Anxiety Before Your Period: Managing Fluctuating Hormones

Medically reviewed by Laura Angers Maddox, NCC, LPC and Julie Dodson, MA, LCSW

Updated October 29, 2024by BetterHelp Editorial Team

There are many side effects, like anxiety, that may accompany a period or menstrual cycle. For example, many people experience bloating, gastrointestinal disturbances, and cramps that can affect their daily life. However, the symptoms that come with the menstrual cycle can also impact one’s mental health. For example, fluctuating hormones can cause feelings of nervousness or exacerbate underlying anxiety disorders or other existing mental health conditions, which can leave many feeling ill at ease or as if they don't have control over their emotions.

Managing anxiety before your period

Understanding the role of hormonal fluctuations in anxiety may help you achieve a higher quality of life during phases of premenstrual syndrome (PMS) or cycle-related anxiety disorder exacerbation. You may also manage premenstrual anxiety by allowing yourself time to relax, eating a healthy diet, engaging in low-impact exercise, and meditating. Online therapy can act as a helpful tool and resource during all phases of your menstrual cycle.

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Understanding anxiety before your period

Anxiety before a period can be a symptom of premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS) that occurs during the luteal phase of your cycle. Premenstrual dysphoric disorder and premenstrual syndrome can cause both emotional and physical symptoms, such as breast tenderness, which can significantly impact daily life. If you experience severe PMS symptoms or suspect you have PMDD, it's important to seek medical advice for proper diagnosis and treatment.

Factors that may contribute to anxiety before your period

Sometimes, during times of pre-menstruation or menstruation, the body's biochemical processes can trigger nervousness or exacerbate underlying anxiety disorder-related symptoms.

This can be intensified due to fluctuating hormone levels and subsequent hormone “dips,” which may put people at a higher risk of experiencing nervous thoughts and feelings before their menstrual period begins.

Other factors affecting symptoms of anxiety

Other contributing factors to premenstrual nervousness and intensification of anxiety disorders may include:

Stressful situations: High levels of stress can cause worsening symptoms in some. Chronic stress can contribute to long-lasting inflammation, which can make periods more painful and intensify symptomatic experiences.

Changing cortisol levels in the blood: Right before one's period, the stress hormone cortisol can increase in the blood. Science suggests that cortisol increase can be directly influenced by stress levels and over the duration of time the increase is noticed. High cortisol may be associated with symptoms of nervousness or worsening pre-existing anxiety disorders.

Sex hormone imbalance: Throughout the month, one’s sex hormone levels (such as estrogen, testosterone, and progesterone levels) can fluctuate. Imbalance can occur and has been scientifically suggested to be a catalyst for nervousness or intensifying anxiety disorder symptoms.

Many people can experience anxiety before their periods. Brain chemistry can balance and control certain aspects of mental health for many people, and the same brain chemistry may be responsible for triggering the symptoms people experience before and during their periods.

Indicators of premenstrual dysphoric disorder (PMDD)

Statistical analysis suggests that 90% of people experience hormonal changes before their period starts. Symptoms such as mood swings, moodiness, social withdrawal, sudden sadness, tension, and feeling overwhelmed may be common for many during premenstrual phases, but unusually intense symptoms may indicate the presence of a secondary condition (such as premenstrual dysphoric disorder or PMDD). Speaking to a clinician or licensed therapist can be an excellent way to start addressing these symptoms.

How menstrual cycle affects personal health

Every person may experience menstrual cycles and pre-menstruation symptoms differently. Understanding how a cycle can affect your experience can help you have a better overall experience in your personal health management journey, and it may help you feel empowered in your strategies of treatment and support.

Cope with premenstrual anxiety or premenstrual dysphoric disorder

If you're facing premenstrual nervousness or worsening anxiety disorder symptoms before your period, you may consider assessing your situation and determining possible lifestyle changes.

6 effective strategies for managing anxiety before your period

Below, we’ve listed some scientifically suggested strategies to support a higher quality of life for you as you experience premenstrual phases going forward.

