Premenstrual syndrome & hormonal mood swings: What to do

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This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth doctor or request a medical certificate online if clinically appropriate. Please note: Hola Health does not currently offer Mental Health Care Plans.

Overview

Many women experience physical, mental, and behavioural changes before their period. These changes are often triggered by the natural rise and fall of hormones during the menstrual cycle. While mild premenstrual syndrome (PMS) is normal, severe symptoms can disrupt work, relationships, education, and general quality of life. It is estimated that up to 75% of women of reproductive age have premenstrual symptoms; however, the nature and intensity vary across individuals.

This article explains what PMS is, why hormonal mood swings happen, practical ways to manage symptoms, available management options, and when to seek medical advice.

What is premenstrual syndrome?

Premenstrual syndrome (PMS) is a set of physical, emotional, and behavioural symptoms that develop during the luteal phase of the menstrual cycle, often one to two weeks before a period. Symptoms often improve or decrease within a few days after menstruation begins. PMS affects women differently, with some experiencing relatively moderate symptoms while others face major disruptions in their daily lives.

Key facts:

• PMS is caused by natural hormonal fluctuations during the menstrual cycle.
• Symptoms normally appear following ovulation and before menstruation begins.
• Most symptoms improve during the first few days of a period.
• Symptoms often follow a consistent monthly pattern.
• Premenstrual Dysphoric Disorder (PMDD) is a more severe version of PMS with significant emotional and psychological symptoms that may need medical attention.

Why do hormonal mood swings happen?

Hormonal mood swings occur as hormone levels naturally fluctuate during the menstrual cycle. These hormonal changes can affect brain chemicals that regulate mood, making some women more sensitive to their effects than others.

How hormonal changes affect mood:

• Oestrogen and progesterone levels fluctuate during the menstrual cycle.
• These hormonal changes can affect serotonin, a neurotransmitter that regulates mood, sleep, and emotional well-being.
• Serotonin activity changes may cause anger, anxiety, sadness, or mood swings.
• Some women may be particularly vulnerable to hormonal changes due to genetics, stress, sleep quality, or pre-existing mental health disorders.

Common symptoms of PMS

Symptoms vary from person to person and may change from one menstrual cycle to another.

What can you do to manage PMS and hormonal mood swings?

Maintaining a healthy lifestyle helps minimise the intensity of PMS symptoms. Although these measures may not completely alleviate symptoms, they can improve overall physical and mental health.

Eat a balanced diet

Eating regular, healthy meals helps maintain consistent energy levels and promotes overall hormone health.

Include:

• Regular meals rather than skipping meals
• Whole grains
• Plenty of fruits and vegetables
• Lean protein such as fish, eggs, beans, or chicken
• Healthy fats from foods such as nuts, seeds, avocado, and olive oil.
• Limiting sugar and processed foods can also help in managing symptoms.

Stay physically active

Regular exercise benefits both physical and mental health by reducing fatigue, improving mood, and relieving bloating.

Helpful activities include:

• Brisk walking
• Cycling
• Swimming
• Yoga
• Gentle stretching exercises

Aim for at least 150 minutes of moderate physical exercise each week.

Prioritise good sleep

Poor sleep may worsen mood swings, irritation, and exhaustion. Good sleep patterns include the following:

• Going to bed and getting up at the same time every day.
• Avoiding screens right before bedtime.
• Keeping your bedroom cold, dark, and quiet.
• Limiting caffeine later in the day.

Adults generally benefit from 7–9 hours of sleep each night.

Manage stress

Stress may worsen PMS symptoms. Finding appropriate relaxation techniques may enhance one's emotional well-being.

Helpful approaches include:

• Deep breathing exercises
• Meditation
• Mindfulness
• Progressive muscular relaxation
• Gentle yoga
• Speaking with a counsellor or psychologist if necessary

Monitor your menstrual cycle

Keeping track of your menstrual cycle might help you recognise patterns and prepare for symptoms before they occur.

Tracking may help you:

• Identify when symptoms are likely to develop
• Identify potential triggers
• Monitor whether symptoms are severe.
• Provide important information to your doctor.

Limit common triggers

Certain lifestyle habits can worsen PMS symptoms in certain people.

Consider limiting

• Excess caffeine
• Alcohol
• Smoking or vaping
• Highly processed foods rich in salt or added sugar

Mandatory Disclaimer: This information is for educational purposes only. You should consult a medical practitioner before attempting new wellness programs or lifestyle changes to ensure they are safe for your specific condition.

Clinical management options that may help

If lifestyle changes are not enough, medical management may help reduce PMS symptoms. The most appropriate management depends on your symptoms, medical history, and whether you have PMS or PMDD.

