Before and During Your Period: Strategies for Handling Mood Swings

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Premenstrual mood swings are common. They’re often caused by premenstrual syndrome (PMS) or its more severe form, premenstrual dysphoric disorder (PMDD).

If you notice that you feel more irritable, sad, or anxious than usual before or during your period, you’re in good company. A recent large global survey found that 64 percent of people who menstruate reported having premenstrual mood swings or anxiety. Twenty-eight percent reported that their premenstrual symptoms interfered with their daily life each menstrual cycle.

For many, what’s known as premenstrual syndrome (PMS) can start up to a week before a period, and some symptoms may continue through the first few days of a period.[2] PMS is a set of emotional and physical symptoms that happen during your period. Emotional symptoms of PMS can include mood swings and irritability, as well as feeling sad, depressed, or anxious, among others.

Some may experience a more severe and sometimes debilitating type of PMS called premenstrual dysphoric disorder (PMDD). This may involve more intense mood-related symptoms like anger, severe anxiety, or severe depression.

Here’s what to know about the causes of mood swings before and during your period and how to manage them if they’re interfering with your day to day.

What Causes Mood Swings Before and During Your Period?
The causes of PMS and PMDD, which are largely responsible for mood swings before and during menstrual periods, aren’t entirely known. They’re thought to be caused in part by fluctuations in hormones, or chemical messengers in the body. Specifically, levels of the hormones estrogen and progesterone change before and throughout the menstrual cycle.

As these hormones fluctuate, they can affect neurotransmitters in the brain, such as serotonin, which influences mood, says Alyson R. Kuroski-Mazzei, DO, a psychiatrist and the CEO and chief medical officer at HopeWay, a provider of mental health care services in Charlotte, North Carolina. “Some individuals are more sensitive to these changes, which can result in irritability, sadness, or anxiety during the premenstrual phase and into menstruation,” she says.

Premenstrual symptoms are most commonly experienced during the luteal phase of the menstrual cycle. “That is the time between ovulation and menstruation, when women can often feel symptoms relating to their physical and mental health,” says Jillian LoPiano, MD, MPH, an ob-gyn and the chief health officer at Wisp, a telehealth sexual healthcare platform.

5 Ways to Manage Mood Swings Before and During Your Period
If mood-related symptoms before or during your period are negatively affecting your everyday life, these five strategies can help you cope.

1. Consider Seeing Your Doctor or a Mental Health Professional
If you’re concerned about the effects of PMS on your mood, it could help to tell your doctor about what you’re experiencing. Depending on the severity of your symptoms, they may suggest certain lifestyle changes or, in some cases, medications like antidepressants or anti-anxiety medications that could help.
Consider reaching out to your doctor or a mental health professional if you’re experiencing any of the following symptoms.

Intense feelings of
Mood swings
Lethargy
Anxiety
Difficulty functioning at work, school, or in personal relationships because of mood changes
Feeling out of control or experiencing thoughts of aggression
A noticeable pattern of extreme emotional distress before or around the time of your

Self-harm or suicidal thoughts or behaviors (If you experience these symptoms, call 911 for immediate medical help or dial the Suicide & Crisis Lifeline at 988 to be connected with a trained crisis counselor who can help.)
If you’re finding that mood changes or PMS symptoms are taking a significant toll on you or disrupting your day to day activities, work, school, or relationships, these could potentially be indicators of PMDD, says Dr. LoPiano. “If this is the case I recommend tracking symptoms on an app or calendar and connect with your doctor for an evaluation,” she says.

2. Track Your Symptoms Throughout Your Menstrual Cycle
Tracking your mood symptoms throughout your cycle is often one of the first steps to managing mood swings caused by PMS or PMDD. While this does not directly help you manage mood swings, it can help you begin to notice patterns for when your mood-related symptoms usually pick up.

If necessary, it can also help you share an accurate picture of your symptoms with a doctor. “This helps your provider assist in evaluating your specific case and come up with a plan for treatment,” says LoPiano.

3. Exercise Regularly
In general, exercising for 30 minutes a day can boost endorphins (feel-good chemicals your body releases in response to stress or pain), improve your mood, and relieve stress, says Kuroski-Mazzei. For PMS in particular, activities that get your heart pumping — like running, brisk walking, cycling, or swimming — can ease symptoms like low mood or fatigue.
Regular exercise can be particularly effective when combined with other stress management techniques, such as mindfulness, meditation, or yoga, Kuroski-Mazzei says.

4. Get Enough Sleep Each Night
A regular sleep schedule can make it easier to deal with PMS symptoms like irritability, mood swings, and fatigue, says Kuroski-Mazzei. That’s because going to bed and getting up at the same time every day (or close to it) will set your circadian rhythm, or your body’s internal clock, and reduce your odds of mood-related symptoms throughout the day. Aim for eight hours of sleep each night.

5. Pay Attention to Your Diet
A nutritious, balanced diet is another way to keep PMS symptoms in check.

As mentioned, one of the main causes of mood swings before your period are shifts in hormones like progesterone and estrogen. “There are things that nutrition can do to support these hormones to make [these shifts] less extreme,” says Emily Sucher, RD, a registered dietitian specializing in women’s health and the founder of Live Well Dietitian.

Some tips that can help include:
Eat smaller, more frequent meals to reduce feelings of fullness, bloating, or bowel issues. For example, rather than three large meals, it can help to have three small meals and three snacks and to space them out every two to three hours.
Cut back on salt and salty foods to prevent fluid retention in your body.

Eat foods rich in complex carbohydrates (think fruits, veggies, and whole grains). “Carbohydrates are needed to give us energy, and also, they are feel-good foods,” says Sucher. “If we can make sure we’re eating enough carbohydrates, fueling our body adequately, we’re less likely to have premenstrual or on-our-period mood swings.”
Limit caffeine and alcohol, which can worsen mood swings or anxiety.
Eat calcium-rich foods, such as dairy products, or consider a calcium supplement if you’re not getting enough calcium from your diet. Research suggests calcium may ease PMS symptoms.

Many people who menstruate experience emotional ups and downs as part of premenstrual syndrome (PMS) or the more severe version of PMS, premenstrual dysphoric disorder (PMDD).
It’s not entirely known what causes PMS or PMDD, but they’re thought to be partly due to hormonal fluctuations that happen before and during your period.

If mood-related symptoms are negatively affecting you, see your doctor, track your symptoms, exercise regularly, maintain a consistent sleep schedule, and eat a nutritious diet.

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