PMS: What It Is, Why We Get It, and How to Treat It

A woman in a robe with her hands over her bloated stomach.


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The experience is different for every woman, ranging from crippling pain to subtle stomach aches, but there's one thing we can all agree on: PMS is no joke. And with the stresses of modern life, our delicate system can be quickly thrown out of balance, causing other complications including mood swings, breakouts, cramping, bloating, and irritability (we've all been there). But while there are myriad stories on how to get rid of period cramps or ease the symptoms, we want to know exactly what PMS is, why we get it, and how to treat it (and preferably before our period hits each month so we can lessen the impact).

This is exactly the plan of attack holistic nutritionist Carly Brawner has each month. In an Instagram story, she shared her personal preparation, which includes a liver detox about a week before her period. Supporting this organ is the key, Brawner wrote, so naturally, we had to reach out and ask her to explain.

Meet the Expert

Carly Brawner is a holistic nutritionist, health coach, and founder of Frolic and Flow.

What PMS Is

Despite suffering from it each month, many women (and men) are still left unsure what PMS actually is. According to Brawner, it's a collection of symptoms about a week before menstruation that 75% of women experience. Often, many of these symptoms continue throughout menstruation, as well. "Common PMS symptoms are bloating, cramping, breast swelling and tenderness, irritability, cravings, and lack of energy, although over 200 have been documented," she tells us. "Some women experience such severe symptoms that doctors have classified a new level of PMS called PPMD (aka premenstrual dysphoric disorder)."

Why We Get PMS

To understand PMS and why we get it, a quick background on female sex hormones is helpful. "In short, estrogen and progesterone are two important sex hormones that work together in unison," Brawner explains. "Their levels fluctuate depending on where you are in your monthly cycle. Estrogen is a growth hormone and is responsible for building the uterus lining in the first half of the cycle. Progesterone keeps estrogen in check and makes sure growth doesn't go overboard in the second half of the cycle. We need both of them for a healthy menstruation cycle."

Brawner says estrogen and progesterone ideally have a harmonic relationship, but that's not always the case: "When there is an imbalance and either too much estrogen (and progesterone is at a normal level) or progesterone levels are low (and estrogen is normal or high), this is called estrogen dominance." This estrogen dominance is what causes PMS and difficult periods, weight gain, and depression, and "makes a woman more likely to be diagnosed with fibroids, ovarian cysts, and fertility issues."

In short, Brawner says PMS can usually be attributed to four main things: diet, stress, toxin exposure, and poor liver function. "Keep in mind there are other hormonal issues, causes, and disorders that lead to estrogen dominance and PMS, and consulting a functional medicine doctor or physician is a great way to learn more about the root cause of your personal hormone situation," she adds.

How to Treat PMS

Hormone imbalance can be as simple as prioritizing a healthy diet, reducing excess toxin exposure, managing stress, and supporting the liver. "For some women, it could mean all of those things, as well as testing and implementing targeted protocols while working with a physician or women’s health specialist," says Brawner.

To help us all get on the pain-free period track, we asked Brawner to share her top hormone-balancing tips:


  • Cut out processed foods full of chemicals, preservatives, trans fats, vegetable oils, and added sugar. For those with severe PMS, alcohol, and caffeine should be consumed in very moderate amounts.
  • Only eat organic meat and dairy. Animals that are injected with growth hormones or fed soy (many conventionally raised animals are) are full of excess hormones that you absorb.
  • Include cruciferous varieties in your four to five servings of vegetables per day, and be sure to get daily helpings of healthy fats, well-sourced protein, and fermented foods.
  • Up your fiber. Regular bowel movements are an important part of hormone balance. Constipation or lack of regularity means the reabsorption of estrogen from the gut to the blood, even after the liver has done its job.


  • "Cortisol is our stress hormone. When we are very stressed, we have lots of cortisol in the body, and more cortisol means less progesterone," Brawner says. "We need the right amount of progesterone to balance out estrogen. Excess stress takes away from humming hormones."

Detox Your Liver One Week Before Your Period

If you're interested in a more detailed timeline and pre-period hormone-balancing plan, then try Brawner's liver detox. About a week before each period starts, she seriously supports her liver. "I try to keep a liver detox in mind when I'm preparing meals, choosing teas, and supplementing," she says. "This is a point in the cycle where estrogen levels are declining, and I like to give my liver a little extra love so it can efficiently get rid of excess hormones. This also helps to set up balanced hormones for menstruation."

Brawner eats plenty of cruciferous veggies, ups her water intake (and adds some chlorophyll to her H20), drinks liver-cleansing teas like dandelion root and milk thistle, and has a daily sauna to relax and combat stress. "I also take an NAC supplement, a precursor to glutathione which is an important antioxidant made in the liver," she says.

Brawner says acne breakouts around the time of menstruation are also a signal that hormones are out of balance. "It signals that I need to put in a little extra work around supporting blood sugar, hormones, and the liver," she says. "For some struggling with PMS, supporting the liver is enough to see improvement. However, for others, seeing a physician for a hormone analysis may be appropriate."

Article Sources
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  1. Ricciotti H. Premenstrual Dysphoric Disorder: When It’s More Than Just PMS. Harvard Women's Health Watch. October 12, 2015.

  2. Matsumoto T, Egawa M, Kimura T, Hayashi T. A Potential Relation Between Premenstrual Symptoms and Subjective Perception of Health and Stress Among College Students: a cross-sectional study. Biopsychosoc Med. 2019;13:26.

  3. St. Albert Naturopathic Clinic. Estrogen Dominance: The Underlying Cause of PMS Symptoms. July 12, 2012.

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