PMS and Food Cravings: Why Your Appetite Changes and What It Means for Your Mental Health

If you have PMS, you will likely recognise the experience of the premenstrual phase changing not just your mood but your relationship with food. Appetite increases, specific cravings arrive with unusual intensity, eating patterns shift in ways that can feel out of character or even out of control. Understanding why PMS affects appetite and eating the way it does — and what that means from a mental health perspective — is the focus of this article.

Why PMS Changes Your Appetite

The appetite and eating changes associated with PMS are not random, and they are not simply a matter of willpower or self-discipline. They are driven by real hormonal and neurological processes that operate largely outside conscious control. Understanding these processes is the first step towards relating to the changes with something other than frustration or self-criticism.

In the late luteal phase — typically the ten to fourteen days before menstruation begins — levels of progesterone and oestrogen shift significantly. These hormonal changes affect several neurochemical systems that are directly relevant to appetite and eating behaviour. Serotonin levels, which influence mood, impulse control, and the sense of satisfaction that eating produces, tend to fall during this phase. The body’s attempt to restore serotonin through food is one of the biological drivers behind the characteristic premenstrual craving for sweet, starchy, or comfort foods.

The Role of Cortisol and Stress

The hormonal changes of the luteal phase also affect the body’s stress response system. Cortisol — the primary stress hormone — is often elevated during the premenstrual phase, and elevated cortisol has a consistent association with increased appetite, reduced impulse control around food, and a heightened preference for energy-dense foods. This is not incidental: the body under stress is biologically primed to seek energy-rich nutrition. The problem is that the stress is hormonally generated rather than situationally accurate, meaning the appetite signals do not correspond to any genuine energy deficit.

PMS Food Cravings: What the Psychology Tells Us

The food cravings that accompany PMS are not simply physical sensations — they have a psychological dimension that is worth understanding. For many people, food during the premenstrual phase functions as emotional regulation: a reliable, accessible way of temporarily improving a mood state that the hormonal environment is making significantly worse. This is not a conscious strategy. It is an automatic response to dysphoria, anxiety, and irritability that develops over time through the repeated experience of feeling better — briefly — after eating something comforting.

Food as Self-Soothing

From a psychological perspective, using food as self-soothing is a functional coping strategy in the short term. It works — temporarily. The problem is that it tends to generate a secondary emotional response: guilt, shame, or frustration about the eating itself, which then contributes to the negative mood state and sometimes triggers further eating. This cycle — premenstrual dysphoria, eating to soothe it, shame about the eating, more dysphoria — is one of the most psychologically costly aspects of PMS for many people, and it is also one that is most amenable to therapeutic support.

It is important to be clear that using food for comfort is not a character failing. It is an understandable response to a genuinely difficult mood state. The goal of therapeutic work in this area is not to judge or eliminate the impulse to eat for comfort but to understand it, to develop a wider range of coping strategies so that food is not the only available option, and to address the shame and self-criticism that often makes the pattern more entrenched rather than less.

The Gut-Brain Connection and PMS

The relationship between PMS and eating behaviour is also shaped by the gut-brain connection — the bidirectional communication system between the digestive system and the brain that influences mood, appetite, and emotional regulation. The enteric nervous system, which governs the gut, contains a significant proportion of the body’s serotonin — the neurotransmitter most directly implicated in both mood regulation and appetite satisfaction.

Why Digestive Symptoms Affect Mood

Many people with PMS experience significant digestive symptoms — bloating, cramping, changes in bowel habit — during the premenstrual phase. These symptoms are not only physically uncomfortable; they also have a direct effect on mood. The gut-brain bidirectional relationship means that gut discomfort reliably worsens mood, and worsened mood reliably affects appetite and eating behaviour. For people with more severe premenstrual symptoms — including those with PMDD — this gut-brain interaction can significantly amplify the overall psychological distress of the premenstrual phase.

