5 PMS Symptoms That Are Signs of a Hormone Imbalance

If you’re someone who dreads the week before your period, you’re not alone. While some PMS symptoms are totally normal, others could be red flags that your hormones are out of balance. I used to think that my intense pelvic pain and crippling depression were just part of being a woman. Spoiler alert: they weren’t.

If your PMS symptoms feel debilitating, your body is trying to tell you something very important.

First, what is PMS?

Many people mistakenly use the words “PMS” and “periods” interchangeably, but they’re not the same thing; PMS happens before your period during the luteal phase, while your actual period is the shedding of the uterine lining which signals the start of a new menstrual cycle.

Understanding this distinction is important because your hormones follow different fluctuation patterns during each menstrual cycle phase and knowing which phase you are in is essential for determining if your hormones are in balance or not.

If you’re curious about identifying hormone imbalance signs through your period blood, I’ve written an in depth guide on what period blood colors, textures, and smells mean here. But first, here are:

5 PMS Symptoms That Could Mean A Hormonal Imbalance

1. Severe Mood Swings, Anxiety, or Depression

If you feel like an entirely different person before your period — extremely anxious, irritable, angry, or depressed — this is not normal. While a slight change in mood is a common PMS symptom, you should not feel like you’ve completely lost yourself and gone crazy each month (no matter how much certain doctors might want to gaslight you into believing all of your symptoms are just in your head). While you might feel crazy, you are not crazy. Having these extreme mood changes is very likely either a sign of estrogen dominance, low progesterone, and/or a neurotransmitter imbalance.

And these extreme PMS symptoms are actually not PMS at all — once debilitating, they are referred to as PMDD (premenstrual dysphoric disorder).

If your emotions feel unbearable before your period, it’s important that you start documenting all of your symptoms so that you can track exactly how many days before your period they appear. Tracking these patterns is one of the only ways to get a PMDD diagnosis from a doctor. If you’d like a cute way to symptom map, check out my menstrual cycle daily journal.

2. Extreme Fatigue

Being a little tired before your period is normal. But if you are experiencing such severe fatigue that you can barely get out of bed, or you’re falling asleep at work, or needing excessive naps, it could be a sign of low progesterone, thyroid dysfunction (which can cause issues with iron absorption), or blood sugar imbalances.

3. Intense Cramps

Painful cramps can be linked to excess prostaglandins (inflammatory compounds that cause uterine contractions), but they can also be a sign of estrogen dominance or underlying conditions like endometriosis (this was the secret reason behind all of my pain). If your cramps have you curled up in bed every month, your hormones are definitely out of sync.

4. Severe Acne Breakouts

A few small pimples before your period? Normal. Painful, cystic breakouts all over your jawline, chin, and cheeks? Not normal. If your skin completely freaks out before your period, it’s a sign that your androgens (hormones like testosterone) and/or estrogen are out of balance.

During the luteal phase, progesterone rises and estrogen dips. In a healthy cycle, this is balanced. But when androgens (like testosterone and DHEA-S) are too high or estrogen is too low, your oil glands go into overdrive, leading to clogged pores and deep, inflamed acne.

Signs that your PMS acne is hormone-related include:

• Deep, cystic pimples on the chin, jawline, and lower cheeks

• Breakouts that take weeks to heal

• Acne that worsens with eating just a little bit of sugar

  
  

This type of acne is often linked to high stress, candida overgrowth, insulin resistance, liver detox issues, or PCOS. To help rebalance your skin, focus on supporting liver detoxification (crucial for estrogen metabolism) and reducing inflammation — learning how to do this can be incredibly difficult and stressful (hello extra breakouts), but not to worry! I can help you learn how to reduce inflammation and heal your skin in my balance course where I share all of my secrets for how I healed my own skin.

5. High Sugar Cravings

PMS can flare up candidiasis causing extreme sugar cravings.

Candidiasis is a fungal overgrowth caused by an imbalance of Candida yeast in the gut. Candida naturally exists in small amounts in the body, but when it overgrows, it can lead to a whole range of symptoms — including intense sugar cravings, bloating, brain fog, and recurring yeast infections.

Estrogen dominance during the luteal phase (the days between ovulation and your next period) creates the perfect environment for candida to thrive. High estrogen levels can suppress immune function and increase glycogen (a form of sugar) in vaginal tissues, giving candida even more fuel to multiply. This is why some women notice increased vaginal itching, digestive issues, or white-coated tongues right before their period — all potential signs of candida overgrowth.

The problem? Candida thrives on sugar. When your PMS cravings hit, they’re often not just hormonal but also driven by Candida demanding to be fed. So if you constantly find yourself craving sweets or alcohol before your period, Candida overgrowth might be playing a role in your symptoms.

Medical News Today also says that:

“High levels of estrogen in the body may be an overlapping feature between endometriosis and increased levels of Candida.”

Other signs of candida overgrowth include:

• Chronic bloating and digestive discomfort

• Recurring yeast infections or UTIs

• Persistent fatigue and brain fog

• Skin issues like acne breakouts or rashes

If you would like to learn how to get rid of candida overgrowth, again, my balance course can help! 💛

The Bottom Line

PMS shouldn’t leave you feeling miserable every month. If your symptoms feel extreme, take it as a sign that it is time to dig deeper into your hormone health. By making small but powerful changes, you can bring your cycle back into balance — and finally feel like yourself all month long. If you’d like a brief overview of how your hormones should be fluctuating during the four menstrual cycle phases, I’ve written about it in this post 👇