Expert insights to help you understand PMS

Premenstrual symptoms can affect women in very different ways - from mood changes and fatigue to bloating, cravings, anxiety and disrupted sleep. Yet many women are still told their hormone levels are 'normal,' leaving them frustrated, unheard and unsure where to turn next.

To explore the connection between PMS, nutrition and lifestyle, we spoke with nutritionist Bella Dorey from Bella’s Nutrition, who regularly works with women experiencing hormone-related symptoms. Drawing from both current research and her own clinical experience, Bella shares her perspective on why PMS symptoms can persist even when blood tests appear normal, how stress can intensify symptoms, and what women should actually look for when choosing a PMS supplement.

The following insights reflect Bella’s personal professional experience and nutritional approach to supporting women with PMS.

With the conversation around women’s hormones growing, what drew you to this field?

Hormone-related issues have affected me personally, along with pretty much every woman I know, so when I trained, it just felt right to help other women with these issues. The truth is, if you work with women in any capacity, hormones are always part of the picture. You can’t separate them out. 

PMS affects up to 75% of women yet is still widely dismissed as "just part of being a woman" – what’s actually happening hormonally in the lead-up to a period that causes those symptoms?

PMS symptoms typically begin in the luteal phase, when oestrogen and progesterone both fluctuate, before dropping sharply right before the period. That hormonal shift directly affects neurotransmitters like serotonin and dopamine, which is why PMS symptoms are both physical and psychological. 

On top of this, insulin sensitivity can change, and the stress response can be amplified, which is why many women feel more anxious, emotional tired or hungry before their period. It really does feel like everything is working against you, because hormonally, it is!

Are there specific nutrients or foods that have a genuinely meaningful impact on PMS symptoms?

Absolutely. I always start with blood sugar levels and the nervous system, because both directly influence hormone balance. That means prioritising eating enough protein, healthy fats and fibre with every meal. Around 90% of us don’t eat enough fibre, and that alone can be a gamechanger for symptoms. Chromium is brilliant addition to support blood sugar stability too. 

B vitamins are a non-negotiable for me, because they support the nervous system, mood and hormone metabolism all at once. Ashwagandha is wonderful for calming the stress response, and Agnus Castus has robust research behind it for PMS specifically.

Supporting the gut and liver function is also important, as if either are sluggish, it can make symptoms worse. 

For someone who's been told their hormone levels are "normal" but still feels terrible before their period every month - what would you say to them?

Keep investigating. “Normal” on a standard blood panel doesn’t mean optimal, and it certainly doesn’t mean nothing can be done. Trust how you feel - your body is telling you something. 

There is so much that nutritional therapy can offer here, from blood sugar regulation, to stress support and gut health, the levers we can pull are significant. There is no reason you should be suffering every month, and finding the right support can be genuinely life changing. 

Many women notice their PMS worsens during stressful periods - why is that?

Stress is a massive piece of the puzzle that often gets overlooked. Our stress response is heightened in the luteal phase, while the stress threshold can be lower, meaning things that wouldn’t normally affect you, suddenly feel overwhelming. 

Cortisol is our main stress hormone, and it can disrupt blood sugar levels as well as interfere with sleep, both of which have a direct, knock-on effect on hormone balance. It’s a compounding cycle. Managing stress is genuinely clinically supportive of PMS.

Looking back, is there anything you wish you knew sooner about PMS?

That you don’t have to just put up with it. For so long, I assumed that this was just the deal, but it isn’t.

If you find the right person to support you, the answers you need will be found, and this can drastically improve quality of life. 

I also wish there was more awareness of the emotional and cognitive symptoms: the anxiety, low mood and overwhelm. The impact that hormonal shifts can have in the brain is real.

With so many PMS supplements available, what separates a well-formulated PMS supplement from clever marketing?

B vitamins are at the top of my list. B6 in particular has solid evidence for reducing PMS symptoms, and the B vitamins collectively support mood, energy, sleep and hormone metabolism. 

Agnus Castus is one of the most well-researched herbs for PMS, helping to support hormonal balance across the cycle, with particular evidence for reducing breast tenderness, mood changes and irritability. 

Chromium supports blood sugar stability during the luteal phase. And ashwagandha as an adaptogen helps modulate the cortisol response that can exacerbate symptoms.

Vitamin D deficiency is extremely common and closely linked to worsening PMS, so this is worth checking and supplementing where indicated.  

What I love about PMS Hero^® is that it brings many of these key ingredients together. It’s a considered, evidence-informed formula, that is built around the hormonal mechanism, not just symptom management, whilst at the same time, giving broader support. 

Bella Dorey, Registered Nutritional Therapist, BSc, mBANT, CNHC

Bella Dorey is a BANT-registered nutritional therapist with a First Class BSc (Hons) from the Institute for Optimum Nutrition. She has over six years of experience supporting adults with hormonal health, digestion, skin health, low energy and general wellbeing. She has a particular interest in hormonal health, and the way hormones, gut health, stress and lifestyle factors interact to influence how we feel throughout the month. Bella takes a root-cause, whole-person approach, helping clients understand what may be driving their symptoms and supporting them with practical, realistic changes that fit into everyday life. Her focus is on simple, personalised nutrition and lifestyle strategies that support long-term balance, without unnecessary restriction or complexity.

Visit her website: https://www.bellasnutrition.co.uk