For some women, PMS tension means tight muscles, an achy back or neck, or tension headaches. Others consider it stress or feeling anxious, or on edge. Whatever the case, tension is pretty common and may be caused by or related to any number of other PMS issues: high stress, a lack of sleep, physical discomfort, unstable moods, difficulty concentrating, or even depression. For example, you may be tense because you have PMS-related sleep problems mood swings, or your tension may be the result of high stress levels, which is a risk factor for PMS.

The Causes of Tension and Pain

Physical pain and tension may—or may not— be related to hormones. For example, tension headaches appear to be related to low levels of estrogen (which impacts pain-reducing substances, such as serotonin) and muscle contractions (which are responsible for that tense feeling but may not even play a primary role in tension headache).

Magnesium may also play a role. It turns out that low levels magnesium may trigger muscle tension, especially as related to tension headaches. A 2001 study by researchers at Brooklyn’s Center for Cardiovascular and Muscle Research found that muscle tightness, tenderness, cramps, and strain were all related to tension headaches and to a magnesium deficiency. The study suggested that magnesium supplementation would be a “great benefit” in many situations.

Stress plays a role in pain and tension, both in a biological sense (stress hormones flood the body and produce physical effects, such as muscle contractions) and in a psychological sense (causing worry and anxiety).

High levels of estrogen in the body can cause anxiety. The week prior to the premenstrual period, when estrogen is high (estrogen peaks at about day fourteen of the cycle, then drops) and progesterone is low, may be riddled with anxiety and tension (remember, progesterone mediates the effects of estrogen).

Severe cases of tension or anxiety may require medication antidepressants), but other milder forms of tension can be with the following:

• Over-the-counter pain relievers

• Massage

• Exercise

• Yoga

• Epsom salt bath (helps to relieve aches and pains)

• Elimination of caffeine and sugar

• Increased intake of magnesium