Many individuals who menstruate experience anxiety or other mood changes before or during their period. Seeking treatment can provide relief.

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Mental health symptoms can linked to a variety of medical conditions. When it comes to periods, this is not an exception. Periods can already be uncomfortable to deal with, but some people deal with intense pain and mood shifts that can become overwhelming.

These mood shifts can cause anxiety and depression and interfere with work, school, and your relationships with others. The pain can stop you from doing the things you love to do.

Experiencing anxiety before your period isn’t uncommon. Treatment can help stabilize your mood and reduce pain.

If you menstruate, you may experience anxiety before and during your period. 2022 research supports a link between psychiatric symptoms and menstrual cycles. This may be due to the fluctuating hormones you experience before and during your period.

Premenstrual exacerbation (PME) and premenstrual dysphoric disorder (PMDD) can also be contributors to anxiety and other mood disorders. PME occurs when the symptoms of other disorders become worse before your period.

PMDD is an endocrine condition where you have premenstrual syndrome (PMS) symptoms and extreme mood changes. In individuals with mood disorders, about 60% of women experience PME. The authors also suggest that fluctuations in sex hormones during the menstrual cycle contribute to PME and PMDD.

Another 2022 study of 238,114 respondents found that approximately 64% of participants in the research reported anxiety or shifts in mood during or right before their menstrual cycles. The authors indicate no differences in reported mood changes across the lifespan.

A consistent link across all studies is the role of the fluctuations of hormones in increased mood symptoms. If you experience anxiety during or before your period, this is likely why.

PMDD vs. PME

PMDD and PME are both conditions that people who menstruate can experience. Both conditions can cause shifts in moods.

Research indicates that PMDD is caused by changing sex steroid levels that occur with menstrual cycles. PMDD includes symptoms such as:

  • mood shifts
  • irritability
  • depression
  • anxiety
  • lack of interest
  • difficulty concentrating
  • tension
  • changes in sleep patterns
  • changes in appetite
  • joint swelling, soreness, or stiffness
  • bloating

PMDD usually occurs only during the menstrual phase and isn’t present outside of this time.

Research indicates that PME and PMDD symptoms are fairly similar. PME just includes the worsening of mood disorders such as depression or bipolar disorder, or an increase in existing anxiety disorders during or before your period.

If you live with PMDD or PME, or just notice an increase in anxiety during menstruation, you may consider seeking treatment.

If you live with PMDD or PME, first-line treatments, according to a 2022 overview, include selective serotonin reuptake inhibitor (SSRI) medications such as:

The authors note that SSRIs can take 4-8 weeks to be efficient in the treatment of mood and anxiety disorders. SSRIs can help reduce the mood symptoms associated with your period.

SSRIs are often paired with combined oral contraceptives to treat PMDD, according to a 2022 review of PMDD. They note that the only combined oral contraceptive that is FDA-approved for the treatment of PMDD is Drospireone.

Other methods of treating anxiety that are menstrual-related include non-pharmacological options. There’s some evidence that suggests that doing yoga and acupressure can help alleviate symptoms of premenstrual syndromes, according to a 2021 study. Yoga was found to help more than acupressure.

In rare cases where an individual may not respond well to medications or experience adverse effects of other treatments, research suggests that surgery may be recommended for PMDD.

Surgery options include the removal of one or both ovaries, known as an oophorectomy. Oophorectomies with low dose estrogen therapy are known to be effective in treating premenstrual-related mood disorders.

If you’re experiencing anxiety, you may also consider finding a therapist who uses cognitive behavioral therapy (CBT), which is the most evidence-backed treatment for anxiety. CBT can help you switch maladaptive ways of thinking, feeling, and behaving to healthier thoughts, feelings, and behaviors.

If you’re living with menstrual-related anxiety, it may be hard to know when to seek support. Treatment and therapy can help alleviate your symptoms.

Some signs you should seek support from your healthcare professional or a mental health professional include:

  • mood shifts that interfere with your relationships
  • depressed mood or suicidal thoughts
  • anxiety or depression that interferes with your daily life
  • if you need support to deal with the symptoms

If you experience mood changes around the time of your period and it impacts your ability to go about your daily activities, consider speaking with your healthcare professional.

A medical professional can help recommend treatments that are suitable for you.

Anxiety is worry about a perceived threat or threat that can impact your daily life. People who menstruate can experience conditions like PME or PMDD that can cause extreme mood shifts.

The fluctuation in your hormones before and during your period can likely cause mood changes.

Treatment options include:

  • medication
  • therapy
  • lifestyle changes
  • in rare cases, surgery

If your symptoms interfere with your daily life, this may be a sign to seek some additional support. If you’re experiencing suicidal thoughts, you can reach out to a support hotline or go to your nearest emergency room.

You can also use the Findcare Tool to locate mental health and medical providers in your area. If you experience mood changes before or during your period, you aren’t alone. Treatment can help.