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Take a break to control your mood swings

You might not be able to take a break from work or other obligations. However, prioritizing mental and physical rest may result in a better overall premenstrual experience. Hobbies and activities to consider during this period can include resting, reading, indulging in self-care, and allowing yourself to relax as much as possible. Finding repose in “safe” or comfortable, familiar environments can put you at ease, even if you are experiencing symptoms of nervousness and mood swings.

Meditate for anxiety

Making a habit of meditation and breathwork can help reduce symptoms of nervousness and anxiety disorders that may be brought on by your menstrual period. A simple way to begin may be by closing your eyes and focusing on your breath, even if only for a few minutes. Doing this can help you embrace a mindset of acceptance and mindfulness while actively offering you the opportunity to take your mind off your discomfort.

Try low-impact exercise or movement

Exercise can be a scientifically supported way to improve PMS symptoms for some. Low-impact exercise like yoga can support your overall flexibility and vitality and may positively impact feelings of nervousness associated with your premenstrual phase.

Regular aerobic exercise can also increase the endorphin and serotonin levels in your brain. These brain chemicals often promote mood control and feelings of happiness and comfort.

Manage your diet

According to peer-reviewed studies, eating an anti-inflammatory diet full of fresh produce, healthy fats, and lean protein can support a less intense premenstrual experience.

Consider medication as treatment

If you've been taking birth control pills and you experience nervousness during your premenstrual phase, you may want to consider using a different form of birth control or talking to your doctor about trying another brand.

Additionally, your doctor may recommend selective serotonin reuptake inhibitors (SSRIs), which are commonly prescribed antidepressants that can help alleviate symptoms of premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), panic disorder, and generalized anxiety disorder. You may also speak to them regarding formal supplementation or pharmaceutical intervention.

We do want to note that you can have a more rewarding and successful experience with this option if you connect with your clinician prior to beginning any sort of medication or supplementation regimen. Doing so without the approval and supervision of your provider can result in negative health effects.

Track your cycle and PMS symptoms

If you are experiencing nervousness related to your menstrual cycle, you might consider tracking your cycle. Understanding when symptoms start and stop can help you identify possible contributing factors and mitigation strategies. Some may choose to use a calendar, a journal, or an app to track their cycles. This information may also be helpful to your clinician’s diagnostic process.

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Experiencing increased anxiety before your period?

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Therapy for premenstrual anxiety & generalized anxiety disorder

Treatment options such as online therapy can offer additional resources and strategies to assist you in managing a mental health condition, whether or not it is related to your menstrual cycle. While nervousness and symptoms of anxiety disorder can be worsened when one is put into an unfamiliar or “clinical” situation, online therapy can offer many users the opportunity to enjoy therapeutic support from the comfort of their own home or another familiar space. You may be able to connect more directly with your therapist via in-app messaging, which can support you during a wider range of hours and times that traditional therapy may not offer.

Online therapy has been scientifically suggested to be just as effective as in-person therapeutic intervention. In addition, it generally showed reduced levels of psychological distress in the test group referenced in BMC Psychology.

Takeaway

Many may experience nervousness or exacerbated anxiety disorder-related symptoms prior to the start of their periods. However, there may be a variety of scientifically supported methods and strategies you can leverage to support a higher overall quality of life in all phases of your cycle. These can include eating a healthy diet, trying low-impact exercise, meditating, and tracking your cycle. Speaking with a therapist or clinician can help you identify what the next step may look like in your personal medical journey. Online therapy may also provide you with additional resources to support you in moments of premenstrual anxiety.

Frequently asked questions

Read more below for answers to questions commonly asked about this topic.

When is anxiety highest during the menstrual cycle?

Some recent research has found that anxiety, stress, and binge eating are generally more elevated throughout the luteal phase. The luteal phase begins as the second part of the menstrual cycle, occurring right after ovulation and lasting until the start of a person’s period.

