PMS During Perimenopause: What It’s Really Trying to Tell You
Summary
In this episode, Françoise dives into the intensification of PMS symptoms during perimenopause — why they occur, how they’re connected to nervous system regulation (not just hormones), and what they might be trying to teach us. From scientific explanations to lifestyle support tools, this conversation explores daily practices that ease the emotional and physical overwhelm of PMS, including vagal toning, essential oils, nutrition, cannabis, and even orgasm. It’s a powerful reframing of PMS as a monthly check-in — and an invitation to listen deeper.
Keywords
Perimenopause, PMS, nervous system, vagus nerve, estrogen dominance, vagal toning, hormone balance, essential oils, Clary Sage, magnesium, B6, cannabis, orgasm, midlife wellness, cycle awareness
Resources & Links
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Book a private session with Françoise – Learn more
Takeaways
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PMS during perimenopause is often more intense due to declining progesterone and heightened estrogen sensitivity.
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The vagus nerve plays a crucial role in regulating emotional and physical symptoms of PMS.
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Daily vagal toning practices like gargling, cold exposure, and breath work can dramatically reduce PMS symptoms over time.
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Aromatherapy (e.g., Clary Sage, rose, geranium, grapefruit) can help regulate mood and hormones through inhalation.
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Supplements like magnesium, B6, and evening primrose oil can ease physical symptoms.
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Cannabis (where legal) and orgasm can serve as effective “reset” tools when symptoms peak.
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PMS is not just a hormonal event — it can reveal deeper emotional truths and highlight areas of life that need attention or change.
Chapters | Timestamps
00:00 Understanding PMS in Perimenopause
05:57 Vagal Tone and Its Impact on PMS
12:07 Lifestyle Strategies for Managing PMS
17:48 Listening to Your Body's Signals
Full Transcript
Francoise Decatrel (00:01)
Today we’re going to talk about a topic that I’m sure we’ve all experienced to some degree—PMS during perimenopause. I decided to do this topic today because I’m in the thick of it myself. And not only that—tonight is a full moon, so it’s a lot.
As I worked my way through this over the past week, I started thinking it would be great to put all this info in one place so you can access it whenever you feel like you need to be talked off a ledge—or whatever it is you’re going through—because PMS during perimenopause can be extra.
We’re going to start with why that is. As we usually do, we’ll begin with the science, then get into lifestyle tools that help prevent PMS, as well as how to calm yourself down when you're in it—because sometimes there’s only so much you can do. I’m also going to talk about what PMS is actually trying to show us. I view every month of PMS, from when we’re teenagers and get our period for the first time, as a kind of report card from your body—what’s going on physically, emotionally, and so on.
So, what is PMS in perimenopause? Again—it’s extra. It’s funny—this weekend I mentioned to a friend of mine in her late 30s that I had PMS, and she said, “Oh my gosh, me too!” And I thought, “Oh please... you don’t even know how crazy it can get.”
PMS symptoms do become more pronounced during perimenopause, even if they were mild before. The emotional aspects especially intensify—mood swings, increased anxiety, rage, weepiness, and that general emotional sensitivity where everything makes you cry. Physical symptoms may change too—breast tenderness, bloating, insomnia, fatigue. A lot of women I work with experience itchy skin right before their period, especially at night when trying to sleep, which then affects sleep. It becomes this cycle that lasts about a week and can be very frustrating.
So why does this happen?
It’s all about hormonal shifts. Progesterone starts to decline earlier than estrogen, which creates what’s known as estrogen dominance. That means less progesterone—and less calm and grounding for the nervous system. Without enough progesterone, we’re more reactive. More estrogen makes us more hyped up and sensitive.
During perimenopause PMS, there’s a huge nervous system component. It’s not just hormonal—it’s neurological. And I know we’ve talked about the vagus nerve before, but just to recap: it’s a cranial nerve that descends from the brainstem and governs most of your major organs—esophagus, bladder, heart, gut, etc. It’s really important. By the time we reach perimenopause, our vagus nerve can be a little worn out and frazzled.
