The main sign your period has come is menstrual bleeding, but did you know you may get other signs and symptoms that accompany your period? Some symptoms arrive before your period has started and act more like a sign that your period is coming, other symptoms occur once you start bleeding. Read on to find out all about 10 of the most common period symptoms, what causes each, and what risk factors may make you more susceptible to certain symptoms.
In this article
1. Period pain or menstrual cramps
Period pain is one of the most common menstrual symptoms. Most women at some point in their life will experience some cramping during their period or around their period. It can feel like painful muscle cramps around the abdomen as a dull or constant pain, or even as intense spasms.
Some women may feel the intensity of this pain vary between cycles, with some periods causing little to no pain, and others being much more painful.
Period pain usually begins when you start bleeding, but some women may also experience menstrual cramps in the days leading up to their period.
Causes of period pain
During your period, the uterus contracts to help the lining shed. This contraction compresses the blood vessels in the lining, temporarily cutting off the blood and oxygen supply to your uterus. The lack of oxygen in the tissues of your uterus causes chemicals to be released that can trigger pain.
The body also releases prostaglandins, chemicals which encourage the uterus muscles to contract even more, which can also cause pain.
It’s possible that some women feel more pain than others due to a build-up of prostaglandins, which make the contractions stronger.
Health conditions that can make period pain worse
- Endometriosis. A condition where the tissues that line the uterus grow outside the uterus, on spots like the fallopian tube and ovaries. Women with endometriosis can experience intense pain when the lining sheds.
- Fibroids. These non-cancerous tumours can grow around the uterus and intensify the pain of menstrual cramps.
- Pelvic inflammatory disease. This infection of the uterus, fallopian tubes and ovaries causes severe inflammation.
- Adenomyosis. This is a condition similar to endometriosis, in that tissue that normally lines the uterus grows elsewhere, except in this case it’s within the muscular uterus wall. This makes periods especially painful as the lining sheds.
See your doctor if you have severe pain or you notice your normal menstrual patterns change, for example, you get heavier periods than usual, or they become irregular.
2. Breast pain or tender breasts
Tender breasts or breast pain are common period or pre-period symptoms. Tenderness or pain due to menstruation can:
- Feel like a dull, heavy or aching pain that can range from mild to severe.
- Begin up to two weeks before the period, get worse with time and then go away once the period is over.
- Affect both breasts (but not always) and can even spread to the area around the armpit.
Causes of breast pain during or around your period
The most likely cause of breast pain or breast swelling around your period are hormonal changes during the menstrual cycle. As the start of your period approaches, increased levels of progesterone are the most likely to cause tenderness or pain.
Progesterone levels increase after ovulation and peak around day 21 of a 28-day cycle before falling as the period approaches. Breast pain around this time could be due to growth of the breasts’ milk glands due to high levels of progesterone However, if you notice breast pain that persists or you have it other times of your menstrual cycle, talk to your doctor to rule out anything more serious.
Health conditions that can make breast pain worse
If you suffer from
- PMS (premenstrual syndrome)
- Fibrocystic breast disease (a benign breast disease)
then you are more likely to get breast swelling. Although most women will experience some breast tenderness leading up to their periods, risk factors may include
- a family history of breast tenderness before or during periods
- a high-fat diet
- too much caffeine (although there is no precise figure for how much caffeine, especially as more research is needed in this area, some women do notice a decrease in breast pain when they limit caffeine consumption or cut it out completely).
Most of the time breast pain will go away by the time your period is over. However, if you notice any other symptoms, such as those listed below, see your doctor:
- Bloody or clear discharge from the nipple
- A new lump that does not go away after your period
- Persistent and unexplained pain
- Redness, pus around the nipple, or fever, all of which could indicate an infection.
Some women may notice they get spots or acne flare-ups around their period, usually before. In fact, acne in the days leading up to one’s period as an adult woman is more common than you might think!
A study of 400 women in 2001 found that 44% experienced premenstrual acne1. In another study from the same year, 65% of the participants reported a perimenstrual acne flare2.
Causes of breakouts
Although acne can happen in men as well, women are more likely to get acne due to changes in hormone levels across the menstrual cycle.
