# PMS

Category: Conditions

Also known as: premenstrual syndrome, premenstrual, PMDD

Premenstrual syndrome (PMS) is defined by the presence of recurrent, severe symptoms occurring before menstruation with a complete absence of symptoms after menstruation. The syndrome encompasses over 150 different symptoms across multiple organ systems, including headaches…

8 passages · 3 authors · 1984–2021 · Most-cited: [Katharina Dalton](https://bioenergeticoracle.com/md/voices/katharina-dalton/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/pms

## Synthesis

**Premenstrual syndrome (PMS)** is defined by the presence of recurrent, severe symptoms occurring before menstruation with a *complete absence of symptoms after menstruation*. [Source 2] The syndrome encompasses over 150 different symptoms across multiple organ systems, including headaches, migraine, backache, joint pains, bloatedness, asthma, hay fever, and epilepsy, but these are only classified as PMS when they exhibit a strict temporal relationship with the menstrual cycle and a symptom-free interval in the postmenstrual phase. [Source 2] Katharina Dalton, who named the syndrome in 1953, emphasized that the condition is limited to menstruating women and is distinct from continuous depression that lacks a postmenstrual reprieve. [Source 1, 2]

The etiology of PMS, according to Dalton, lies not with serum hormone levels but with the behavior of **progesterone receptors (PR)**. [Source 3] She proposed that PMS results from a failure in the transport of sufficient progesterone molecules by PR into the cell nuclei, which explains why symptoms occur in the luteal phase when progesterone is present and are absent during pregnancy when progesterone levels are massively elevated. [Source 3, 7] This hypothesis accounts for the clinical observation that PMS is unrelated to blood levels of progesterone, estradiol, or other hormones, and why *pharmacological doses of progesterone*—often reaching blood levels equivalent to the third month of pregnancy—are required for effective treatment. [Source 7] Dalton reported that among 1,096 PMS patients, the most frequent dose was 800 mg of progesterone suppository daily, with 30% requiring even higher doses. [Source 7]

Ray Peat framed PMS primarily as a consequence of a *progesterone deficiency* driven by declining thyroid function and rising estrogen, particularly as women approach their late 30s and 40s. [Source 6] He argued that the pharmaceutical industry created the misconception that menopause is an estrogen deficiency, when in reality the failure of progesterone production is the central problem. [Source 6] Peat explained that as estrogen rises, thyroid and progesterone decline, leading to a sluggish digestive system, increased absorption of **endotoxins**, and a vicious cycle that can manifest as migraines and other premenstrual symptoms. [Source 6] He noted that supplementing thyroid or increasing dietary fiber to reduce endotoxin can break this cycle and restore progesterone balance. [Source 6] Georgi Dinkov extended this perspective by characterizing PMS as largely an **energetic disorder** driven by estrogen's role as a major brain excitant and excitotoxin, which elevates cortisol and produces symptoms ranging from psychosis to water retention. [Source 4]

The clinical consequences of untreated PMS are severe and extend beyond the sufferer. Dalton documented that 37% of women attending a PMS clinic had a previous psychiatric hospital admission, 34% had attempted suicide or homicide, and 6% had a history of criminal behavior. [Source 1] Surveys showed that the attempted suicide rate increased sevenfold and shoplifting was thirty times more common in women during the second half of their menstrual cycle. [Source 1] The condition also profoundly affects family members; Dalton found that 54% of mothers bringing children to a surgery for coughs or colds were in their paramenstruum, and children under two years were at highest risk of a surgery attendance during their mother's premenstrual phase. [Source 8] Postnatal depression frequently transitions into PMS, with 84% of women who experienced postnatal depression later developing PMS, suggesting a common pathology involving progesterone receptor failure at different reproductive stages. [Source 5]

## People also ask

### How does progesterone receptor failure cause PMS symptoms?

Dalton proposed that PMS results when progesterone receptors fail to transport enough progesterone into cell nuclei, so symptoms appear in the luteal phase despite normal blood hormone levels, and only massive pharmacological doses of progesterone can overcome this transport defect.

### Why did Ray Peat link PMS to thyroid and endotoxin?

Peat argued that declining thyroid function and rising estrogen create a progesterone deficiency, which slows digestion and increases endotoxin absorption, fueling a vicious cycle that can be interrupted by thyroid supplementation or dietary fiber to reduce endotoxin.

