Mood swings are significant changes in mood that come and go within a short space of time. They can happen to anyone, and have a range of causes.

In females, mood swings may occur as part of the typical hormonal fluctuations that occur during the menstrual cycle, pregnancy, or menopause. They can also be the result of medical conditions that require treatment.

Keep reading to learn more about mood swings in females, including the potential causes, treatments, and how to manage them.

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Mood swings are significant shifts in a person’s emotional state. They can begin suddenly and without warning, and may dissipate just as quickly. They are different from the changes in mood people experience in everyday life.

It is natural for emotions to change over time. Sometimes, they may change rapidly in response to a shocking or upsetting situation. In people with mood swings, though, the change is typically more intense than this, and may be unrelated to life events.

There are several causes for mood swings that specifically affect females. These include:

Premenstrual syndrome

Premenstrual syndrome (PMS) refers to a group of symptoms that can occur around 1–2 weeks before a period. Over 90% of females experience some premenstrual symptoms, which can include mood swings.

Other symptoms of PMS include:

PMS happens because of the hormonal changes that take place before menstruation, but scientists do not understand why it affects some people more than others.

Some people find that certain types of hormonal birth control help to reduce significant PMS symptoms. But it may require trying several types to find one that helps.

Learn more about PMS.

Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is a severe premenstrual condition that causes significant irritability, anxiety, or depression 1–2 weeks before a period starts. The symptoms typically get better soon after the period begins.

The symptoms can include:

  • mood swings
  • feeling angry and short-tempered
  • feeling tense or anxious
  • a lack of interest in things a person usually enjoys
  • trouble focusing
  • tiredness
  • trouble sleeping
  • feelings of despair or suicidal thoughts

Researchers are not sure what causes PMDD, but it may be related to changes in a person’s hormones or serotonin levels before a period. Serotonin is a neurotransmitter that influences mood and cognition, among other things.

Treatment options include certain types of hormonal birth control or selective serotonin reuptake inhibitors. In severe cases, some may consider inducing early menopause by taking medications, or undergoing surgery.

Learn more about PMDD.

Premenstrual symptom exacerbation

Sometimes, people with preexisting mental or physical health conditions find that their symptoms get worse before a period. This is known as premenstrual symptom exacerbation (PME). In those with mental health conditions, PME may cause significant mood changes that are similar to a mood swing.

Examples of conditions that may worsen due to PME include:

  • anxiety
  • depression
  • eating disorders
  • schizophrenia
  • substance misuse disorders

PME and PMDD can seem similar, but a crucial difference between them is that with PME, the symptoms of a preexisting mood disorder will be present throughout the hormonal cycle. With PMDD, symptoms only appear between ovulation and menstruation.

This is important, as some treatments for PMDD – such as surgery to remove internal reproductive organs – will not work for PME.

Pregnancy

Mood swings are a common sign of pregnancy, and can begin during the first weeks after conception. Other early symptoms of pregnancy include:

  • a missed period
  • tender or swollen breasts
  • tiredness
  • food cravings
  • nausea
  • vomiting (morning sickness)
  • heartburn
  • more frequent urination

If pregnancy is a possibility, a person should purchase an over-the-counter pregnancy test or speak with a doctor.

Menopause

Menopause refers to the time when a person’s periods naturally stop. The phase before this is perimenopause, when a female’s reproductive hormones are starting to decline.

Perimenopause typically begins when someone reaches their early 40s, but it can sometimes start earlier. During this time, estrogen and progesterone levels fluctuate, which can affect the production of serotonin. This can lead to a range of symptoms, including mood swings.

Hormone replacement therapy can boost low levels of estrogen and progesterone, while SSRIs may help to stabilize serotonin levels, which may help with mood. But these medications can have side effects, so it is important to discuss this with a doctor.

A condition known as primary ovarian insufficiency can also cause menopause-like symptoms, such as mood swings, at a much younger age.

Learn more about what to expect during menopause.

