Demystifying The Worst PMS Case I’ve Ever Seen

Picture this: You wake up feeling like a stranger in your body. Hives blanket your skin, itchy and angry. Fatigue weighs you down like a lead blanket, stealing your energy and focus. School? Work? Forget it. This wasn’t just a bad period for one of my patients – it was a life sentence dictated by her PMS.

So, if you feel like a hostage to your hormones or your PMS is hijacking your calendar, dictating your mood, and sabotaging your well-being. Know that you’re not alone!

Millions of women struggle with the debilitating symptoms of PMS, trapped in a monthly roller coaster of emotions and physical discomfort.

But there’s good news: the solution doesn’t lie in hiding or suffering in silence.

It lies in understanding the complex landscape of your menstrual cycle, hormone pathways, and personalized testing options. This blog is your guide to unlocking the secrets to your PMS and reclaiming control of your cycle.

It’s time to reclaim your month, health, and power.


woman's daily planner calendar

Understanding Your Cycle

Before we dive too deep into how you can conquer your PMS, you must understand how your cycle works. Your menstrual cycle is like a monthly symphony of hormones, with estrogen and progesterone conducting the show. [1] [2]

Estrogen Takes the Lead (Days 1-12):

  • Estrogen starts the show, building up the lining of your uterus and preparing an egg in your ovary for a potential pregnancy.
  • Around Day 12, estrogen peaks, signaling to the next stage…

The Big Release (Day 14):

  • Another hormone, LH (luteinizing hormone), bursts onto the scene. It tells the egg to pop out of its follicle in your ovary, a process called ovulation.
  • This is your fertile window, where you’re most likely to get pregnant if sperm is present.

Progesterone Takes Over (Days 15-28):

  • Progesterone steps in, transforming the empty follicle into a welcoming spot for a fertilized egg.
  • Around Day 21, progesterone reaches its peak.

No Guest? No Problem! (Days 28-ish):

  • If no pregnancy happens, progesterone levels drop, and the cozy lining of your uterus gets shed. This is your period, the monthly curtain call.

Understanding these hormonal peaks and valleys gives you valuable knowledge to help you navigate your cycle, predict your fertile window, and even track potential PMS symptoms. And remember, your cycle is unique. Your cycle can be longer or shorter than 28 days, but knowing the basic storyline gives you the power to be the leading lady of your well-being!


woman conquering her cycle

Conquering PMS and Reclaiming Your Cycle

Next, I’ll dive deeper into the science behind your monthly PMS symptoms, exploring the hidden culprits behind mood swings, cramps, and fatigue. We’ll dissect the hormone pathways, uncover the secrets of saliva and hormone sensitivity testing, and empower you to pinpoint your PMS triggers.


woman choosing between paths

Hormone Pathways

At this point, you might ask yourself, “Where do these hormones come from, and how do they interact?” Let’s explore the intricate pathways that fuel your cycle, starting with an essential building block: cholesterol.

Cholesterol, often demonized for its role in heart health, is the raw material for various hormones. Cholesterol gets converted into a key compound called pregnenolone, the starting point for many essential hormones.

From pregnenolone, two main pathways branch out: [3] [4]

Pathway 1: The Progesterone Path:

Pregnenolone can be transformed into progesterone, a crucial hormone for the second half of your cycle. Progesterone helps prepare the lining of your uterus for a potential pregnancy and helps regulate mood and stress. It also influences cortisol production, another hormone involved in stress management and keeping you balanced during the pre-period phase.

