PMS
PMS treatment in Dublin: finding what drives your symptoms
Do the days before your period bring bloating, sore breasts, irritability, low mood and broken sleep? If all of it lifts once the bleeding starts, that is the pattern of premenstrual syndrome, or PMS. PMS treatment starts with finding out why the second half of your cycle goes the way it does. We do that whether or not you're trying to conceive. The first step is a 20-minute women's health consultation, EUR 100, and you don't need a GP referral to book it.
What PMS is, and how it differs from PMDD
PMS is a recurring set of physical and emotional symptoms that builds in the days before your period and clears when it arrives. Bloating, breast tenderness, irritability, low mood, carbohydrate cravings, fatigue and disturbed sleep are the usual ones. A day or two of this before a period sits within the range of normal. Four or more days, cycle after cycle, is PMS. Roughly one woman in four has it.
PMDD is premenstrual dysphoric disorder, the severe end of the same spectrum, where symptoms get in the way of work, family and relationships. Roughly one woman in twenty has it. If that sounds closer to your month, our page on PMDD treatment is the one to read.
Timing is what matters. Symptoms that clear with your period point to PMS or PMDD. Symptoms that run all month point somewhere else and need a different investigation. The symptoms are real, they follow the hormones of the cycle, and they're worth investigating rather than riding out.
What drives PMS symptoms
PMS belongs to the second half of the cycle, the weeks between ovulation and your period, which doctors call the luteal phase. What happens in those weeks depends a lot on the quality of the ovulation before them. That is why ovulation matters even when you aren't trying to conceive.
In our clinical experience, women with PMS consistently show lower progesterone, oestradiol and beta-endorphin in the second half of the cycle than women without it. Beta-endorphin is one of your body's own pain-relieving, mood-lifting chemicals, so when it runs low, mood, pain tolerance and sleep all feel it. We call this pattern clinical endorphin deficiency. That's a mouthful, but it just means your own endorphin supply is short when you need it most.
Low progesterone after ovulation can make the symptoms heavier, and low endorphins can do the same. The two sit side by side, so when we investigate PMS we look at both together.
Investigating PMS: the chart, the hormones and the timing
A symptom diary on its own isn't enough, so what we do is we look at three things together. We look at your chart, we look at your hormones, and we look at where in the cycle the symptoms land.
The chart comes first. You record your symptoms and how severe they are against each cycle day in the ChartNeo app, and the pattern often shows itself clearly. Charting is useful here even if pregnancy isn't on your mind.
The hormones come next. A 7 DPO blood test, the progesterone test timed from your chart, is taken seven days past ovulation, mid-way through the second half of your cycle. It measures progesterone and oestradiol, and it tells us about the quality of that ovulation. The test is EUR 50 each time. We arrange it after your women's health consultation, and it can't be booked on its own.
We read the chart and the results together, because a hormone level means little without the cycle day it was taken on. If those answers don't explain everything, we look further, at thyroid and adrenal function.
PMS treatment at NeoFertility
Treatment follows what the investigation finds, and it goes in steps. First comes the groundwork: diet, regular exercise, and supplements such as B vitamins and omega 3. Exercise earns its place for a specific reason, because it gives you an endorphin surge of its own.
When symptoms need more than that, medical treatment is the next step, and the choice depends on your results. For some women that includes low dose naltrexone (LDN), a prescription medicine used off-label for PMS that works with your body's own endorphin system. We go through whether it suits you at your consultation. Where your 7 DPO result calls for it, we also look at progesterone support for the second half of the cycle.
If the first step isn't enough, we move to the next one. Medical treatment typically begins in your first or second cycle. Treatment is a process over time, and we follow the clinical picture until the symptoms settle.
The women's health consultation
The women's health consultation is a 20-minute appointment and costs EUR 100. It's a separate appointment from the fertility consultation. It's about your symptoms and your cycle, and it doesn't commit you to anything beyond that first conversation. These consultations are usually with Dr Agnes Toth, who focuses on the broader hormonal medicine side of the practice. If pregnancy is part of what you want, the fertility consultation (45 minutes, EUR 300) is the right first appointment instead.
You can book directly through our contact page. There's no GP referral needed. If you're not sure which appointment you need, the contact page is the place to ask. Payment is taken at booking, and the fee is fully refundable with two working days' notice.
At the first appointment we go through your symptom history and your cycle history. Then we plan your first hormone tests around your next cycle, so the 7 DPO sample falls on the right day.