What This Means for Eating During PMS

Understanding the gut-brain connection during PMS has a practical implication: the eating changes of the premenstrual phase are not simply about willpower or appetite in the conventional sense. They are part of a complex interaction between hormonal changes, mood dysregulation, digestive discomfort, and the automatic attempt to self-regulate through food. Addressing these patterns effectively requires working with the emotional and psychological dimensions, not only with the eating behaviour itself. This is why counselling — rather than purely dietary intervention — is relevant for people who find that food and eating become a significant source of distress during the premenstrual phase.

When PMS Eating Patterns Become a Source of Distress

For many people, the eating changes associated with PMS are manageable — uncomfortable, perhaps, but not significantly affecting wellbeing or daily functioning. For others, the premenstrual relationship with food becomes a significant source of distress: a pattern of eating that feels out of control, followed by strong negative feelings, that recurs predictably with the cycle and compounds the existing psychological burden of PMS.

Emotional Eating and PMS

Emotional eating — eating in response to emotional states rather than physical hunger — is one of the most common presentations of food-related distress in the premenstrual phase. It is important to understand that emotional eating is not the same as an eating disorder, and experiencing it does not mean a person has disordered eating. It is a common, understandable response to emotional difficulty that becomes problematic when it is the primary available coping strategy, when it consistently produces significant guilt or shame, or when it begins to affect quality of life.

If emotional eating during PMS has become a significant source of distress, the psychological dimensions of the pattern are appropriately addressed in individual counselling. For any concerns about disordered eating that go beyond the premenstrual phase or that significantly affect physical health, a GP assessment is the appropriate first step.

The Shame Cycle

One of the most psychologically damaging aspects of premenstrual eating patterns for many people is not the eating itself but the shame that follows it. The shame cycle — eating something in response to emotional distress, feeling guilty about it, experiencing shame about the guilt, and using that shame as evidence of inadequacy — is a significant source of sustained psychological distress that is directly addressable through therapeutic work. CBT is particularly effective here, both in challenging the catastrophic self-evaluations that shame generates and in developing a more accurate and compassionate understanding of what the eating behaviour is actually about.

PMS, PMDD and Your Relationship With Food

For people with PMDD — the more severe form of premenstrual syndrome — the relationship between the premenstrual phase and eating behaviour is typically more intense than in PMS. The emotional dysregulation that characterises PMDD amplifies the emotional eating pattern: the mood states that drive the eating are more severe, the impulse control difficulties of the luteal phase are more pronounced, and the shame that follows is often greater.

Many people with PMDD describe a specific awareness of the cyclical nature of their eating pattern: knowing, in the follicular phase, that the premenstrual phase will bring a deterioration in their relationship with food, and experiencing a sense of helplessness about this that itself contributes to the pattern. This awareness without agency is a psychologically familiar feature of PMDD — and it is one that therapeutic work can meaningfully address.

Seeking Dietary Guidance Alongside Psychological Support

This article has focused on the psychological dimensions of PMS, PMDD, and eating behaviour, which is the appropriate scope for a counselling practice. If you are also looking for specific guidance on nutrition during the premenstrual phase, the appropriate professionals are your GP, who can assess whether any medical factors are relevant, or a registered dietitian, who can provide evidence-based nutritional guidance within their area of expertise. Counselling and dietary support are complementary rather than competing approaches to premenstrual wellbeing.

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THE AUTHOR

Ian Stockbridge

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Founder & Clinical Director — Hope Therapy & Counselling Services

MBACP (Senior Accredited) · SNCPS (Acc) · BSc (Hons) CBT · PGCert Clinical Supervision

Founder of Hope Therapy, published author, clinical supervisor, and co-presenter of The Talk Room Podcast. Practising therapist with 25+ years of senior leadership experience.

Before Ian Stockbridge was a therapist, he was a leader. For more than 25 years he worked in senior management and directorial roles across commercial organisations — at times managing teams of more than 200 people. He was effective at it. But the longer he did it, the harder something became to ignore. The people around him were struggling. Capable, committed, often high-achieving people carrying invisible weight that had nowhere to go. Stress accumulated quietly across months and years. Anxiety managed behind professionalism. Relationships and mental health dealt with in the margins of a working life that left little room for either.

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