While mood swings can have hormonal causes, there are also a number of other causes that can affect people of any sex. These include:

  • Puberty: When a person goes through puberty during adolescence, their hormonal levels change considerably. This can cause strong emotions and sudden shifts in mood that are more intense than usual.
  • Mental health conditions: Some mental health conditions cause mood swings regardless of a person’s menstrual cycle. These include borderline personality disorder (BPD), bipolar disorder, and cyclothymia. People with substance misuse disorders may also go through significant changes in mood as a result of using a particular drug, or stopping its use.
  • Neurological conditions: People can develop mood changes as a result of conditions such as migraine, Parkinson’s disease, dementia, and many more.
  • Medications: Many medications can have a negative impact on mood as a side effect, including some of the drugs doctors use to treat mood-related disorders. Antidepressants, hormonal birth control, and steroids are a few examples. Sometimes the side effects are mild or wear off over time, but some people may find they do not.

It is important to discuss persistent or severe mood swings with a doctor so that they can identify the cause. They will start by asking questions about a person’s symptoms and medical history before moving on to diagnostic tests that give them more information.

They may perform:

  • a physical examination
  • blood tests to rule out common conditions, such as vitamin deficiencies or thyroid conditions
  • blood tests to see if a person might be pregnant, or if they are entering perimenopause

If there are signs the cause might be neurological, the doctor may also request medical imaging tests. If the cause could be part of a mental health condition, a person may benefit from an evaluation with a psychologist.

Keeping a symptom diary

Before an appointment, it may help to track mood swings in a diary. This can help doctors understand if the mood swings might be related to the menstrual cycle, or other factors.

Record when the mood swings happen, how long they last, and any other important details, such as stressful events or lack of sleep. Then, track the days when menstruation happens. Continue doing this over several months. People can do this in a notebook or period tracking app.

If mood swings happen more frequently in the fortnight before a period, it may indicate a premenstrual condition such as PMS or PMDD.

Mood swings can be disruptive and cause unpleasant feelings. Depending on the cause, it can be possible to reduce the impact they have on a person’s daily life and emotional well-being. A person may wish to try:

  • Being self-compassionate: Sometimes, mood swings are unavoidable, and make someone feel down or irritable for no apparent reason. It may help to remember that this is very common, and that it is not the person’s fault that they have them.
  • Practicing mindfulness: Mindfulness can help someone notice when their emotions change, which may help them to notice mood swings as they appear and fade away. People can practice mindfulness by journaling, through meditation, or by checking in with themselves throughout the day.
  • Avoiding caffeine, alcohol, and smoking: Caffeine and alcohol can both worsen PMS and menopause symptoms. People who smoke also experience more severe PMS symptoms compared with those who do not smoke.
  • Getting enough sleep: Where possible, try to maintain a regular sleep schedule. A lack of sleep can worsen irritability, anxiety, depression, and fatigue (low energy).
  • Trying relaxation techniques: Relaxation can reduce stress and improve sleep, which both have a positive impact on mood. Examples to try include breathing exercises, yoga, tai chi, or massage.
  • Staying active: Physical activity increases the production of hormones that can boost a person’s mood.
  • Doing enjoyable activities: Try to continue activities that are enjoyable, even if a mood swing is making it more difficult. Spending time in nature, creative hobbies, gardening, and listening to music can have a positive impact on well-being.

While mild or moderate mood swings are common in females who experience PMS, they should not be long-lasting, occur throughout the month, or significantly affect a person’s ability to function. Mood swings that do may be a sign of another condition that requires medical attention.

It is important to speak with a doctor about mood swings, particularly if they are new, severe, or persistent. If mood swings are impacting a person’s mental health, the person may also benefit from speaking with a therapist.

If mood swings are causing a person to have suicidal thoughts, they should speak with a doctor or mental health professional as soon as possible.

Do not alter types or doses of prescription medications before speaking with a doctor.

Mood swings are short-term emotional shifts that are more intense than the typical changes people experience in daily life. They can have a significant impact on a person’s quality of life.

Mood swings in females can be the result of PMS, PMDD, PME, pregnancy, and menopause. Females can also experience mood swings as a result of conditions that affect all sexes, such as mental health conditions. A doctor can diagnose the cause and recommend treatments.