Premenstrual Syndrome

 

PMS?

Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms that start a week or so before your period. It makes some people feel moodier than usual and others bloated and achy.

For some people, PMS can also cause mood swings in the weeks leading up to their period. Mood swings involve a sudden, unexplained change in mood. You might wake up in a great mood but find yourself becoming angry and irritable an hour or two later for no reason.

Other emotional symptoms of PMS can include:

• sadness
• irritability
• anxiety
• anger

Two related conditions can also make you feel moodier before your period:

• Premenstrual dysphoric disorder (PMDD). PMDD is very similar to PMS, but its symptoms are more severe and tend to involve emotions. For some, it causes intense mood swings that interfere with daily life. While recent research estimates about 75 percent of women have PMS during their reproductive years, only 3 to 8 percent have PMDD.
• Premenstrual exacerbation. This refers to when symptoms of an existing condition, including anxiety, bipolar disorder, or depression, become worse in the weeks or days leading up to your period. About half of all women who receive treatment for PMS also have either depression or anxiety.

Read on to learn more about the connection between PMS and mood 

Why does it happen?

Experts aren’t sure about the exact cause of PMS, but it’s likely linked to hormonal fluctuations that happen during the second half of the menstrual cycle.

Ovulation happens about halfway through your cycle. During this time, your body releases an egg, causing estrogen and progesterone levels to drop. A shift in these hormones can lead to both physical and emotional symptoms.

Changes in estrogen and progesterone levels also influence serotonin levels. This is a neurotransmitter that helps regulate your mood, sleep cycle, and appetite. Low levels of serotonin are linked to feelings of sadness and irritability, in addition to trouble sleeping and unusual food cravings — all common PMS symptoms.

How to manage it

Track your symptoms

If you don’t already, start keeping track of your menstrual cycle and your emotions throughout its different stages. This will help you confirm that your mood swings are indeed linked to your cycle. Knowing there’s a reason you’re feeling extra moody can also help keep things in perspective and offer some validation.

Having a detailed log of your last few cycles is also handy if you want to bring up your symptoms with your doctor. There’s still some stigma around PMS. Having documentation of your symptoms might help you feel more confident about bringing them up. It can also help your doctor get a better idea of what’s going on.

You can track your cycle and symptoms using a period-tracking app on your phone. Look for one that allows you to add your own symptoms.

You can also print out a chart or make your own. Across the top, write the day of the month (1 through 31). List your symptoms down the left side of the page. Put an X in the box next to the symptoms you experience each day. Note whether each symptom is mild, moderate, or severe.

To track mood swings, make a note when you experience any of these symptoms:

• sadness
• sudden, unexplained changes in your mood
• crying spells
• irritability
• poor sleep or too much sleep
• trouble concentrating
• lack of interest in your daily activities
• tiredness
• low energy

Hormonal birth control

Hormonal birth control methods, like the pill or patch, can help with bloating, tender breasts, and other physical PMS symptoms. For some people, they can also help with emotional symptoms, including mood swings.

But for others, hormonal birth control can make mood swings worse. If you go this route, you might have to try out different types of birth control before you find a method that works for you.

If you’re interested in the pill, opt for a continuous one that doesn’t have a week of placebo pills. Continuous birth control pills can eliminate your period, which sometimes helps eliminate PMS, too.

Natural remedies

A couple of vitamins may help relieve PMS-related mood swings.

A clinical trial found that a calcium supplement helped with PMS-related feelings of sadness, irritability, and anxiety.

Many foods are good sources of calcium, including:

• milk
• yogurt
• cheese
• leafy green vegetables
• fortified orange juice and cereal

You can also take a daily supplement containing 1,200 milligrams of calcium, which you can find on Amazon. Don’t be discouraged if you don’t see results right away. It can take about three menstrual cycles to see any symptom improvement while taking calcium.

Vitamin B-6 might also help with PMS symptoms.

You can find it in the following foods:

• fish
• chicken and turkey
• fruit
• fortified cereals

Vitamin B-6 also comes in supplement form, which you can find on Amazon. Just don’t take more than 100 milligrams a day.

Lifestyle changes

Several lifestyle factors also seem to play a role in PMS symptoms:

• Exercise. Try to be active for at least 30 minutes more days of the week than not. Even a daily walk through your neighborhood can help with feelings of sadness, irritability, and anxiety.
• Nutrition. Try to resist the junk food cravings that can come with PMS. Large amounts of sugar, fat, and salt can all wreak havoc on your mood. You don’t have to cut them out completely, but try to balance out these foods with fruits, vegetables, and whole grains. This will help keep you full throughout the day and help avoid drops in blood sugar, which can make you irritable.
• Sleep. Not getting enough sleep can kill your mood if you’re weeks away from your period. Try to get at least seven to eight hours of sleep a night, especially in the week or two leading up to your period. See how not getting enough sleep affects your mind and body.
• Stress. Unmanaged stress can worsen mood swings. Use deep breathing exercises, meditation, or yoga to calm both your mind and body, especially when you feel PMS symptoms coming on.

Medication

If other treatment options aren’t helping, taking an antidepressant may help. Selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressant used to treat PMS-related mood swings.

SSRIs block the absorption of serotonin. This increases the amount of serotonin in your brain. Examples of SSRIs include:

• citalopram (Celexa)
• fluoxetine (Prozac and Sarafem)
• paroxetine (Paxil)
• sertraline (Zoloft)

Other antidepressants that work on serotonin might also help treat PMS mood swings. These include:

• duloxetine (Cymbalta)
• venlafaxine (Effexor)

Work with your doctor to come up with a dosage plan. They might suggest you only take an antidepressant during the two weeks before your symptoms tend to start. In other cases, they might recommend taking them every day.