### What is the connection between postnatal depression and PMS?

Dalton found that 84% of women who experienced postnatal depression later developed PMS, suggesting a shared underlying pathology of progesterone receptor failure that manifests at different reproductive stages.

## Related concepts

- [Coconut oil](https://bioenergeticoracle.com/md/concepts/coconut-oil/index.md)
- [Free radicals](https://bioenergeticoracle.com/md/concepts/free-radicals/index.md)
- [Histamine](https://bioenergeticoracle.com/md/concepts/histamine/index.md)
- [Menopause](https://bioenergeticoracle.com/md/concepts/menopause/index.md)
- [PCOS](https://bioenergeticoracle.com/md/concepts/pcos/index.md)
- [Pituitary Gland](https://bioenergeticoracle.com/md/concepts/pituitary-gland/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Once a Month: Understanding and Treating PMS

Katharina Dalton · Book · 1999

> Before the month had passed, I had found a further case of asthma, two of epilepsy, and two of migraines that all occurred just before menstruation. They also responded successfully to progesterone. Together with Dr. Raymond Greene (brother of author Graham Greene) I continued to find more cases of PMS, and in 1953 we published in the British Medical Journal the first paper in medical literature describing the many bodily premenstrual presentations, as well as tension, and gave it the name "premenstrual syndrome."
>
> Under the NHS, general practitioners were allowed to prescribe any drugs needed, but no toiletry or food. This meant that I was able to give progesterone treatments to all my diagnosed PMS patients. Every year our prescribing costs were studied, and those practitioners whose costs were above average received a visit from the Man from the Ministry, who discussed costs and ways in which they could be reduced. Those doctors persistently overprescribing after being advised three times were entitled to be heard by a tribunal before being fined. So in 1958 I attended the first ever NHS Tribunal on Over Prescribing and was judged by a barrister, a professor of obstetrics from Liverpool, and a general practitioner from Birmingham. The Medical Defence Union defended me superbly. The problem arose from my prescribing progesterone for thirty-five PMS patients during one specified month. Their full medical records were available showing their menstrual charts, previous suicide attempts, mental hospital admissions, and normal gynecological examinations. Finally the tribunal agreed that "progesterone is reasonable and necessary treatment for premenstrual syndrome." They did add that mine was not an average practice as it had more females than males (surprised?), that if all doctors prescribed as I did the cost of progesterone would go down, but that if all doctors prescribed progesterone to all their patients with PMS immediately the cost to the nation would equal the annual defense budget. The announcement was low-key, the media of the day did not cover it, and I continued treatment of an everincreasing caseload of PMS patients.
>
> Surveys in North London showed that the attempted suicide rate increased sevenfold for women who were in the second half of their menstrual cycle, and shoplifting was thirty times more common in women who were in the second half of the cycle.

### Source 2 — Depression After Childbirth: How to Recognize, Treat, and Prevent Postnatal Depression

Katharina Dalton · Book · 2001

> ### Definition of premenstrual syndrome
>
> **Katharina Dalton:** It is important to know the correct definition of PMS, because the phrase is often used loosely and frequently in the wrong context (see Box). Using this definition, you will understand why Stage 2 in Fig. 24 could never be PMS, because the depression continues during the postmenstruum. It is only in Stage 3, when there is no depression in the postmenstruum, that the title PMS can be used. The word 'syndrome' means a collection of symptoms which commonly occur together. In PMS there are over one hundred and fifty different symptoms; among this great variety of symptoms are headaches, migraine, backache, joint pains, bloatedness, asthma, hay fever, and epilepsy. These symptoms occur in different organs of the body and, of course, occur also in men and children, but they are only included in PMS if there is a close time relationship with menstruation and if there are a few days completely without symptoms, always in the same phase of the menstrual cycle.