Pathway 2: The Androgen Path:

Pregnenolone can also take a different route, turning into DHEA, a hormone associated with energy, vitality, and sex drive. DHEA, in turn, can be converted into testosterone and other androgens, which influence muscle growth, strength, and confidence. Additionally, DHEA can be further converted into the estrogen family, a group of three important hormones:

  • Estrone (E1): While it plays a role in your cycle, E1 levels tend to be lower before menopause and may contribute to some PMS symptoms. [5]
  • Estradiol (E2): The most potent and well-known estrogen, E2 influences bone health, mood, and that pre-ovulation glow. [6]
  • Estriol (E3): The least potent estrogen, E3 offers protective benefits and is highest during pregnancy but plays a minor role in pre-menopausal cycles. [7]

Understanding these pathways and how different hormones are produced is crucial to comprehending your PMS and finding ways to optimize your hormonal balance. So, the next time you experience PMS symptoms, remember: it’s not just random discomfort – it’s a reflection of the intricate dance of hormones within your body.


woman with PMS symptoms

Common PMS Symptoms and Causes

Ever wonder why you crave chocolate one day and feel like a dragon the next? PMS symptoms can be a confusing roller coaster, but understanding what’s behind them can be empowering.

Here’s a breakdown of common PMS woes and their likely hormonal culprits: [8]

  • Acne: Increased androgen (testosterone and DHEA) levels relative to estrogen, leading to overactive oil glands and inflammation.
  • Bloating and water retention: Increased aldosterone affects sodium and water balance.
  • Breast tenderness: Increased progesterone levels.
  • Cramps: Uterine contractions caused by the release of prostaglandins to shed the uterine lining.
  • Diarrhea: Increased prostaglandin release, which can also affect digestion.
  • Fatigue: Fluctuations in estrogen and progesterone, leading to disrupted sleep and energy levels.
  • Headaches: Changes in blood vessel tone due to hormonal fluctuations.
  • Anxiety and irritability: Fluctuations in serotonin and other neurotransmitters impact mood regulation.
  • Mood swings: Rapid fluctuations in estrogen and progesterone, along with neurotransmitter changes, can lead to emotional volatility.
  • Changes in appetite: Food cravings or decreased appetite due to hormonal shifts and serotonin levels.
  • Trouble sleeping: Fluctuations in serotonin and its metabolite, melatonin, and other sleep hormones linked to changes in estrogen and progesterone.

Tip: Identify your PMS triggers. Keep a symptom journal to identify foods, activities, or stressors that worsen your symptoms. This self-awareness is crucial for tailoring your management plan.


Beyond Blood: Saliva and Hormone Sensitivity Testing

Remember my patient whose PMS hijacked her life with debilitating symptoms and school absences? Her journey to reclaim control began with three powerful tools: blood testing on the peak days of estradiol and progesterone during the cycle, day 12 and day 21, saliva hormone testing, and hormone sensitivity testing.

Knowing the length of her average cycles, we were able to assess in blood the peak levels of hormones and the ratio between the two on those days. This information can also be compared against the salivary testing for a comprehensive look at hormonal fluctuations.

Saliva testing offered a dynamic picture of her hormonal symphony, unlike traditional blood tests that capture a snapshot in time. We could observe the intricate rise and fall of her estradiol, progesterone, and other key players through repeated saliva samples collected throughout her cycle.

This continuous monitoring and the blood test on day 21 revealed a hidden truth: her progesterone levels, while seemingly adequate, weren’t holding strong enough during the crucial luteal phase, leading to her debilitating symptoms.

But the story didn’t end there. Hormone sensitivity testing unlocked another layer of the puzzle. [9] This test assessed how her body reacted to specific hormones like estrogen and progesterone.

It revealed that while her hormone levels might seem normal on paper, her body was hypersensitive to them, amplifying the effects of even slight fluctuations. This explained the exaggerated mood swings and physical discomfort she experienced.

Although this sounds unusual, in our practice, we have found that people often develop sensitivities to their own hormones and neurotransmitters. Many of our mold-exposed patients or patients with allergies or autoimmune conditions develop sensitivities to many things, like food, mold, cats, dogs, environmental triggers, AND reactions to their own hormones and neurotransmitters, even histamine.

Imagine having allergies that elicit a histamine response and then having reactions to your own histamine!  It’s a little like a hive on top of a hive!

Armed with this newfound knowledge, we adjusted her diet and lifestyle to support hormonal balance, explored natural options like herbal supplements, and even considered bioidentical hormone replacement therapy – all guided by the insights gleaned from her saliva and sensitivity tests.

