What can cause anxiety before a period?
Anxiety before a period can be a sign of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). It may result from hormonal changes. Existing mental health conditions can also worsen at this time.
PMS and PMDD can cause varying levels of physical symptoms, as well as mental ones. These conditions occur due to hormone level changes around the time of a period.
This article discusses why anxiety can occur or worsen before a period and what treatment options exist.
What causes anxiety before a period?
People may experience anxiety before a period due to PMS and PMDD.
Discover more about anxiety in our dedicated hub.
Anxiety is a symptom of PMS, which affects 30–80% of people who have periods.
The severity of PMS symptoms can vary. Some people experience no signs of PMS. Others, on the other hand, can develop severe symptoms, which may be a sign of PMDD.
Other psychological symptoms of PMS may include:
- changes in appetite
- mood swings
- loss of interest in sex
- difficulties with memory or concentration
- sleeping too much or too little
Physical symptoms may include:
- swollen and tender breasts
- constipation or diarrhea
- a lower tolerance for light or noise
PMDD is a more severe condition that causes symptoms similar to PMS.
The Office on Women’s Health (OWH) says researchers do not fully understand why some people develop PMDD and others do not. However, similarly to PMS, fluctuations in hormone levels may play a role.
The OWH also indicates that serotonin levels may play a part in the development of anxiety and persistent depressive disorder symptoms. Similarly to other hormones, serotonin levels change during the menstrual cycle.
The OWH and the Anxiety and Depression Association of America (ADAA) both indicate that people who experience PMDD are likely to also experience anxiety or depression.
Other symptoms of PMDD may include:
- feeling overwhelmed
- an increased depressed mood
- severe mood swings
- sensitivity to rejection
- more severe irritability and anger
- social withdrawal
- sudden tearfulness or sadness
Learn more about the differences between PMS and PMDD here.
Why does it happen?
PMS is a combination of emotional and physical symptoms that people experience after ovulation during the luteal phase. The luteal phase begins after ovulation and typically lasts for 14 days. It ends when a person’s period, known as the menstrual phase, begins.
The OWH notes that researchers do not fully understand why anxiety occurs before a period, but it may occur due to changing hormone levels. According to research, the luteal phase corresponds with peak levels of estradiol and progesterone.
PMDD vs. PME
PMDD and premenstrual exacerbation (PME) are similar conditions with similar symptoms.
The International Association for Premenstrual Disorders characterizes PMDD as experiencing severe physical and emotional symptoms that begin during the luteal phase. Symptoms will subside within a few days after the period begins.
PME refers to the worsening of the symptoms of a preexisting mental health condition, such as generalized anxiety disorder, during the luteal phase.
Other conditions that can prompt PME effects include:
- major depressive disorder
- suicidal tendencies
- alcohol use disorder
- eating disorders
Doctors may have difficulty telling the two conditions apart. The correct diagnosis is important for a person to receive the necessary treatment and care.
Treatment depends on the severity of anxiety and other symptoms a person may experience.
A person can try several strategies to help reduce anxiety and other symptoms of PMS. These include:
- Regular exercise: Studies show that aerobic exercise can effectively reduce PMS symptoms.
- Sleep: People should aim for 8 hours of sleep per night.
- Avoiding smoking: A 2019 study found that those who smoke are more likely to develop PMDD and PMS.
If possible, people can also try relaxation techniques, such as yoga, massage, meditation, and breathing exercises.
Additionally, people will benefit from eating a healthful diet and avoiding alcohol, caffeine, and salt.
Learn more about what to eat during a period here.
If home remedies and treatments are not helping with symptoms of anxiety, a person should contact a doctor about additional medical treatments and therapies.
According to the OWH, common treatments for PMDD include:
- using hormonal birth control
- taking selective serotonin reuptake inhibitors (SSRIs)
- taking antianxiety medications
Some medical professionals may also recommend:
- light therapy
- benzodiazepine alprazolam (Xanax)
- hormone intervention using gonadotropin-releasing hormone agonists
A person may not be able to prevent anxiety caused by PMS, but they may be able to help lessen their symptoms, such as lack of sleep, or exposure to stressors.
For example, people can track their anxious feelings in a diary or app. Doing this may help people identify certain lifestyle patterns or triggers behind their PMS symptoms.
Learn more about journaling for anxiety here.
Creating a regular sleep schedule and improving the quality of a person’s sleep environment can help them fall asleep faster and get better quality of sleep.
Learn more about sleep routines and sleep hygiene here.
When to contact a doctor
In some people, home treatment may be enough to reduce the symptoms of anxiety related to PMS or PMDD.
If a person’s anxiety or other symptoms associated with PMS interfere with their daily life and activities, they should seek guidance from a doctor. A doctor can recommend additional treatment options or prescribe medication that may help.
It is possible that a person will not receive the correct diagnosis due to the similarities between PMDD and PME.
If the treatments are not working or become less effective, a person should contact a doctor about adjusting their treatment and ensuring they have the correct diagnosis.
Anxiety before a person’s period is a common symptom of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Researchers do not fully understand the difference between people’s experiences with the symptoms, but generally, they believe it is due to fluctuations in hormone levels.
A person should contact a doctor if they experience anxiety before their period or if the steps taken to treat their anxiety are not working or are working less effectively. A proper diagnosis can help a person more effectively treat their symptoms.