Premenstrual syndrome despite taking the pill


Premenstrual syndrome is the combination of psychological and physical symptoms that occur due to the hormonal fluctuations before the menstrual period. It is a multifactorial disorder, which is composed of psyche, nervous system and hormonal balance.

Normally the birth control pill is there to control the hormones in the cycle and a premenstrual syndrome should not occur here. This is different, however, with the mini pill and with a pill that is too weakly dosed, since the body's own hormones maintain an almost normal cycle.

Read more on the topic: Test for premenstrual syndrome

Why can premenstrual syndrome develop despite the pill?

Since the exact cause of premenstrual syndrome is not yet clear, various possibilities are discussed. One possibility why premenstrual syndrome develops despite the pill is simply underdosing the pill.

Not every woman needs the same amount of hormones in her cycle and gynecologists try low-dose preparations, especially when starting to take them, which is not always sufficient. The body is therefore still subject to fluctuations in the hormonal balance. The pill break, which many women take after three weeks, also causes cyclical hormone fluctuations and can therefore also trigger symptoms.

Read more on the topic: What happens when you stop taking the pill

Since psychological factors also seem to play a role in the development of premenstrual syndrome, knowledge about the pill break and the upcoming withdrawal bleeding can already cause symptoms.

Read more on the topic: Mood swings

Another reason for premenstrual syndrome is taking the mini pill. This is a pure progestin preparation that only prevents the sperm from entering the uterus and does not prevent the egg cell from maturing. The mini pill allows the body to have an almost natural cycle and thus cannot prevent premenstrual syndrome.

Read more on the topic: Ovulation despite the pill

Can the pill also trigger premenstrual syndrome?

Since the cause of the premenstrual syndrome is at least partially to be found in the hormonal balance of women, an artificial supply of hormones with a pill break can also cause symptoms that did not occur before the pill was taken.

It is also discussed as a cause that some women do not tolerate the degradation products of the progestins and these are contained in all pill preparations. If this thesis is correct, the pill is also a possible cause of premenstrual syndrome.

Read more on the topic:

  • Hormonal drugs
  • Side effect of the pill
  • Depression from the Pill? - Is there something to it?

In addition, women can conclude that they have PMS with the help of various (online) tests. The following article tells you about it: Test for premenstrual syndrome

Premenstrual syndrome after stopping the pill

After stopping the birth control pill, the body finds its way back into a natural cycle relatively quickly, which also includes the hormonal fluctuations that are at least partially responsible for the premenstrual syndrome.

Stopping the pill is a major change in the hormonal balance for the body and can also trigger premenstrual syndrome in women who have never had symptoms. In addition, most of those affected only develop premenstrual syndrome after the age of 30, and this is often the period in which the pill is discontinued due to the desire to have children. Many girls today already take a pill in their early adolescence and do not even know about their natural physical reactions during their monthly cycle. These girls and women sometimes already perceive mild symptoms as premenstrual syndrome.

However, if the symptoms mean restrictions in everyday life after stopping the pill, you can consider taking the pill again. For some sufferers, stopping the pill can also lead to an improvement in symptoms, as the mood is often improved by the elimination of the systemic hormones.

Read more on the topic:

  • Premenstrual Syndrome and Depression
  • Premenstrual Syndrome and Nausea

What can you do?

In the case of premenstrual syndrome despite taking the pill regularly, the dosage may be to blame for the symptoms. Switching to a higher dose pill can prevent premenstrual syndrome. A fundamental change in the preparation can also help, as not all pills are put together exactly the same and even slight changes in the dosages can help.

Taking the pill can also prevent the cyclical symptoms. Many women only take their pill for 21 days and then take a 7-day break. However, this is not necessary for most preparations, as it is an old intake scheme, which had more social reasons. By eliminating the break, the women affected receive the same amount of hormones every day and are not subject to any cyclical changes that can be the cause of the symptoms.

A change from the mini pill to a standard pill can also be the solution to premenstrual syndrome, as the effect is completely different. The mini pill does not interfere with the actual cycle and therefore does not prevent premenstrual syndrome.

In addition to hormonal preparations, drugs can be taken directly against individual symptoms. Commercially available painkillers such as ibuprofen or paracetamol can be used for pain and a psychiatrist can prescribe mood-enhancing medication for depressive moods.

Read more on the topic:

  • Drugs for depression
  • Over-the-counter antidepressants


Most women with premenstrual syndrome will have these symptoms for the entire length of time leading up to menopause. However, with long-term intake of a sufficiently dosed pill, the symptoms can be completely suppressed.

When the menopause occurs, the premenstrual syndrome disappears and the women do not need any further treatment.

Read more on the topic: Signs of menopause