### Source 3 — The Aetiology of Premenstrual Syndrome Is with the Progesterone Receptors

Katharina Dalton · Article · 1990

> Medical Hypotheses (1990) 31, 323-327
> © Longman Group UK Ltd 1990
> 0306-9877/90/0031-0323/$10.00
>
> # The Aetiology of Premenstrual Syndrome is with the Progesterone Receptors
>
> K. DALTON
>
> 100 Harley Street, London W.1, UK
>
> **Abstract** — Recent work by molecular biologists into the behaviour of progesterone receptors (PR) has suggested an aetiological hypothesis for premenstrual syndrome (PMS). The proposition is that PMS is related to the transport by PR of sufficient progesterone (P) molecules into the cell nuclei during menstruating years. PR are widely distributed in target cells throughout the body (1, 2, 3, 4, 5, 6, 7). It suggests also why measuring P blood levels is of no value in PMS (8, 9, 10, 11); why pharmacological doses of P are required (8); and explains the failure of current double blind trials using low dose P (12, 13, 14, 15, 16).
>
> ## Introduction
>
> PMS is the presence of recurrent premenstrual symptoms with complete absence in the postmenstruum (8), and is limited to menstruating women. Patients benefit from high dose P (8, 17, 18, 19, 20, 21), even though other studies have shown that neither the disease nor its severity is related to P blood levels (9, 10, 11), and double blind controlled studies show low dose P to be no more effective than placebo (12, 13, 14, 15, 16). PMS has a high placebo response rate (22), and others suggest PMS represents not one but many syndromes (23). Recent work on PR suggests a possible explanation of these confounding results.
>
> Date received 22 February 1989
> Date accepted 2 May 1989
>
> ## Reasons for implication progesterone
>
> P was first used for PMS because PMS symptoms are present in the luteal phase and absent after menstruation (8). Thus symptoms occur in the luteal phase when P blood level is raised, and symptoms are absent in the follicular phase when blood P is absent.

### Source 4 — PMS, PCOS, and Breast Cancer [Generative Energy #17]

Danny Roddy · Interview · Dec 30, 2015 · https://www.youtube.com/watch?v=sDu-bLKwnSI

> **Georgi Dinkov:** Basically, whenever you have any kind of a dysregulation, any kind of a disorder that involves mood, mental disorders, or bleeding, chances are that estrogen is involved. As of right now, at least the psychiatric industry, if I can call it this way, is already aware that PMS is largely an energetic disorder. So they have almost given up on treating it with birth control. So now they're actually starting to prescribe drugs that are known to sort of calm the brain. So Some of the latest treatments for PMS are actually GABA agonists, drugs that are used either for treating anxiety or epileptic seizures or other disorders. And as we well know, estrogen is a major brain excitant. If you want to get the same effects but probably less harmful than estrogen, you can inject yourself with cocaine. They have identical effect on the brain. Severe cases, it actually, it can have like the seizures, the mania or extreme depression. They have bipolar disorder. Some of the people that suffer from really bad cases of PMS, they have cramps, abdominal cramps. They're known to retain water more easily. For every single one of these symptoms, estrogen has a very central role. it disturbs brain function as i just described it's an excitotoxin so it kills brain cells even if the exposure is i think within within a few minutes of elevated estrogen exposure your brains just start to die it also increases the production of cortisol like i mentioned before and destroys the negative feedback mechanism so you'll get high cortisol as well whenever you have high cortisol you will not be in a good mood you know if cortisol is mildly elevated you'll be in a state which many people may confuse with a mild euphoria But anything beyond that gives you very nasty symptoms. Even in moderately elevated cortisol, it gives you nasty symptoms like psychosis.

### Source 5 — Depression After Childbirth: How to Recognize, Treat, and Prevent Postnatal Depression

Katharina Dalton · Book · 2001

> ### Premenstrual syndrome
>
> **Katharina Dalton:** In view of the fact that PND so often develops into premenstrual syndrome (PMS), the survey reported at the 1985 Marce Society meeting in San Francisco was further analysed to find whether PMS had started before or after the PND. Before the pregnancy that was followed by PND, 20 per cent of the women reported having recognized PMS recurring with each cycle, which is a similar percentage to that present in the general population. However, a completely different picture emerged on analysing the incidence of PMS after PND: as many as 84 per cent of the women suffered from PMS afterwards. The commonest premenstrual symptoms before PND were tension (depression, irritability, and tiredness) and headaches, whereas after PND, epilepsy, asthma, and somatic symptoms were often mentioned, but they were cared for by other specialists and not by psychiatrists. The finding that PND gradually changes to PMS suggests a common pathology, and it is probable that both illnesses represent a failure at cellular level of progesterone receptors at different times in a woman's reproductive life—namely, after delivery and after ovulation. PMS is the subject of the next chapter.

