Open communication and understanding may help minimize challenges of premenstrual syndrome (PMS) on your relationship.

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Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are consistent, monthly experiences for many people that may occur alongside a cycle of often uncomfortable emotional and physical sensations.

You may have heard about the ways that PMS or PMDD can almost immobilize an individual experiencing it. But, the symptoms that accompany PMS in an individual may also cause distress in their relationships.

The good news is that there are ways you and your partner can take care of each other during the PMS/PMDD time span.


Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are related but not identical.

PMS describes a group of behavioral, emotional, and physical symptoms that a person may experience a week or two before a period. PMDD is a more severe form of PMS that can have a greater impact on your day-to-day life.

According to the Office on Women’s Health of the U.S. Department of Health and Human Services, about 90% of women experience PMS symptoms. Some of those symptoms include:

  • fatigue
  • irritability
  • changes in mood
  • decreased sex drive
  • tender breasts
  • bloating
  • cramping

As we mentioned, PMDD is a severe form of PMS, and it affects 3% to 8% of the population. Unlike PMS, healthcare professionals classify PMDD as a depressive disorder. PMDD includes not only physical and behavioral symptoms, but also psychological symptoms like severe irritability, a sense of hopelessness, and even suicidal thoughts. Symptoms appear a week or two before your period.

The exact cause of PMS and PMDD remains unknown, but research points to fluctuations in hormones as responsible. Your sensitivity to changes in estrogen and progesterone levels may determine whether you experience PMS. Two other factors that may play a role in whether you experience symptoms are genetics and stress.

Whom do they affect?

PMS and PMDD don’t only affect people who were assigned female at birth; they may also affect trans women, trans men, and nonbinary and gender-expansive individuals. Anyone who still has an ovary/ovaries can have PMS or PMDD because they still have a menstrual cycle. Transgender individuals experiencing PMS or PMDD often don’t receive the support they need.

Someone who was born without ovaries cannot generally experience PMS or PMDD, since there is no menstrual cycle to trigger clinical symptoms. Nonetheless, some transgender women, who were assigned male at birth, report PMS-like symptoms when using hormone therapy, via estrogen and progesterone intake.

Trans men who were assigned female at birth and, thus, may have ovaries, can experience both PMS and PMDD. Research has not found any evidence that testosterone hormone therapy causes a worsening of mental health conditions. In fact, trans men are more likely to experience improvements in social functioning and reduced anxiety and depression once testosterone therapy is begun.

Additionally, there is evidence that women across cultures and ethnicities experience and name PMS symptoms in different ways.

In 2014, researchers published a study exploring PMS in different ethnic groups and observed various differences in how symptoms were perceived and what kind of symptoms were experienced by different groups. For example, compared with African American and white respondents in the United States, Chinese participants in Hong Kong reported fewer pain- and concentration-related PMS symptoms. They also reported significantly lower levels of emotional symptoms.

The results of this study indicate that PMS symptoms are interpreted differently by different racial and ethnic groups.

PMS and PMDD don’t only affect the individual experiencing them — they may also impact relationships.

Physical symptoms, as well as anxiety and irritability, are the most severe and widely experienced signs of PMS. These feelings may interrupt your relationship with your family, especially in situations where there are overwhelming demands from a partner or children and the person experiencing PMS may find it more difficult to work through or tolerate negative emotions.

A partner’s response to PMS significantly impacts how a person experiences the premenstrual change.

Research conducted between 1990 and 2001 and summarized in a 2008 study indicates that negative PMS experiences can be a crucial factor in a couple’s relationship satisfaction. For example, women who experience symptoms of PMS are more likely to report difficulties or dissatisfaction in their relationship. On the other hand, women felt less PMS distress if their partnership involved effective communication.

This indicates that a partner’s response may either improve or worsen the symptoms of PMS a person experiences. Partners should not be dismissive and should offer extra support.

It’s important to know that PMS affects both partners differently.

In lesbian partnerships and relationships between partners who both have an ovary or ovaries, the time during which PMS occurs is reported to be more supportive and understanding. According to older research, this comes from the lesbian partner’s awareness and recognition of premenstrual change, responsiveness to their partner’s needs, willingness for open communication, and general responsibility sharing.

In contrast, a 2013 study found that cis men were unable to understand the premenstrual situation and often suspected that the signs and symptoms reported by their partners were imaginary, or were dismissed and ignored. Consequently, this misunderstanding may lead to a lack of emotional and practical support, especially for tasks like domestic duties, from the cis male partner.

Women who are straight and experiencing symptoms of PMS show a decrease in shared good experiences with their cis male partner and an increase in relationship conflict during the last week of the cycle. This seems to be the case because while experiencing PMS symptoms, people with ovaries seem to be more sensitive to the unpleasant things in the environment and pay more attention to problems in the relationship than they normally would.

Any partner, regardless of gender, can make a significant positive influence on their partner with PMS, and PMS’s effects on the relationship can be managed.

First, the partner should let the person with ovaries know that they take their PMS or PMDD seriously. The fear that the partner would not take PMS experiences seriously — known as partner dismissal — is one reason why women, particularly those in a heterosexual relationship, may hesitate to give PMS as an explanation for a negative change to mood and behavior.

Communication is critical during this time, and its absence within a couple’s relationship may lead to a higher likelihood of PMS distress. On the contrary, if the partner of someone experiencing PMS responds positively to the other’s open expression of their concerns during this time it is linked to lower rates of premenstrual stress.

During this time period, a partner can show support to the person experiencing PMS by giving them emotional and physical space when needed. Additionally, using patience and acceptance during this time is a helpful way to deal with your partner.

You can also support your partner in practical ways, like doing housework or giving emotional assurance.

In a 2013 study of relationships between cis men and cis women, understanding the women’s experience, and how it differs from that of a cis man, helped men more readily adapt to the woman’s premenstrual changes. It’s also important that the man doesn’t listen to internalized, medicalized concepts and assumptions about PMS, and instead asks directly about his partner’s experience.

Couples-based cognitive behavioral therapy (CBT) is proven to have a greater positive impact on coping behavior, perception of the relationship, and support. For example, one study showed that women who received CBT therapy that included both partners experienced fewer intimate relationship difficulties. On the other hand, women who received individual CBT therapy or no therapy experienced an increase in relationship difficulties.

Aside from your partner or immediate family, social support from friends or your community may also help some people better cope with PMS symptoms.

Lastly, depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome and may help you find additional ways to relieve symptoms.

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are normal behavioral, emotional, and physical symptoms that a person may experience a week or two before a period.

These conditions don’t only affect people who were assigned female at birth but may also affect trans women, trans men, and nonbinary and gender-expansive individuals. Plus, they may affect not only the individual but also their relationships. A partner’s response significantly affects how a person experiences the premenstrual change.

We recommend using this time to practice communication, patience, generosity, and sensitivity. If you and your partner have difficulty managing this cycle alone, reaching out to a therapist for CBT couple’s therapy may be helpful. You also may want to consult a doctor about your symptoms to consider medication.

While PMS symptoms can be challenging both for the person experiencing them and their relationships, challenges can be overcome with teamwork and the right tools by your side.