When does pms start?

Introduction: Why PMS Needs a New Approach

90% of women experience PMS, yet most are told it’s “normal.” At Patients Medical in NYC, we uncover the hidden hormonal and metabolic imbalances behind your symptoms—from estrogen dominance to nutrient deficiencies—and create personalized plans to restore balance naturally.We treat the whole hormonal system, not just your symptoms

What Is Premenstrual Syndrome?
PMS refers to physical and emotional symptoms that occur 1-2 weeks before menstruation and resolve with your period.

Types of PMS:

  • PMS-A (Anxiety): Irritability, mood swings
  • PMS-C (Cravings): Sugar cravings, fatigue
  • PMS-D (Depression): Sadness, brain fog
  • PMS-H (Hydration): Bloating, breast tenderness
  • PMDD: Severe, debilitating symptoms affecting daily life

 

Common Symptoms of PMS

Root Causes: Why Does PMS Start?

PMS isn’t just a hormonal issue—it’s a whole-body imbalance. At Patients Medical, we use a functional medicine approach to identify deeper causes:

  1. Estrogen Dominance: Too much estrogen relative to progesterone triggers irritability, bloating, and breast tenderness.

  2. Progesterone Deficiency: Low progesterone contributes to mood swings, anxiety, and disrupted sleep.

  3. Poor Gut Health: An imbalanced microbiome affects estrogen detox and contributes to systemic inflammation.

  4. Blood Sugar Instability: Frequent sugar crashes worsen cravings, fatigue, and mood instability.

  5. Chronic Stress: Excess cortisol depletes progesterone and throws off the menstrual cycle.

  6. Toxin Accumulation: Environmental toxins (plastics, pesticides) act as endocrine disruptors that worsen PMS.

  7. Nutrient Deficiencies: Lack of magnesium, B vitamins, and omega-3s impairs neurotransmitter and hormone regulation.

Diagnostic Testing We Use

To uncover what’s really behind your PMS symptoms, we offer advanced diagnostic tools

DUTCH Hormone Test (estrogen, progesterone metabolites)

Micronutrient Panel (magnesium, B vitamins, zinc)

Blood Sugar & Insulin Tests (fasting glucose, HbA1c)

Gut Health Analysis (microbiome, zonulin for leaky gut)

Neurotransmitter Testing (serotonin, GABA, dopamine)

Thyroid Panel (TSH, free T3/T4, antibodies)

Integrative Treatments for PMS

Hormone Balancing

  • Vitex (Chasteberry): Supports progesterone production
  • DIM & Calcium-D-Glucarate: Promotes estrogen detox
  • Bioidentical Progesterone (if deficient)

Nutritional Therapy

  • Anti-inflammatory diet (rich in cruciferous veggies, flaxseeds)
  • Targeted supplements (magnesium glycinate, omega-3s, vitamin B6)

Gut-Liver Support

  • Liver detox protocols (milk thistle, NAC)
  • Probiotics for estrogen metabolism

Stress & Mood Support

  • Adaptogens (rhodiola, ashwagandha)
  • 5-HTP or GABA for serotonin support

Pain & Inflammation Relief

  • Acupuncture for cramp relief
  • Turmeric & Ginger (natural COX-2 inhibitors)

Real Case Study: Healing PMS Naturally

Julia, 31, struggled with severe PMS—mood swings, migraines, and fatigue every month. She was prescribed birth control and antidepressants but still felt unwell.

Our testing revealed:

  • Estrogen dominance with low progesterone
  • Poor gut microbiome diversity
  • High cortisol and low magnesium

We created a 12-week integrative plan with:

  • Gut repair protocol and estrogen detox support
  • Progesterone-supporting herbs
  • Nutritional therapy and stress reduction

By the end, Julia reported 80% symptom improvement, regular cycles, and no longer needed medication.

Testimonials

Frequently Asked Questions

PMS symptoms often begin 5 to 14 days before your period, during the luteal phase of the menstrual cycle.

 Mild symptoms may be normal, but moderate to severe PMS is often a sign of hormonal, nutritional, or stress-related imbalances.

 Yes. With the right diet, supplements, hormone balance, and lifestyle changes, many women eliminate or reduce PMS significantly.

Not always. Many patients respond well to herbs, nutrition, and stress management. In some cases, bioidentical hormones can help.

 We treat the whole person—addressing gut health, stress, detox, nutrition, and hormone synergy to restore cycle harmony.

 Absolutely. Low thyroid or adrenal burnout can worsen PMS and menstrual symptoms.

 Magnesium, vitamin B6, calcium, omega-3s, and zinc are among the most effective.

 PMS often worsens in the late 30s and 40s due to perimenopausal hormone shifts.

 Yes—gut bacteria influence estrogen metabolism, inflammation, and neurotransmitter function.

 We’re out-of-network but provide superbills for reimbursement. Many labs may be partially covered.

Begin Your Journey with Patients Medical

Patients Medical specializes in gently helping the patient identify the root cause of their medical issues and then assist them to recover from their problems to help them move forward to good health.

Request your consultation today!

To schedule an in person on Tele-medicine appointment, please call our office at (212) 794-8800 or email us at info@PatientsMedical.com We look forward to hearing from you

Our medical center in New York City.

Patients Medical PC
1148 Fifth Avenue, Suite 1B New York, NY 10128

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