### Source 6 — One Radio Network: Ray Peat with Patrick Timpone — October 18, 2021

Ray Peat · Interview · Oct 18, 2021

> **Ray Peat:** Around the late 30s and into the 40s and 50s, the failure of progesterone is the main problem related to menopause and premenstrual syndrome. And the pharmaceutical industry was responsible for creating the idea that the menopause is a deficiency of estrogen when in reality it's a deficiency of progesterone. And if your thyroid is being blocked progressively by stress or a in adequate diet or rising estrogen, the production of progesterone is largely the consequence of this. So as estrogen rises, thyroid and progesterone decline. That means that your digestive system is going to be sluggish and tend to increase the endotoxins absorbed from a sluggish intestine. And all of those processes interact. So cleaning out the intestine by having a very fibrous food every day. Very often that will break the whole cycle of migraine and related symptoms. But the reason the intestine needs the fiber to work properly is because it's under energized by the decreasing thyroid. And so supplementing thyroid is very similar to supplementing fiber in your diet. It gets the endotoxin down, gets your intestine working.

### Source 7 — The Aetiology of Premenstrual Syndrome Is with the Progesterone Receptors

Katharina Dalton · Article · 1990

> Thus symptoms occur in the luteal phase when P blood level is raised, and symptoms are absent in the follicular phase when blood P is absent. PMS is also absent during pregnancy, when a massive increase in P blood level is present, but severe attacks occur following the precipitous drop of P in the puerperium. In 1953, using P injections, successful treatment of PMS was reported in 87% of carefully diagnosed women (17).
>
> ## Progesterone levels
>
> Adrenal P present in men, women and children is converted into various steroids. During childbearing years, ovarian P is present from ovulation to menstruation, and in pregnancy from the placenta. Following ovulation there is an increase in the P level in peritoneal fluid (24). PMS is not related to the blood levels of P (9, 10, 11, 25), oestradiol (11, 25), follicle stimulating hormone (11), luteinising hormone (11), testosterone (11, 26), prolactin (11, 26, 27), cortisol, aldosterone (7) nor serotonin (28). However, Backstroom et al (29, 30) and Munday et al (31) showed lower plasma P and altered oestrogen levels in PMS subjects. P has a hypotensive action (32). Following tubal sterilisation blood P level drops (33).
>
> ## Progesterone therapy
>
> PMS benefits from P administered intramuscularly (8, 17, 18, 20, 21), rectally or vaginally (8, 19, 21, 34). Micronised oral P relieves mild psychological symptoms (35). Differences in suppository base affect absorption (36, 37, 38, 39). Nasal absorption of P increases with the area of mucosa covered (40, 41). After intramuscular P, serum levels of deoxycorticosterone were two to three times higher than after oral P administration (42, 43). There is an individual variation in the absorption of P, both in time taken to reach peak level and in duration of effectiveness (36, 37). P therapy is from ovulation to menstruation (8).

### Source 8 — The Premenstrual Syndrome and Progesterone Therapy

Katharina Dalton · Book · 1984

> In its mildest form other adults should be able to joke about premenstrual syndrome, making allowances for the temporary disturbing behaviour, but when it is severe, with symptoms causing marital stress and family suffering, specific treatment should be given.
>
> ### The young infant
>
> Children and young infants of only a few months are most sensitive to mother's changes of temperament; they find it impossible to understand the mood changes and fluctuations and may react with psychosomatic problems, such as a cough, runny nose, endless crying or vomiting. In the author's general practice mothers were asked to record the dates of their menstruation, and on a separate chart to record the days of their children's recurrent symptoms. After two or three months it was astonishing how many children's ailments reflected their difficulty in adjusting to the disturbances of mother's paramenstruum (Fig. 25.1). Even a nine-month-old girl reacted with an upper respiratory infection for three consecutive months, each one occurring during her mother's premenstruum (Dalton, 1966).
>
> Fig. 25.1 Relationship of a child's colds to mother's menstruation.
>
> A survey of 100 mothers attending surgery because their children had coughs or colds, showed that 54% of the mothers were in their paramenstruum (Fig. 25.2). The children at risk of a surgery attendance during their mother's paramenstruum were those under two years (71%), only children (67%), those with symptoms of less than 24 hours' duration (66%) and those whose mothers were under 30 years (63%).
>
> Fig. 25.2 Surgery attendance of mothers with sick children. (From Dalton K. (1969). The Menstrual Cycle, Penguin Books.)
>
> There was a possibility that the general practice was biased, so the survey was repeated at the North Middlesex Hospital, a general district hospital, questioning the mothers of 100 children who had been admitted as an emergency. The result was similar; whether the admission was for an accident or an illness, 49% of the mothers were in their paramenstruum at the time of their child's admission (Fig. 25.3).

_Generated 2026-07-20 from the Bioenergetic Oracle corpus._