Note: Management should always be tailored to your individual symptoms, medical history, and your healthcare provider's recommendations.

When should you see a doctor?

While mild PMS can be treated with lifestyle modifications, you should consult a doctor if your symptoms become more severe, occur often, or interfere with your daily life. A doctor can determine whether your symptoms are the result of PMS, PMDD, or another medical condition and prescribe suitable medications, if clinically appropriate.

Emergency Note: If you experience severe, worsening, or life-threatening symptoms, including thoughts of self-harm or suicide, call 000 immediately or attend your nearest Emergency Department (ED). You can also seek urgent support from Lifeline on 13 11 14.

Visit a doctor if:

• Symptoms become more severe each month.
• Mood fluctuations are impacting your career, studies, and relationships.
• Over-the-counter remedies are not effective.
• Symptoms occur throughout the month rather than only before your period.
• You suspect you may have PMDD.
• Your periods are also heavy, irregular, or very painful.
• You experience depression or anxiety that is worsening.
• You have thoughts of self-harm or suicide.

Can telehealth help?

Telehealth is a convenient option for appropriate healthcare needs and can complement in-person healthcare. It is not a replacement for face-to-face care. Some health concerns, such as those requiring a physical examination or mental health crisis assessment, require an in-person assessment or emergency care.

An online doctor can:

• Assess PMS symptoms and menstrual history.
• Discuss hormonal mood swings and potential triggers.
• Offer lifestyle and self-care recommendations.
• Prescribe medications where clinically indicated.
• Refer you to mental health support services, if required.
• Refer you to a gynaecologist, psychologist, or psychiatrist.

If your symptoms require a physical examination or an immediate assessment, your doctor may suggest an in-person consultation.

How Hola Health can help

Hola Health offers secure online consultations with AHPRA-registered doctors. If you experience PMS or hormonal mood swings, a doctor can:

• Evaluate your symptoms.
• Offer women's health advice.
• Discuss management options.
• Prescribe medications when clinically appropriate.
• Issue referrals to specialists. (if clinically appropriate)
• Provide medical certificates (if clinically appropriate)

Key takeaways

• PMS is a common condition caused by natural hormonal fluctuations before menstruation.
• Symptoms include mood changes, irritability, anxiety, bloating, exhaustion, headaches, and breast tenderness.
• Healthy lifestyle practices such as frequent exercise, a balanced diet, stress management, and proper sleep may help to alleviate symptoms.
• Some women may benefit from medical management, particularly if symptoms are severe or significantly affect daily life.
• PMDD is a more severe condition than PMS and requires medical assessment and appropriate management.
• Seek immediate medical help if you experience severe depression, suicidal thoughts, or thoughts of self-harm.

FAQs

What causes PMS?

PMS is caused by the natural increase and fall of oestrogen and progesterone during the menstrual cycle. These hormonal fluctuations might influence brain chemicals like serotonin, causing emotional and physical problems in some women.

How long do hormonal mood swings linger before menstruation?

Hormonal mood swings often appear one to two weeks before menstruation and usually resolve during the first few days after your period begins. The timing and severity vary between individuals.

What is the difference between PMS and PMDD?

PMS causes mild to moderate mental and physical symptoms before menstruation. PMDD is a more severe version of PMS, characterised by major mood changes such as severe sadness, anxiety, or irritability, which can impact work, relationships, and everyday functioning.

Can diet and exercise help reduce PMS symptoms?

Yes, eating a balanced diet, exercising regularly, staying hydrated, getting adequate sleep, and controlling stress can help many women minimise the intensity of their PMS symptoms.

However, some women may require medical care.

When should I see a doctor about PMS or hormonal mood swings?

You should see a doctor if your symptoms interfere with daily life, become more severe each month, do not improve with self-care, occur outside the premenstrual phase, or if you suspect PMDD or another underlying condition.

What are the remedies for severe PMS?

Management may include hormonal contraception, selective serotonin reuptake inhibitors (SSRIs), pain-relieving medicines, psychological therapies, and lifestyle modifications. Your doctor will recommend the best management depending on your symptoms and medical history.

Can an online doctor help manage PMS symptoms?

Yes. A telehealth doctor can evaluate your symptoms, offer lifestyle advice, prescribe medications when clinically indicated, discuss treatment choices, and issue referrals to specialists.

Are hormonal mood swings an expected aspect of the menstrual cycle?

Mild mood swings before menstruation are common due to natural hormonal fluctuations. However, mood changes that are severe, long-lasting, or have a major impact on your daily life aren't considered normal and should be evaluated by a healthcare professional.