The most unusual treatment aspect that we introduced was something called sublingual immunotherapy, through which we sought to reduce her sensitivity to progesterone. Vials of homeopathic progesterone were administered to her in ever-increasing doses as her body continued to improve its tolerance and reduce its reactivity.

The results were transformative. Her PMS symptoms gradually subsided, her hives resolved, her energy returned, and she reclaimed her life. She no longer missed school, her mood stabilized, and the debilitating discomfort became a distant memory.

This patient’s story is a testament to the power of understanding your unique hormonal landscape. Traditional blood tests often fall short, providing a static snapshot in a dynamic process. The combination of blood testing on appropriate days, plus saliva and hormone sensitivity testing, offers a more nuanced and personalized approach, empowering you to take control of your cycle and rewrite the narrative of your PMS.


woman sitting by lake

Beyond the Cramps: Embracing the Wisdom of PMS

Although my menstruating days are now over, I can’t help but recall the raw emotions, the swirling turbulence that danced just before my cycle commenced. PMS wasn’t merely a physical inconvenience; it was a spotlight glaring on the cracks in my life, amplifying dissatisfaction in relationships, career choices, and everything in between.

There was a time in my second year of med school when each pre-period phase urged me towards drastic measures – a haircut so drastic it bordered on rebellion, a desire to shatter the mold I’d sculpted myself into. These weren’t just hormonal tantrums but the raw, unfiltered cries of my inner compass, a voice desperate to be heard.

With time and wisdom, I’ve come to understand this pre-cycle time as a sacred space. It’s a stripping away of societal expectations, parental whispers, and self-imposed pressures. It’s a moment where the veil is thin, where our intuitive whispers become deafening roars. Instead of resisting the upheaval, I now see it as an invitation to tune in, to listen to the messages our bodies, our very beings, are yearning to convey.

So, instead of fighting the tide of your PMS, consider this: what is the storm trying to tell you? What truth is your intuition whispering through the discomfort? Open your heart, lean into the discomfort, and listen. In that act of surrender, in that willingness to hear your voice, the symptoms may just melt away, replaced by a newfound clarity, a deeper understanding of your authentic self.

Remember, PMS isn’t just a hormonal dance; it’s a sacred window into our souls. Let’s learn to embrace it, listen to its whispers, and rewrite the narrative of our well-being, one pre-cycle revelation at a time.

Ready to listen to your intuitive whispers?

Grab a journal and explore your next pre-cycle phase with curiosity instead of resistance. You might be surprised by the wisdom awaiting you.

And remember, saliva and hormone testing is just the tip of the iceberg for most people.

Working with a functional medicine provider who will address your whole being – mind, body, and spirit – is vital for managing your PMS (or any issues related to your period or lack of them). Schedule a discovery call to learn about becoming a patient of The Spring Center.

Imagine calmer, happier periods. In an upcoming blog, we’ll explore serotonin’s surprising power to unlock joy before your cycle.  Stay tuned for science-backed tips & expert insights!



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  2. “Estrogen synthesis and signaling pathways during ageing – NCBI.” 22 Jan. 2013, Accessed 24 Jan. 2024.
  3. “Evolution of steroid concentrations in saliva from immature to ….” Accessed 24 Jan. 2024.
  4. “Conversion of pregnenolone to DHEA by human 17alpha … – PubMed.” Accessed 24 Jan. 2024.
  5. “Estrone Is a Strong Predictor of Circulating Estradiol in Women Age ….” Accessed 24 Jan. 2024.
  6. “Estradiol – StatPearls – NCBI Bookshelf.” 28 Jun. 2023, Accessed 24 Jan. 2024.
  7. “Estriol – an overview | ScienceDirect Topics.” Accessed 24 Jan. 2024.
  8. “Premenstrual Syndrome – an overview | ScienceDirect Topics.” Accessed 24 Jan. 2024.
  9. “Safety and value of skin test to sex hormones … –” Accessed 24 Jan. 2024.