How To Control PMS Anger: 8 Tips For Emotional Balance

Anger and irritability can be common PMS symptoms, typically occurring due to hormonal fluctuations that influence neurotransmitters involved in mood regulation. These symptoms can lead to significant life disruptions, but they can be managed with the right approach. Here, you’ll find a guide to PMS anger, including why it occurs, causes and risk factors, and practical strategies for managing symptoms and maintaining emotional balance, including working with a therapist.

Understanding psychological PMS symptoms

Premenstrual syndrome (PMS) can encompass a range of symptoms, with irritability, mood swings, and increased sensitivity being among the most common mental and emotional effects. For some, these symptoms can evolve into anger or even rage, potentially causing significant disruption to daily function and well-being.

In general, symptoms occur due to the hormonal changes that happen in the final phase of the menstrual cycle, known as the luteal phase. During this time, estrogen levels usually fall, and progesterone levels rise. This often impacts neurotransmitters that affect mood regulation. This can cause or worsen mental and emotional challenges. 

In some individuals, these effects may be especially pronounced, leading to a more severe form of PMS known as premenstrual dysphoric disorder (PMDD). PMDD is usually characterized by more intense psychological PMS symptoms, such as mood swings, irritability, and depression, which significantly impact daily life.

PMS anger and irritability: Causes and risk factors

PMS anger and irritability are primarily driven by hormonal fluctuations, but they can be influenced by factors like stress, physical health, and overall socioemotional function. 

Hormonal fluctuations

The hormonal fluctuations during the luteal phase, particularly the drop in estrogen and the rise and fall of progesterone, can disrupt neurotransmitters like serotonin, which typically regulates mood. This imbalance can lead to irritability, as lower serotonin levels usually make it harder to manage stress and emotional responses. Some women find that regulating hormones with oral contraceptives can help with emotional PMS symptoms.

Emotional regulation skills

Emotional regulation skills generally allow us to manage our reactions to upsetting situations, and women lacking these coping skills may be more susceptible to the emotional disruptions that can occur during PMS. One study found that women who had experienced childhood trauma often experienced worse PMS symptoms, likely because they struggled more with managing their emotions.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Stress

The hormonal changes that occur during PMS can lower resilience to stress, leading to reactions that might seem out of proportion to relatively minor triggers. Everyday irritations or stressful events, which might otherwise be manageable, can contribute to anger, irritability, and emotional outbursts. One study found that stress management training could decrease the psychological symptoms of PMS, although updated evidence may be needed.

Cognitive distortions

Cognitive distortions can be described as irrational thoughts that lead us to interpret events in an overly negative way, potentially contributing to anger and irritability. One study observed that negative cognitive styles seemed to be more common in women with PMS and PMDD. Cognitive behavioral techniques, such as those learned in therapy, can be an effective way to mitigate the unhelpful thoughts that can trigger emotional disruptions.

Pre-existing mental health conditions

Mental health conditions can exacerbate the psychological symptoms of PMS, and research has discovered significant overlap between premenstrual symptoms and underlying mental illnesses. While updated research may be necessary, one study found that approximately 39% of women seeking treatment for PMS/PMDD also met criteria for mood or anxiety disorders, with mood disorders being nearly twice as common. 

How to control PMS anger: 8 evidence-based tips

PMS-related anger can seem overwhelming, but by implementing healthy coping skills and prioritizing physical and mental self-care practices, you can maintain emotional balance throughout your cycle. Consider the following evidence-based strategies for managing PMS anger and irritability.

1. Track your periods and moods

A good first step may be to track your moods and habits throughout your cycle. You might also consider keeping a daily journal to record other factors that may influence your state of mind, such as life stressors, interpersonal conflicts, or health issues. This can enhance self-awareness and give you a detailed understanding of how your emotional state correlates with your menstrual cycle.

2. Use anger management techniques

Learning effective coping strategies can be essential in managing the emotional symptoms of PMS. Consider exploring different anger management techniques to add to your self-care toolkit, such as deep breathing exercises, mindfulness meditation, and cognitive reframing. These strategies can help you calm down and regain mental clarity when anger and mood swings occur.

3. Get plenty of exercise

Research suggests that exercise can help alleviate PMS symptoms, although updated evidence may be beneficial. Exercise typically releases mood-boosting endorphins, improves sleep, and reduces stress levels, which can help with emotional regulation. Try to make time for daily exercise, particularly during your luteal phase. You can also use exercise to help you process anger, such as by going for a walk when you feel frustrated. 

