Some 75 percent of women experience symptoms associated with their period, both mental and physical. For the most part, they're mild and even difficult to notice. But for some women, anxiety associated with their menstrual cycle can be debilitating. As hormone levels change throughout the cycle, it can have an impact on both mind and body. But knowing what’s happening and what you can do about it can make a big difference.
How Does PMS Cause Anxiety?
According to Dr. Patricia Salber, founder of the popular blog The Doctor Weighs In, estrogen and progesterone are the main causes of PMS -- but it’s not the fluctuations that cause anxiety, rather, women with PMS and PMDD (Premenstrual dysphoric disorder) may have an abnormal response to the normal hormonal fluctuations that occur during the menstrual cycle.
“The different sensitivity to ovarian steroids [like estrogen and progesterone] may lead to alterations in brain neurotransmitters, particularly serotonin,” says Dr. Salber. She adds that women with PMS or PMDD may have a slowed release of serotonin which can cause symptoms of anxiety and depression.
When Do These Symptoms Occur?
This is really important because in order for anxiety or depression to be associated with your menstrual cycle it has to occur in the second, or luteal phase, of your cycle and end by the first (follicular) phase. The luteal phase begins after ovulation and lasts about 14 days (unless fertilization occurs) and ends just before a menstrual period. The follicular phase begins on the first day of menstruation and lasts until the 13th day of the menstrual cycle. Tracking your cycle to see when symptoms occur is important to knowing whether it’s PMS that's causing your anxiety or depression.
How is PMDD Different?
PMDD is a more serious sometimes debilitating extension of PMS that can involve extreme mood swings and damaging thoughts as well as physical symptoms. Symptoms may include the following:
- Severe sadness
- Feelings of hopelessness
- Severe anxiety or depression
- Extreme sensitivity to rejection
In addition to the symptoms above, according to Dr. Salber, women must also have one or more of the symptoms listed below to have PMDD:
- Difficulty concentrating
- Changes in appetite, food cravings, overeating
- Diminished interest in usual activities
- Extreme fatigue, decreased energy
- Feelings of being overwhelmed or out of control
- Breast tenderness, bloating, weight gain, or joint/muscle aches
- Sleeping too much or not sleeping enough.
Are Women Prone to Depression or Anxiety More Likely to Have PMS or PMDD?
Yes, says Alisa Vitti, creator of the My Flo Tracker App and author of "Women Code." Women who have symptoms of anxiety or depression are more likely to experience PMS or PMDD. That said, women who have not experienced these symptoms outside of their luteal cycle can still suffer from PMS or PMDD. It’s important to track your cycle and then talk to your healthcare provider if you’re dealing with the symptoms above. PMDD especially can be serious and in some women, seeking treatment can be life altering.
“PMS is a hormonal imbalance that gets worse over time from a diet and lifestyle that doesn't support hormonal balance,” says Vitti. “If anxiety/depression are present, and PMS goes untreated, those symptoms can intensify.”
What Can You Do To Deal With Your Symptoms?
First of all, talk with your healthcare provider and don’t let your symptoms go untreated. For serious symptoms, treatment with serotonin reuptake inhibitors (antidepressants) that increase serotonin may be effective in treating the disorder, according to Dr. Salber. You can take a number of other steps to reduce your symptoms.
“Get off the pill, the pill increases depression for women who are predisposed and can cause depression in those who haven't previously suffered from it by depleting key micronutrients and disrupting the microbiome,” says Vitti.
Other tips for reducing anxiety associated with your period:
1. Knowledge is power.
Take a few months to know whether it’s your period that’s causing your serious symptoms by tracking them in conjunction with your menstrual cycle.
2. Journal about it.
Take time to write it down and then read through what you wrote when you’re not suffering. This can help you take an aerial view of your feelings rather than getting wrapped up in them.
Throughout the month this can help you avoid getting caught up in your emotions and reduce those out of control and panic feelings.
4. Take a probiotic supplement.
It will support the microbiome in its role in manufacturing serotonin and dopamine.
5. Stimulate serotonin.
This may seem drastic, but according to Vitti, when you feel the symptoms coming on, jump on a trampoline or jump rope for a few minutes every hour you're at home. This stimulates endorphins to boost mood, and flushes cortisol which will reduce anxiety. Running, walking, biking, or vigorous exercise in general is also known to stimulate serotonin.
According to the Mayo Clinic, some research has shown that consuming 1,200 mg of calcium daily may possibly reduce symptoms of PMS and PMDD in some women. Vitamin B-6, magnesium, and L-tryptophan also may help, but talk to your doctor before you start taking them.
7. Try yoga.
Some research, according to Dr. Salber, has shown that doing yoga throughout the month may help lessen your symptoms. Though more research needs to be done, it may have a positive impact and probably can’t hurt.
8. Control lifestyle factors.
Especially during the luteal phase, abstain from caffeine, alcohol, excessive sugar, and smoking.
9. Avoid emotional triggers.
After ovulation (which is marked by a thick vaginal discharge) avoid triggers that normally make you upset. This is not a time to test yourself. Instead, try and stay relaxed, meditate often, get a massage, turn off the news, avoid conflict as best you can, and do the things that make you happy, says Dr. Salber.