do with your cycle. The content and insights are free and always will be.


Post by Miranda Bromage