4. Maintain nutritious eating habits

Research has found a link between eating habits and PMS symptoms, with evidence suggesting that processed, high-carbohydrate, and high-fat foods may increase the risk of PMS symptoms. In contrast, unprocessed, nutrient-dense foods may maintain stable blood sugar levels, promoting mood regulation and healthy sleep patterns.

5. Implement mindfulness practices

Mindfulness is a mental skill that can help you maintain emotional control and remain grounded in the present moment. One study found that women who scored higher on measures of mindfulness usually experienced significantly lower levels of PMS severity. Mindfulness practices like meditation, yoga, and deep breathing can help you develop this skill and effectively manage your emotions. 

6. Vitamins and supplements

Studies have found that calcium, vitamin D, and vitamin B6 can help alleviate symptoms of PMS and PMDD. Prioritize foods rich in these nutrients, such as the following:

• Leafy greens, dairy products, and fortified plant-based milks (calcium) 
• Fatty fish and egg yolks (vitamin D)
• Bananas, chickpeas, and poultry (vitamin B6)

An herbal supplement called agnus castus fruit extract (also known as chasteberry) has also demonstrated effectiveness for improving PMS symptoms, including irritability, mood alterations, and anger, as well as physical symptoms, like headaches and breast fullness.

7. Consider therapy

Cognitive behavioral therapy (CBT) may improve emotional symptoms of PMS and PMDD. This type of therapy usually focuses on identifying cognitive distortions and learning more helpful ways of thinking. You’ll also learn healthy coping skills, work toward beneficial self-care habits, and identify any underlying mental health conditions that could be worsening your PMS symptoms. 

8. Talk to your doctor

It may be worth discussing your PMS symptoms with your doctor. They may prescribe medications like oral contraceptives, which can regulate hormone levels and improve PMS symptoms. If your provider diagnoses you with PMDD, they may refer you to a psychiatrist, who can prescribe other forms of medication. Your psychiatrist may also recommend that you attend therapy.

Premenstrual dysphoric disorder: Signs and symptoms

Premenstrual dysphoric disorder is a condition typically characterized by severe psychological and behavioral symptoms that occur during specific times throughout the menstrual cycle. Symptoms typically appear during the luteal phase (which begins with ovulation), start to resolve within a few days of the follicular phase (the start of your period), and are absent in the week following your period. 

Symptoms may include the following:

• Depressed mood, hopelessness, or self-deprecating thoughts
• Increased anxiety, tension, and edginess
• Mood swings, such as sudden feelings of sadness or sensitivity
• Significant anger, irritability, and increased interpersonal issues
• Decreased interest in usual activities
• Difficulty concentrating
• Appetite changes, such as overeating or food cravings
• Increased tiredness or lack of energy
• Sleep issues, such as hypersomnia (sleeping too much) or insomnia (difficulty sleeping)
• A sense of overwhelm
• Physical symptoms (e.g., breast tenderness, headaches, muscle or joint pain, bloating)

In order for your doctor or therapist to make a diagnosis, these symptoms must cause significant disruptions to your ability to function at work, school, and in relationships. Note that your provider may also screen you for other mental health disorders to rule them out, and they may ask you to track your symptoms throughout the month to help them establish a PMDD diagnosis.

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Premenstrual exacerbation (PME): How PMS can worsen depression and anxiety

Premenstrual exacerbation (PME) is a term generally referring to the worsening of existing mental health conditions, such as depression and anxiety, during the luteal phase of the menstrual cycle. While PMS commonly affects mood and emotional regulation, individuals with PME may experience heightened symptoms of their underlying conditions, making it more challenging to cope. 

If you have an underlying mental illness and experience severe PMS symptoms, it may be advisable to discuss your concerns with a doctor, as well as your mental health provider. Your doctor may prescribe medication to stabilize your mood or hormone levels, as well as offer guidance on managing your symptoms with lifestyle changes. 

Online mental health support for PMS, PME, and PMDD

For those struggling with severe PMS, including premenstrual dysphoric disorder and premenstrual exacerbation, online mental health support can be an invaluable resource. Through virtual therapy platforms like BetterHelp, you can attend weekly therapy appointments with a licensed mental health professional trained in evidence-based CBT and anger management techniques.

Online therapy can be just as effective as in-person treatment, and it may be preferable for those in need of a convenient and cost-effective way to access mental healthcare. With tools and features like digital CBT worksheets, guided journaling, and group sessions, you can get the most out of your mental health investment.