As you approach your period, the levels of estrogen and progesterone drop, and this triggers the grease-producing glands next to your hair follicles in the skin to produce more oil (sebum).
Too much sebum can clog the pores in your skin, which can cause bacteria to thrive, resulting in skin inflammation and…acne?
Health conditions that can make acne around menstruation worse
Acne can also be a symptom of polycystic ovarian syndrome (PCOS). Consider talking to your doctor if you notice any of the following symptoms in addition to acne:
- irregular or no periods
- excessive hair growth on the face, chest, back or rear
- weight gain
- hair loss or thinning hair
- struggling to conceive if you are trying to get pregnant.
4. Period fatigue
Period fatigue may refer to an episode of tiredness experienced just before your period starts or during.
Fatigue is a symptom of PMS, which many experts link to hormonal changes. Over the course of the menstrual cycle, levels of estrogen and progesterone change which can result in feelings of fatigue.
The decrease in estrogen and progesterone in the luteal phase (the phase in your menstrual in-between ovulation and the first day of your next period) can also cause a decline in another hormone called serotonin, which is a mood-boosting neurotransmitter (a happy hormone!) When serotonin levels dip, it can lead to a low mood and a decrease in energy levels.
Things that can make period fatigue worse
Period fatigue could also be caused by:
- Low iron levels. Sometimes heavy bleeding during a period could lead to anaemia due to an iron deficiency, and this can cause weakness and fatigue because iron is so important for carrying oxygen in the blood.
- Sudden changes in blood sugar. Some women may get certain cravings around their periods which can lead to eating too many sweets or food with added sugar. Eating food like this can cause a spike in blood sugar, followed by an energy crash.
- Disturbed sleep. If your period pain keeps you up at night, or mood changes make it hard to stay asleep, it’s natural to feel tired the next day.
If your fatigue is debilitating or interferes with your daily activities, or it doesn’t go away after your period, talk to your doctor to get it checked out.
5. Abdominal bloating and water retention
If you’ve noticed your jeans are tighter than usual around your period, chances are it’s your period that’s causing the snug fit. One common PMS symptom is bloating or water retention just before the period begins. This symptom can appear one to two weeks before your period is due, making it a good sign your period is coming.
Causes of bloating and water retention around your period
Like with many other PMS symptoms, water retention is likely caused by fluctuating hormones. However, a diet that’s high in salt can also increase water retention around your period.
If this is a recurring issue, talk to your doctor about what treatment options may be available to you.
6. Lower back pain
A 2015 study found that 16% of women who suffered from period pain, also experienced lower back pain during their period3.
Causes of lower back pain during your period
During your period, the uterus contracts to shed the old lining. These contractions can cause additional muscular pain (on top of other types of period pain) and it can radiate into the lower back.
Health conditions that can increase back pain during your period
There are certain medical conditions that can make back pain during your period worse, including:
- Uterine fibroids
- Back conditions or injuries.
If your lower back pain is so severe you cannot perform daily activities, consult your doctor to determine the cause and the appropriate form of treatment for your personal situation.
7. Headaches or migraines
Periods can be a trigger for so-called “hormone headaches.” Headaches or migraines associated with hormonal changes can get worse around the time you expect your period.
According to Dr Anne MacGregor from the National Migraine Centre in the UK4, a migraine is most likely to appear in the two days leading up to a woman’s period, or during the first three days of her period.
Causes of headaches or migraines around your period
Menstrual migraines or hormone headaches are usually caused by a natural drop in estrogen towards the end of the luteal phase and at the beginning of menstruation.
Things that can trigger hormonal headaches
Hormonal headaches can also be triggered by
- oral contraceptives
- the menopause
See your doctor if your headaches are persistent, unbearable or continue beyond your period.
8. Mood swings and disorders
Mood swings, anxiety, depression and irritability are common signs your period is on its way. Mood changes are one of those classic PMS symptoms. Some women also experience what’s known as enhanced mood disorders or premenstrual dysphoric disorder (PMDD). This is essentially an extreme form of PMS.
With PMDD, emotions are heightened and mood swings are more severe. Both PMS and PMDD tend to hit around 7 to 10 days before your period starts, lasting until the first days of your period.
