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PMS and training: working with the week before your period

By Chris Ayers 6 min read

The week before a period is where PMS lives, and it is easy to talk about loosely. PMS has a clinical definition, and knowing it helps, because “I feel off” and “this is a pattern that shows up every month in the same place” are different things.

What PMS is

ACOG, the American College of Obstetricians and Gynecologists, describes PMS as physical or mood changes in the days before menstruation that happen month after month and “affect a woman’s normal life.” The NHS puts it as “the symptoms women can experience in the weeks before their period.”

For a doctor to call it PMS, ACOG says symptoms need to be present “in the 5 days before a period for at least three menstrual cycles in a row”, and they need to end “within 4 days after a period starts”. The timing is the point. A rough week that lands anywhere in the month is not PMS by this definition. A rough week that lands in the same spot three cycles running is.

How common symptoms are in women who train

A 2021 study in the British Journal of Sports Medicine surveyed 6,812 exercising women recruited through the Strava app, none of them on combined hormonal contraception. The most common symptoms were “mood changes/anxiety (90.6%), tiredness/fatigue (86.2%), stomach cramps (84.2%) and breast pain/tenderness (83.1%)”. Women who reported more symptoms were more likely to miss or change training (an odds ratio of 1.09). The authors’ summary was plain: “Menstrual cycle symptoms are very common in exercising women”.

A smaller study followed 58 endurance athletes for a full year, the FENDURA project, published in the Journal of Sports Sciences in 2025. The athletes logged symptoms, sleep quality, readiness to train and resting heart rate across the year. Symptom severity was higher on bleeding days than on the days before, or on other days, in every group. “Perceived sleep quality was lower during pre-bleeding compared to bleeding days”. And “Symptom severity was negatively associated with sleep quality and physical readiness-to-train”. In plain words, the worse the symptoms, the worse the sleep and the less ready the athletes felt. The authors’ advice was to “prioritize symptom management and the adjustment of recovery strategies on an individual basis”.

These are endurance athletes and self-reports, not lifters in a lab. Still, the pattern is worth knowing. In this group, sleep was rated worse in the days before bleeding than during it, and worse symptoms came with lower readiness to train.

Why exercise is on the self-help list

Both ACOG and the NHS list regular exercise among the things that may help with PMS. ACOG: “For many women, regular aerobic exercise lessens PMS symptoms. It may reduce fatigue and depression.” The word to notice is regular. ACOG adds: “Exercise regularly, not just during the days that you have symptoms.” The NHS self-help list also includes sleep and reducing stress.

This is where PMS and exercise cut both ways for someone who trains. Movement is on the list of things that may help. The week before your period is also the week you are most likely to want to skip it. There is no trick here. A lighter session you actually do probably serves you better than a heavy one you cancel, and the evidence above is about regular exercise, not about hitting a number.

Tracking it

Both bodies say to write it down. ACOG: “Each day for at least 2 to 3 months, write down and rate any symptoms you feel. Record the dates of your periods as well.” The NHS says to “keep a diary of your symptoms for at least 2 menstrual cycles”.

That is the part I built. Ferrabelle has a daily log for symptoms, mood, energy and sleep, and it sits on the same timeline as the lifting log. Over a few cycles you can see whether your rough days land where PMS would predict, and whether your training changes with them. The app does not diagnose anything. It keeps the diary ACOG and the NHS are asking for, in one place, with your lifts next to it so you can bring both to a doctor if you want to.

There is one more thing it can do, and it is the feature my wife likes most. With her say-so, the app sends me short notes. The example on the creator page reads: “Quick heads-up: my period could start any day now. A little patience and a slow evening would be great.” Notes never mention fertile days, weight or symptoms, and they are off unless she turns them on. They do not fix anything. They help me show up a little better in the week it matters.

When to see a doctor

ACOG says that if symptoms “are severe and cause problems with work or personal relationships”, it may be PMDD, “a severe type of PMS”. That is a reason to see a doctor, not something to manage with a training tweak. The NHS says to see a GP if lifestyle changes have not helped or if symptoms affect daily life.

Neither body suggests pushing through severe symptoms, and neither do I. I am not a doctor. Your doctor knows your history, and a two-month symptom diary is a useful thing to walk in with.

This is general information, not medical advice. Talk to your doctor about your own health.

Ferrabelle is in a closed test on Google Play right now. If you want to try it, you can join at ferrabelle.com/testers.

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