Why do I get intrusive thoughts before my period?

According to the Anxiety and Depression Association of America, intrusive thoughts may affect about six million Americans. Sometimes, intrusive thoughts may be associated with a mental health disorder, but many people experience intrusive thoughts without an existing mental health condition. Intrusive thoughts can be triggered by stress or anxiety, which may be higher before your period, and hormone shifts may also bring them on.

Why do I feel weird before my period?

There are a lot of hormone shifts that occur during your menstrual cycle. As hormones like estrogen and progesterone rise and fall, they can cause many abnormal feelings. In the first half of your cycle, which is generally the first two weeks after your period starts, you may have more energy and feel more clear-headed. But in the days leading up to your period, you may experience premenstrual syndrome or feel sluggish or forgetful, and you may experience premenstrual exacerbation of symptoms of other health problems, like irritable bowel syndrome or depression.

What are the 11 mental health symptoms of PMDD?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), premenstrual dysphoric disorder PMDD can lead to anxiety before a period and lead to an increased risk of a range of other severe symptoms, including:

Anger or severe irritability that may affect others.
Mood swings.
Lack of interest in relationships.
Feelings of despair or sadness or even severe depression.
Lack of interest in daily activities.
Trouble focusing or thinking.
Low energy or feeling tired.
Trouble sleeping or oversleeping.
Binge eating or low-energy food cravings.
Feeling out of control and experiencing panic attacks.
Physical symptoms, like headaches, cramps, breast tenderness, bloating, and muscle or joint pain.

Notably, PMDD affects the body and the mind, which may cause physical and psychological symptoms.

What are mood swings?

Mood-related symptoms are commonly associated with hormonal fluctuations that can occur during menstruation. One mood-related symptom is mood swings, which are frequent or extreme changes in a person’s mood. Some individuals experience mood swings as a standalone symptom of PMS, but it is not uncommon for them to be accompanied by other PMS symptoms as well. Stress management can help with mood control.

How do I stop hormonal anxiety and stress?

If you are experiencing PMS anxiety, talk to your doctor. In some cases, like when someone is experiencing PMDD, treatment may include selective serotonin reuptake inhibitors (SSRIs) combined with lifestyle changes. Working with a therapist can also help you learn more about your premenstrual symptoms and some techniques for managing them.

How can I increase my serotonin before menstruation?

You may be able to increase serotonin naturally by making some lifestyle changes. Exercise can provide a serotonin boost, as can exposure to sunlight, so heading outdoors and going for a run or a long walk may help. If you are experiencing anxious feelings or other mental health issues before your period, talk to your doctor about what else you can do to boost serotonin and reduce anxiety.

How do I assist my wife who has PMDD?

First, it can be helpful to remind yourself that PMDD is a medical diagnosis to take seriously. Understand that the physical, mental, and psychological symptoms your wife is experiencing are likely not easy for her, and do not dismiss her experience. Communication can be critical. Give your wife emotional and physical space when she needs it, and try to be patient with her. Helping with housework or offering to cook dinner can help remove excess stress during this time. Encourage your wife to talk to her doctor about any available treatments she may not be taking advantage of, and consider talking to a couples therapist to learn how you can support each other and better cope with the challenges of your relationship.

What not to say to someone with PMDD?

People who are dealing with the physical and emotional symptoms of PMDD need support and understanding. It can be best to avoid saying things that dismiss what they’re going through, like, “Oh, it can’t be that bad,” or, “Just get over it.”

How do you calm down from PMDD?

Research has shown that mindfulness-based stress reduction may be beneficial for people with some PMDD symptoms. In this study, the relaxation techniques used included body scans, sitting meditation, yoga, walking meditation, and mindfulness, along with discussions about emotional resilience and the psychophysiology of the stress response.

Is my anxiety caused by hormones?

Anxiety is a complex condition with many contributing factors; hormones may be one of them.

Regulate anxiety in a compassionate environment

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The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.

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