Anxiety before a period can be a symptom of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Existing mental health conditions can also worsen during the menstrual cycle.

PMS and PMDD can cause varying levels of physical and mood-related symptoms, including anxiety.

This article discusses why anxiety can occur or worsen prior to a period and what treatment options exist.

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Anxiety is a symptom of PMS, which affects 30–80% of people who have a period.

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, otherwise known as the menstrual phase, begins.

The Office on Women’s Health (OWH) note that researchers do not fully understand why anxiety occurs before a period. However, it may occur due to the changing hormone levels. According to a 2018 article, the luteal phase corresponds with peak levels of estradiol and progesterone.

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:

Physical symptoms may include:

PMDD

PMDD is a more severe condition that causes similar symptoms to PMS.

The OWH say researchers do not fully understand why some people develop PMDD and others do not. However, similarly to PMS, the fluctuations in hormone levels may play a role.

The OWH also indicate 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.

Both the OWH and the Anxiety and Depression Association of America indicate that people who experience PMDD are likely to also experience anxiety or depression.

Other symptoms of PMDD may include:

  • a feeling of being overwhelmed
  • increased depressed mood
  • severe mood swings
  • sensitivity to rejection
  • more severe irritability and anger
  • social withdrawal
  • sudden tearfulness or sadness

PMDD and premenstrual exacerbation (PME) are similar conditions with similar symptoms.

According to the International Association for Premenstrual Disorders, healthcare professionals characterize 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:

Doctors may have difficulty telling the two conditions apart. The right diagnosis is important for a person to receive the correct treatment and care.

Treatment depends on the severity of anxiety and other symptoms a person may experience.

Home treatments

A person can try a number of strategies to help reduce anxiety and other symptoms of PMS. These include:

  • Regular exercise: One 2013 study found that 8 weeks of aerobic exercise effectively reduced PMS symptoms in 40 people.
  • 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.

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 possible, people can also try relaxation techniques, such as yoga, massage, meditation, and breathing exercises.

Learn more about the 4-7-8 breathing technique here.

Medical treatments

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:

MGH Center for Women’s Mental Health suggest that a person talk with a doctor about treatments and therapies such as:

  • 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 the symptoms.

People can also track their symptoms in a diary or app. Doing this may help a person identify certain lifestyle patterns or triggers that might be behind their PMS symptoms.

In some cases, 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 daily life and activities, a person 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 PMS and PMDD. Researchers do not fully understand the difference between people’s experience with the symptoms, but they generally believe it has to do with the fluctuations in hormone levels.

A person should contact a doctor if they experience anxiety before their period or if the steps they have 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.