Premenstrual syndrome & hormonal mood swings: What to do

Summary: Premenstrual Syndrome (PMS) and hormonal mood swings are common in the lead-up to menstruation, driven by hormonal fluctuations affecting mood-regulating chemicals like serotonin. Symptoms can range from irritability and sadness to anxiety and fatigue, typically easing once the period begins. While PMS is manageable, severe cases might signal Premenstrual Dysphoric Disorder (PMDD), requiring medical care. Lifestyle changes, stress management, and medical support can effectively reduce mood swings and improve emotional well-being.

Premenstrual Syndrome (PMS) and hormonal mood swings are common concerns for many women in the days leading up to their period. These emotional and physical changes can vary from mild irritability to severe mood swings, fatigue, and other symptoms. Understanding PMS and its relationship with hormonal fluctuations is crucial for managing these challenges. While the effects of PMS and hormonal mood swings can be overwhelming, various strategies and lifestyle changes can ease these issues. Let’s explore the nature of PMS, its hormonal links and effective coping methods.  

Premenstrual syndrome explained

Premenstrual Syndrome refers to a collection of physical, emotional, and behavioural symptoms that occur in the days or weeks before a woman’s menstrual cycle. The menstrual cycle typically spans around 28 days, though it can vary from 21 to 35 days. It is divided into four key phases. Each phase involves the production of different hormones causing various physical and emotional responses.   Here’s how the phases are divided: 

• Menstrual phase: Days 1 to 5 
• Follicular phase: Days 6 to 13 
• Ovulation: Days 14 to 16 
• Luteal phase: Days 16 to 28 

The symptoms of PMS may include bloating, fatigue, headaches, breast tenderness, sleep disruptions, cramping, changes in appetite, mood swings, or increased sensitivity. These symptoms may differ in severity and duration. They usually occur after ovulation and diminish once the menstrual bleeding begins. 

Can premenstrual syndrome (PMS) cause mood swings?

Yes, Premenstrual Syndrome (PMS) can cause mood swings. Hormonal shifts during the menstrual cycle, especially changes in oestrogen and progesterone levels, can affect brain chemistry and emotional regulation. This often leads to irritability, nervousness, sadness, and sudden mood changes. Mood swings can vary from mild frustration to more significant emotional distress, commonly in the two weeks leading up to menstruation, and subsiding once the period starts.   

When are PMS mood swings most likely to occur?

PMS mood swings are most commonly experienced during the luteal phase of the menstrual cycle, which is two weeks after ovulation and just before menstruation begins. This phase usually starts around day 14 of a 28-day cycle and concludes with the beginning of the period. Hormonal shifts, particularly in oestrogen and progesterone, can trigger emotional symptoms such as irritability, anxiety, and mood swings. These symptoms generally ease once menstruation starts.  

What period mood swings feel like

Experiencing mood swings during your period can be tumultuous: one minute, you’re okay, and the next, you’re suddenly overwhelmed by annoyance, sadness, or frustration over trivial matters. 

• Unexpected annoyance: Minor irritations (such as someone eating loudly) can trigger irrational anger. 
• Crying unexpectedly: A heartwarming puppy video? Tears. A slightly sorrowful song? More tears. 
• Feeling unsettled: At times, everything can feel overwhelming, leading you to lose your temper with others even if that wasn’t your intention. 
• Decreased self-esteem: You might feel more insecure or doubtful about things that usually wouldn’t bother you. 
• Episodic joy: Occasionally, there will be random moments of happiness and energy outbursts. 

Mood swings during your period are a chaotic mix of emotions: swift annoyance, unforeseen tears, heightened sensitivity, and momentary surges of joy. These can be traced back to hormonal changes—changes in oestrogen and progesterone influence mood-regulating chemicals like serotonin and GABA – key regulators of mood and emotional stability, making emotions hard to predict. 

Also read: 8 natural menopause treatments that really work

Are there any risk factors?

Yes, certain elements can raise the likelihood of severe period mood swings, including: 

• Hormonal fluctuations: Conditions such as PCOS (Polycystic Ovary Syndrome), which disrupts ovulation and hormone levels,  or thyroid issues, which affect metabolism and mood regulation, can exacerbate hormonal mood fluctuations.Stress: Elevated stress levels can intensify emotional instability. 
• Poor nutrition: A deficiency in crucial nutrients (like magnesium, vitamin B6, and omega-3s) can influence mood stability. 
• Insufficient sleep: Lack of rest can intensify mood swings. 
• Mental health history: Previous conditions like anxiety, depression, or mood disorders can increase emotional sensitivity. 
• Caffeine and alcohol intake: These substances can disrupt hormonal balance and worsen mood changes. 
• Inactivity: Regular physical activity helps regulate mood through endorphin release, so a lack of exercise can lead to mood swings. 

If emotions become extreme and begin to affect day-to-day life, it might signal premenstrual dysphoric disorder (PMDD) and could necessitate medical intervention. 

