No one needs to be told twice that periods have the power to totally mess with our bodies. The days or weeks leading up to that time of the month can bring on any number of symptoms, from physical ailments to unexplained emotions to debilitating pain—all bundled up under the umbrella of PMS. We reached out to two trusted sources—Dr. Prudence Hall and Dr. Sherry Ross—for some expert advice on the matter. Keep scrolling to learn what causes your anxiety to spike during your period and what you can do to help treat it.
Meet the Expert
- Dr. Prudence Hall is a physician and founder of the Hall Center in Santa Monica, CA. Hall's practice and book, Radiant Again & Forever, center around regenerative medicine and addressing causes, not symptoms of disease.
- Dr. Sheryl A. Ross, MD and co-founder of URJA Intimates, is an award-winning OBGYN, author, and women's health advocate whose expertise has been featured in publications including US News & World Report, LA Times, and Marie Claire.
What Causes an Anxiety Spike During Your Period?
If you've noticed your anxiety spike before or during your period, it's likely not just an unfortunate coincidence. "Because of differences in brain chemistry and the impact of hormones such as estrogen and progesterone, women are already more likely than men to suffer from anxiety disorders and even panic attacks," explains Dr. Hall. "And these can definitely be more pronounced right before and during their periods."
Hormones control and regulate our bodies as well as our mental health. Hall says that "due to hormonal fluctuations, PMS (premenstrual syndrome) interrupts and upsets that balance, often triggering symptoms like increased anxiety." Not sure if you're experiencing some common symptoms of PMS? Dr. Ross outlines what to look out for:
- Mood swings
- Crying spells
- Feeling worthless
If you've experienced one or more of these symptoms one to two weeks before your period, it's very likely these emotions are caused by PMS.
How to Treat Anxiety
Dr. Hall and Dr. Ross have a few recommendations for feeling better when your anxiety has been triggered. Two holistic approaches are to overhaul your diet and lifestyle.
According to Hall, an anti-inflammatory diet rich in fruit and vegetables and low in animal products can help ease the anxiety-inducing effects of PMS. She also recommends avoiding alcohol and caffeine. Staying active with exercise and taking time outs with mindfulness practices, such as yoga and meditation, can also help your body to find balance. Getting enough sleep every night is also crucial.
Similarly, Dr. Sanam Hafeez, an NYC-based neuropsychologist, says research shows that calcium and vitamin B6 are effective in alleviating physical and psychological symptoms of PMS. "Eating complex carbs also helps with PMS," she says.
If you take birth control pills and are looking for a more aggressive strategy, Dr. Hall suggests coming off the pill and switching to an alternative that may work better. After studying the effects of birth control pills in her practice, Hall has concluded that the pill is responsible for inhibiting healthy estrogen and testosterone levels, causing increased anxiety and other psychological symptoms. According to Dr. Hall, estrogen is critical for normal brain functioning. After measuring hormone levels in several thousand oral contraception users over the years, Hall found that many of her patients had extremely low levels of estrogen—in fact, as low as her menopausal patients. In her clinical opinion, close to 80% of her patients' anxiety diminished after discontinuing the pill.
Dr. Hall also notes that testosterone, a hormone traditionally associated with men, is also very important for women. Among the many effects of testosterone, Hall notes its key role in regulating confidence, adding that testosterone levels, like estrogen, are also curbed by oral contraception. Ultimately, Hall has found that when patients stop taking the pill, estrogen and testosterone levels rise, and anxiety and other symptoms—like low self-esteem—decrease. To normalize the body’s hormonal state, Dr. Hall also suggests asking your doctor about bioidentical estrogen or natural dietary supplements that can help combat anxiety, promote healthier sleeping patterns, and improve digestion.
Can You Prevent It?
While preventing anxiety completely may not be possible, there are several lifestyle habits you can use to avoid the other PMS symptoms associated with anxiety during your period. Here, Dr. Ross outlines what you can do to help prevent anxiety with dietary changes that benefit other PMS symptoms, too:
- Drink two to three liters of water a day. Adding ginger to hot water can also help.
- Stay hydrated by eating water-based foods (including strawberries, blueberries, celery, cucumber, lettuce, and watermelon).
- Eat healthy food including fresh fruits and vegetables, fish, chicken, and complex carbohydrates such as whole grains and brown rice.
- Eat foods or take supplements that contain calcium, vitamins E and D, thiamine, magnesium, and omega-3 fish oil.
- Eat foods that are natural diuretics, such as celery, cucumbers, watermelon, tomatoes, asparagus, lemon juice, garlic, melon, and lettuce.
- Drink green tea—it's both relaxing and a natural diuretic.
- Exercise four to six times a week for a minimum of 30 minutes.
- Limit alcohol consumption.
- Eat calcium-rich foods or take calcium supplements to reduce muscle cramps (Dr. Ross recommends taking 1,000 mg per day); cheese, yogurt, milk, sunflower seeds, spinach, soybeans, kale, figs, almonds, sesame seeds, and tofu are also excellent sources of calcium.
- Drink warm or hot water to help relax uterine muscles.
Dr. Ross recommends avoiding foods that cause bloating, such as beans, broccoli, Brussels sprouts, cabbage, cauliflower, rich and fatty foods, whole grains, apples, peaches, pears, lettuce, onions, or foods that are high in sodium.
When to See a Doctor
As long as anxiety, depression, and irritability disappear once your period begins, these symptoms are all considered normal signs of PMS. However, "if these emotional changes continue beyond your period, this may suggest a more underlying medical concern of psychological dysfunction," warns Dr. Ross. As she explains, premenstrual dysphoric disorder (PMDD) is a condition where emotional changes—such as anxiety, depression, and irritability—begin to disrupt your work and personal life. Medications that treat depression and anxiety are often prescribed to those with PMDD.
If anxiety begins to disrupt your life, consider seeking professional help.
Keep in mind, if none of the previously recommended treatments such as diet, exercise, or mindfulness help to ease feelings of anxiety, Dr. Ross suggests meeting with a healthcare professional to discuss treatment options.
The Final Takeaway
According to Dr. Ross, a history of depression, anxiety, or other mental health concerns can exacerbate typical PMS symptoms, "including mood swings, extreme depression, fits of anger, and overwhelming anxiety." Ultimately, certain mental illnesses can make common PMS extremely difficult to manage. Remember: You should never feel ashamed for having to seek professional help if your PMS symptoms become unmanageable. Seeking advice from a certified healthcare provider will get you the care you need to help manage your anxiety.