Every month, millions of women deal with symptoms that precede or accompany their period: fatigue, pain, tension, irritability, and sleep disturbances. These manifestations are so common that they are often perceived as a matter of course. Yet, feeling pain or feeling unwell for a good part of the month should not be considered an inevitability to "simply endure."
The menstrual cycle is a perfectly normal physiological phenomenon. But the symptoms that can accompany it—grouped notably under the term premenstrual syndrome (PMS)—deserve to be better understood, better named, and better addressed.
The menstrual cycle: a natural phenomenon, but not always symptom-free
The menstrual cycle lasts an average of 28 days, with normal variations from one woman to another. It is schematically broken down into two main phases, separated by ovulation: the follicular phase, during which estrogens gradually increase, and the luteal phase, which follows ovulation and during which progesterone becomes dominant before dropping sharply if no pregnancy begins.
It is this drop in sex hormones at the end of the luteal phase that precedes the arrival of the period. For many women, it is accompanied by physical repercussions (breast tenderness, bloating, headaches) and psychological ones (irritability, fatigue, mood swings). These hormonal fluctuations are a normal physiological mechanism. What varies greatly from one woman to another is the individual sensitivity to these variations, and therefore the intensity of the symptoms felt.
What is premenstrual syndrome?
Premenstrual syndrome refers to a set of physical and psychological symptoms that appear cyclically in the days leading up to the period, during the luteal phase, and which generally subside with the arrival of or in the days following the start of the period.
The most frequently reported physical symptoms include breast tension or tenderness, bloating, headaches, a sensation of heavy legs, or temporary weight gain linked to water retention. On the psychological level, there is irritability, anxiety, sadness or emotional lability, and sometimes difficulty concentrating or sleep disturbances.
Two characteristics are essential to speak of PMS: cyclicality (the symptoms follow the rhythm of the cycle) and individual variability, both in the nature of the symptoms and in their intensity, which can also vary from one cycle to another in the same woman. According to the diagnostic criteria used in studies, the reported frequency of PMS varies considerably: reference manuals suggest that approximately 13 to 18% of women of childbearing age have clinically identified PMS in the United States, while literature reviews suggest a much wider proportion—up to 75%—if any woman presenting with at least one premenstrual symptom, even a mild one, is included. This gap alone illustrates the difficulty of precisely defining the contours of the syndrome. A severe form, called premenstrual dysphoric disorder, affects a smaller proportion of women, generally estimated between 3 and 8%, and is characterized by a marked impact on daily, social, or professional functioning.
PMS, painful periods: what are we talking about exactly?
It is important not to confuse everything under the generic label of "cycle disorders." Several distinct clinical realities coexist:
- Premenstrual syndrome (PMS) occurs before the period, during the luteal phase, and subsides upon its arrival.
- Dysmenorrhea, or painful periods, corresponds to pelvic pain that begins with or just before the period, caused mainly by uterine contractions linked to an increased production of prostaglandins. We distinguish primary dysmenorrhea, without an identified organic cause, and secondary dysmenorrhea, associated with an underlying pathology.
- Endometriosis is a gynecological disease in its own right, characterized by the presence of tissue similar to the uterine lining outside the uterus. It is thought to affect about one in ten women and can cause chronic pelvic pain, sometimes very debilitating, as well as fertility difficulties.
- Polycystic ovary syndrome (PCOS) is an endocrine disorder that can be accompanied by irregular cycles, without a direct link to PMS as defined above.
This distinction is not just a question of vocabulary: it determines the treatment. Unusual pain, which worsens over time, resists common painkillers, or is accompanied by other symptoms (heavy bleeding, pain during intercourse, marked digestive issues), should lead to consulting a healthcare professional, in particular to rule out endometriosis or another organic cause.
Why does PMS remain so complex to understand?
Despite decades of research, the exact mechanisms of PMS remain partially understood. What is currently documented is based more on a bundle of complementary hypotheses than a single explanation:
- Hormonal fluctuations of the luteal phase (a drop in progesterone and one of its metabolites, allopregnanolone) are considered a central trigger.