When to consult a GP

See a GP if your period mood swings are severe or ongoing or disrupt your daily activities. Look out for signs such as drastic mood shifts, severe anxiety or depression, uncontrollable rage, or thoughts of self-harm. If symptoms worsen before each period and impact relationships, work, or routines, this could be indicative of premenstrual dysphoric disorder (PMDD), a clinically recognised condition. Also, consult a doctor if mood swings are accompanied by irregular cycles, excessive fatigue, or physical issues like severe cramps and headaches. A healthcare provider can evaluate hormone levels, recommend lifestyle alterations, or propose treatment options such as therapy, supplements, or medications for improved mood management. 

A telehealth appointment with a doctor online can be helpful for people who are looking to discuss their condition and request Dr certificate, scripts online or referral from home.  

PMS vs PMDD

Premenstrual syndrome (PMS)

• Symptoms: Mood swings, irritability, bloating, tiredness, breast tenderness, and mild anxiety or depression. 
• Severity: The symptoms are manageable and do not interfere with daily life. 
• Treatment: Treatments include lifestyle adjustments, physical activity, a balanced diet, and over-the-counter pain relief. 

Premenstrual dysphoric disorder (PMDD)

• Symptoms: Symptoms include intense mood swings, extreme irritability, severe depression or anxiety, suicidal thoughts, panic attacks, and physical discomfort. It can affect 3-8% of menstruating women.  
• Severity: PMDD significantly affects work, relationships, and daily functioning. 
• Treatment: Requires medical attention—may involve therapy, antidepressants, hormonal treatments, or lifestyle changes. 

PMS leads to moderate mood swings and physical discomfort, whereas PMDD is a serious, debilitating condition characterised by intense emotional and physical symptoms. If mood alterations considerably affect daily activities, medical advice may be necessary.  Also read: Signs of hormone imbalance: How to tell & next steps 

How to manage it

Mood swings during your period can be overwhelming. It can influence feelings, energy levels, and impact everyday life. Although symptoms can vary, managing them through lifestyle modifications, stress management, and medical assistance can help maintain emotional equilibrium: 

1. Lifestyle modifications: Regular exercise enhances endorphins, while a nutritious diet rich in magnesium, vitamin B6, and omega-3s promotes mood stability. Prioritising sleep aids in regulating emotions. 
2. Stress reduction: Mindfulness, yoga, and deep breathing can alleviate stress. Limiting caffeine and alcohol helps prevent mood variations. 
3. Medical assistance: Pain relief can assist with physical symptoms, and hormonal therapy or antidepressants may be necessary for serious cases. Therapy can also offer effective coping mechanisms. 

A blend of healthy habits, stress management, and medical support can effectively handle period mood swings. Recognising triggers and seeking assistance when necessary ensures improved emotional balance. 

Home remedies

Managing mood fluctuations naturally during your period can help restore emotional stability without resorting to medication. Making simple changes in lifestyle, adjusting your diet, and employing relaxation methods can alleviate feelings of irritability, anxiety, and tiredness. Consistently using home remedies can offer lasting relief and enhance overall well-being throughout your menstrual cycle. 

1. Nutritional support: Incorporating foods rich in magnesium (such as dark chocolate, nuts, and leafy greens) aids in mood regulation. Omega-3 fatty acids found in fish or flaxseeds can lessen feelings of irritability, while vitamin B6 (present in bananas and potatoes) promotes serotonin production. 
2. Herbal solutions: Drinking chamomile or peppermint tea may help calms anxiety and encourage relaxation, though evidence varies  
3. Techniques for relaxation: Yoga, meditation, and deep breathing help alleviate stress. Soaking in warm baths with Epsom salt relaxes muscles and enhances mood. 
4. Lifestyle changes: Consistent physical activity releases endorphins. Reducing the intake of caffeine, alcohol, and processed sugars helps prevent mood swings. 

Utilising straightforward home remedies alongside a healthy lifestyle can effectively reduce mood fluctuations. Recognising triggers and maintaining consistent habits contribute to improved emotional stability. 

Lifestyle changes

Healthy lifestyle modifications can greatly mitigate period-related mood swings by balancing hormones and enhancing emotional health. Engaging in regular physical activity, consuming a nutrient-dense diet, ensuring quality sleep, and managing stress can stabilise mood, minimise irritability, and foster mental and physical well-being throughout the menstrual cycle. 

1. Consistent exercise: Participating in activities such as walking, yoga, or dancing increases endorphin levels, which elevates mood and decreases stress. 
2. Eat nutrient-rich food: Incorporating whole foods high in magnesium, omega-3 fatty acids, and vitamin B6 supports hormone balance and stabilises mood. Avoiding excessive sugar, caffeine, and alcohol helps alleviate mood swings. 
3. Adequate rest: Achieving 7-9 hours of restorative sleep aids in emotional regulation and reduces irritability. Keeping a steady sleep routine is essential. 
4. Lowering stress: Mindfulness, meditation, or deep breathing exercises can diminish anxiety and emotional shifts. 

Embracing a healthy way of living that includes exercise, adequate nutrition, rest, and stress management can effectively lessen period mood swings and enhance emotional health. 

Premenstrual syndrome and hormonal mood swings are common, but they don’t have to dominate your life. Incorporating healthy habits such as a balanced diet, consistent exercise, effective stress management, and sufficient rest can help reduce their effects. Speak with a healthcare provider before starting supplements, especially if you are taking other medications or have underlying conditions.