Causes of mood swings around your period
As with many other period symptoms, the feelings of anxiety or irritability associated with PMS or PMDD are likely due to the hormonal changes around this time of the month.
Things that can make mood swings during your period worse
Although the cause of PMDD is unclear, there are a couple of theories as to why some women have worse mood swings and experience more severe forms of mood disorders around their periods, such as:
- having an underlying case of depression
- being very sensitive to hormonal changes
If you find your moods are extreme or you have suicidal thoughts, discuss your symptoms with your doctor as soon as possible.
9. Gastrointestinal issues
Around your period, you may feel constipated or experience diarrhoea. In fact, a 2014 study found that 73% of the women in the study experienced at least one gastrointestinal issue around the time of their period5, with diarrhoea being one of the most common complaints.
Causes of menstrual diarrhoea and constipation
Like many of the other symptoms of periods, hormones are a likely the culprit here. The build-up of the hormone progesterone—which is responsible for thickening the uterus lining—can cause constipation in some women.
The increase in prostaglandins—the hormones which cause the muscle contractions that help the uterus lining shed—around your period, on the other hand, could cause diarrhoea.
When prostaglandin levels are high, some of the hormone may enter the blood stream and travel to other organs like the bowels. High levels of prostaglandin in the bowels can cause contractions of the muscles of the intestines or colon, leading to diarrhoea.
If these gastrointestinal issues persist, talk to your doctor to diagnose or rule out other possible causes.
10. Poor sleep
Whether its cramps or mood swings that keep you up at night, poor sleep is a common complaint for women around their period. Another possible reason for poor sleep around that time of the month: changes in body temperature.
Causes of poor sleep during your period
Hormone fluctuations can cause your core body temperature to rise about half a degree following ovulation. It’s how the basal body temperature (BBT) method helps you track whether you’ve ovulated or not. This half a degree may not sound like much, but it can affect your sleep because it’s easier to sleep when your body temperature is cooler.
FAQs about period symptoms
What are the signs your period is coming?
Everyone is different, and the signs that your period is coming may be slightly different for you when compared to other women. However, these are some of the possible period symptoms you may experience:
- Mood swings
- Tender breasts
What happens right before your period?
If you’re not pregnant, your thickened uterus lining will shed in response to decreasing hormone levels.
These hormonal changes are responsible for many of the symptoms of PMS that you may experience just before your period starts.
Can early pregnancy feel like a period?
There are some overlapping symptoms, like fatigue, tender breasts, mood swings and difficulty sleeping. If you suspect you may be pregnant you can take a pregnancy test as early as 6 days before your missed period to be sure.
Why do I have period symptoms but no period?
You may experience some period symptoms if you are pregnant as there are some overlapping symptoms. If there is any doubt, take a pregnancy test.
If you are not pregnant, your lack of period is down to something else. Find out other reasons why your period may be late. And if you are concerned, see your doctor.
The bottom line
Although many period symptoms can be annoying, try to rest and take it easy at this time. The typical symptoms of cramping, headaches and fatigue are usually just due to hormonal fluctuations and should go away once your period is over. You can also talk to your doctor about any medications or relaxation techniques you can try to ease a few of the symptoms. As you learn more about your symptoms and what to expect, and what method works the best at handling them, you’ll be more prepared for them as your period approaches.
- Stoll S, Shalita AR, Webster GF, Kaplan R, Danesh S, Penstein A. The effect of the menstrual cycle on acne. J Am Acad Dermatol. 2001 Dec;45(6):957-60. doi: 10.1067/mjd.2001.117382. PMID: 11712049.
- Geller L, Rosen J, Frankel A, Goldenberg G. Perimenstrual flare of adult acne. J Clin Aesthet Dermatol. 2014;7(8):30-34.
- Kural M, Noor NN, Pandit D, Joshi T, Patil A. Menstrual characteristics and prevalence of dysmenorrhea in college going girls. J Family Med Prim Care. 2015;4(3):426-431. doi:10.4103/2249-4863.161345
- Bernstein MT, Graff LA, Avery L, Palatnick C, Parnerowski K, Targownik LE. Gastrointestinal symptoms before and during menses in healthy women. BMC Womens Health. 2014;14:14. Published 2014 Jan 22. doi:10.1186/1472-6874-14-14
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