- Individual sensitivity to these hormonal variations, rather than their simple level, seems to play a decisive role: two women can have comparable hormonal profiles while experiencing very different symptoms.
- Neurotransmitters, particularly serotonin, are involved: some studies report lower levels in the most affected women, and treatments that increase available serotonin can relieve certain symptoms in some patients.
- A slightly exaggerated inflammatory response is also being studied as a possible contributing factor.
- Lifestyle factors—sleep quality, level of chronic stress, physical activity, dietary balance—are associated with the perceived intensity of symptoms, without it always being possible to establish a strict cause-and-effect link.
This complexity explains why the diagnosis of PMS relies essentially on clinical observation of symptoms and their cyclical nature—often via a daily log over several cycles—rather than on a single biological test. This is not a lack of seriousness on the part of medicine, but the reflection of a multifactorial disorder, whose expression varies considerably from one woman to another.
Symptoms long trivialized
If the mechanisms of PMS remain complex, another finding is documented today: pain and symptoms linked to the cycle have long been insufficiently taken into account, both socially and in the care pathway.
A large study based on the French Constances cohort, led by a team including Inserm researchers on more than 21,000 women aged 18 to 49, highlighted the scale of the phenomenon: approximately 90% of menstruating women report dysmenorrhea, and 40% of them describe moderate to severe pain. The researchers behind this study point out that the issue of period pain is rarely asked about in consultations, and that many women do not seek help for fear of not being taken seriously—a finding corroborated by several qualitative studies on women's experiences with the healthcare system.
This trivialization has concrete consequences: according to the French Health Insurance (Assurance Maladie), menstrual pain is the leading cause of school absenteeism among adolescents and a frequent cause of professional absenteeism among young women. This does not mean that medicine "ignores" these symptoms, but that their recognition and management have long suffered from a lack of attention, both in research and in daily clinical practice—a situation that several public health institutions are now actively trying to change.
A more comprehensive approach to menstrual health
Faced with this complexity, a comprehensive approach—not a single remedy—is generally recommended. Several levers, not prioritized here in order of importance, can contribute to well-being around the cycle:
- Nutrition: a balanced diet, with sufficient intake of certain micronutrients, is often cited as a first-line approach.
- Regular physical activity, which can promote better management of stress and certain physical symptoms.
- Sleep, the quality of which influences the general tolerance to cycle-related discomforts.
- Stress management, which interacts with the perception of pain and the intensity of emotional symptoms.
- Cycle tracking, which allows for better anticipation of symptom-prone periods and for objectifying their cyclical nature.
- Medical care, which is essential as soon as symptoms are severe, debilitating, or unusual.
- Micronutrition and dietary supplements, which can have a place in this comprehensive approach, as a complement—not a replacement—to other levers.
It is important to specify: these different levers do not have the same level of scientific evidence. Physical activity, sleep, and medical care are based on more robust data than certain dietary supplements, the value of which remains to be clarified on a case-by-case basis.
Towards a new approach to women's health at AlgoSource
This overview shows it: menstrual health is a subject that is both extremely common and scientifically complex. Better understanding the cycle, its variations, and the many factors that influence the feeling of symptoms is an essential first step toward a more comprehensive—and fairer—approach to women's health.
It is in this spirit that AlgoSource is currently working on the development of a new formula designed to support women around their cycle, combining our magnesium supplement MagOrigine with extracts of lady's mantle, yarrow, and vitamin D. This formula is not intended to treat PMS, dysmenorrhea, or any other gynecological pathology: it is part of a process of raw material quality, traceability, and scientific rigor, consistent with current knowledge and its limitations, as we have just presented them.
We will return shortly, in a dedicated article, to the details of this formula, its formulation logic, and the reasons for the choice of each of its ingredients.
In the meantime, remember one thing: symptoms linked to the menstrual cycle are neither an inevitability to be kept silent, nor an insoluble mystery. They are a real health issue that benefits from being better known, better named, and better supported—by everyone, at their own pace, and with the right people when necessary.