The vagus nerve is responsible for “rest and digest,” the calming part of the parasympathetic nervous system. When it’s not functioning well, we’re stuck in fight-or-flight mode and can’t shift into calm.
If your system is already dysregulated, PMS will feel much more intense. When vagal tone is low, your body can’t move out of fight-or-flight. So your PMS isn’t just hormones acting wild—it’s nervous system overwhelm.
Some symptoms of low vagal tone during PMS include heightened irritability or rage, panic attacks or intense anxiety, digestive upset like bloating, constipation, or nausea, trouble sleeping, and emotional volatility. The key word here is: ungrounded.
To ease PMS, toning your vagus nerve is crucial. These are things I’ve talked about before, but they’re worth repeating. Having a daily vagal toning practice can truly change your experience of perimenopause. They don’t take much time, they’re convenient, and you can use them as needed. But practicing daily makes the biggest difference.
Think of it like exercise—you don’t just get up one day and run a marathon. You train. The more you tone your vagus nerve, the more resilient your system becomes during stress or PMS.
Here are some ways to do it:
- **Gargle with cold water**: I do this after brushing my teeth, morning and night. It’s easy—just 30 seconds and incredibly effective.
- **Cold exposure**: I’m not into cold showers, but if you are, try 30 seconds at the end of your shower. Or just splash cold water on your face or dunk your hands in cold water.
- **Breathwork**: My favorite is the extended exhale breath. Inhale for 4, exhale for 8. Repeat. It’s simple and powerful.
- **Humming, chanting, or singing**: The “voo” sound works well. Or just sing a song you love. Chanting after meditation has made a huge difference in my day-to-day.
- **Safe social connection**: Surround yourself with people who make you feel safe and seen. It’s incredibly regulating.
- **Massage**: Use your Women’s Circle oil and do daily self-massage around your neck, chest, and abdomen. It’s grounding and nourishing.
Let’s move into some lifestyle strategies to support your system:
- **Stabilize blood sugar**: Healthy fats help. If you’re craving sugar, try peanut butter with an apple.
- **Magnesium and Vitamin B6**: B6 is especially helpful for mood and skin (think breakouts or rosacea), and it acts as a mild diuretic.
- **Evening primrose oil**: Start taking it two weeks before your period. It can help lessen PMS symptoms.
- **Hydration**: Drink lots of water. Always, but especially during PMS.
Aromatherapy is another favorite. I love using clary sage, rose, geranium, frankincense, and grapefruit in a diffuser or inhaler. Lately, I’ve been loving a blend of clary sage, grapefruit, and neroli (or pettigrain as a more affordable option). I use it a week before my period, especially at night. Keep your diffuser on an intermittent setting by your bed to get the benefits while you sleep.
Now, let’s say you’ve done everything right—eating well, cutting caffeine, using aromatherapy—but you’re still having a rough day. That’s where I bring in two emergency tools:
1. **Cannabis tincture**: I use a balanced CBD/THC blend (about 50/50). Just the recommended dose helps take the edge off. Only where legal, of course.
2. **Orgasm**: Yes, really. Whether solo or with a partner, orgasms release oxytocin, dopamine, endorphins, and prolactin—all of which reduce stress and emotional intensity. It’s a nervous system reset and can help with cramps and bloating too.
Finally, what is PMS really trying to show us?
I always tell younger women to look at what’s coming up during PMS. If you’re furious, exhausted, or overwhelmed—it’s not just hormones. It’s your body telling you something. If the same issue or person keeps triggering you each month, write it down. Don’t act on it in the moment, but revisit it after your PMS passes. This is your chance to course correct, before things manifest physically.
### Journal Prompts:
1. What patterns or emotions tend to show up before your bleed?
2. What might your body or intuition be trying to tell you?
3. How can you better support yourself emotionally and physically in the week before your period?
Perimenopausal PMS isn’t chaos—it’s communication. When we stop resisting and start tending to ourselves, something softens. We begin to hear the wisdom underneath. And from there, we begin to come home to ourselves.