Anxiety During Period? You’re Not Alone

Anxiety can arise at any time. It may be centered on a specific event or person (stress with family, at work, an argument with a friend) or a generalized sense of dread and fear.

But if you experience this more often than not around your period, you’re not alone. You may feel like your reactions are suddenly out of character, that you feel sudden doom and gloom when you usually consider yourself a pretty even-keeled—even optimistic—person. You may find the news cycle or depressing documentaries suddenly hit hard. 

Instead, you want to protect yourself from a world that suddenly seems unfriendly or downright threatening. Everyday activities become fraught; life seems hard. And then your period comes, and abracadabra! You’re back to normal.

Well, you just experienced one of the common symptoms of PMS: Anxiety.

What Is PMS? The Most Common PMS Symptoms

PMS stands for premenstrual syndrome. It refers to a combination of physical, emotional, and behavioral symptoms that occur in the days or weeks before a menstrual period. PMS affects different women differently, and the severity and specific symptoms can vary from person to person. Here are some possible physical and psychological symptoms associated with PMS:

Physical Symptoms of PMS

• Breast tenderness or swelling
• Bloating and water retention
• Fatigue or low energy levels
• Headaches or migraines
• Muscle aches and joint pain
• Changes in appetite or food cravings
• Digestive issues, such as constipation or diarrhea

Emotional and Behavioral Symptoms of PMS

• Mood swings and irritability
• Anxiety or feeling on edge
• Depression or feelings of sadness
• Increased sensitivity or crying spells
• Difficulty concentrating or memory problems
• Insomnia or changes in sleep patterns
• Changes in libido or sex drive

It's important to note that these symptoms usually occur in the luteal phase of the menstrual cycle (the stage between ovulation and the start of menstruation) and tend to resolve once menstruation begins. 

What Causes Premenstrual Syndrome?

The exact cause of premenstrual syndrome is not fully understood, but it is believed to be a combination of hormonal changes, neurotransmitter imbalances, and individual susceptibility factors. Several factors may contribute to the development of PMS, including:

• Hormonal fluctuations, particularly estrogen and progesterone
• Serotonin imbalance
• Chemical changes in the brain, such as gamma-aminobutyric acid (GABA)
• Genetic factors

How to Manage PMS Anxiety

Managing PMS anxiety can involve a combination of self-care strategies, lifestyle modifications, and, in some cases, medical interventions. Here are some tips that may help relieve symptoms:

1. Maintain a Healthy Lifestyle

• Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins
• Limit your consumption of caffeine, alcohol, and refined sugars, as they can exacerbate anxiety symptoms
• Stay hydrated by drinking plenty of water
• Engage in regular physical activity, such as walking, jogging, yoga, or other forms of exercise that you enjoy
• Get enough sleep and establish a consistent sleep routine
• If you have benefits through your workplace, use them: Registered massage therapy, acupuncture, etc., can all help you destress and stay physically and mentally healthy

2. Practice Stress Management Techniques

• Practice relaxation techniques like deep breathing exercises, meditation, or progressive muscle relaxation to reduce anxiety
• Engage in activities that you find enjoyable and relaxing, such as reading, listening to music, taking a warm bath, or spending time in nature
• Consider trying stress-reducing practices like mindfulness or yoga

3. Make Lifestyle Changes to Support Your Mental Health

• Maintain a regular schedule and prioritize self-care activities
• Seek support from friends, family, or support groups to talk about your feelings and experiences
• Engage in hobbies or activities that promote positive emotions and help you relax

4. Explore Cognitive-Behavioral Techniques

• Challenge negative thoughts and replace them with more positive and realistic ones
• Use coping strategies such as positive self-talk, visualization, or journaling to manage anxiety symptoms
• Consider consulting a mental health professional who can help you develop coping skills specific to your needs

5. Consider Medical Interventions

• If symptoms are severe and significantly impact your daily life, consult a healthcare professional for further evaluation and potential medical interventions
• They may suggest medications, such as selective serotonin reuptake inhibitors (SSRIs) or hormonal birth control, which can help alleviate anxiety symptoms associated with PMS

Remember, listening to your body, being patient with yourself, and experimenting with different strategies to find what works best for you is essential. If symptoms persist or worsen despite self-help efforts, it's best to consult a healthcare professional for further guidance and support.

Premenstrual Dysphoric Disorder: An Extreme Form of PMS

If the symptoms are severe and significantly impact daily life, they may be classified as premenstrual dysphoric disorder (PMDD), a more severe form of PMS. If you experience significant distress or disruption due to PMS symptoms, it is advisable to consult a healthcare professional for further evaluation and management options.

Premenstrual dysphoric disorder is a severe form of premenstrual syndrome affecting a small percentage of menstruating individuals. According to a paper published in the Journal of Women's Health, premenstrual dysphoric disorder affects up to 5% of women of childbearing age.

Like PMS, symptoms of PMDD generally occur a week or 2 before menstruation and improve within a few days of the onset of menstruation. 

Core Psychological Symptoms of PMDD

• Marked mood swings, such as increased irritability, anger, or increased conflicts with others
• Marked feelings of sadness, hopelessness, or severe tension
• Marked anxiety, tension, or feelings of being on edge
• Marked depressed mood, feelings of worthlessness, or self-critical thoughts

Emotional Symptoms

• Intense mood changes, such as feeling overly sensitive, easily overwhelmed, or excessively emotional
• Increased sensitivity to rejection or feeling socially isolated
• Difficulty concentrating or focusing
• Fatigue or low energy levels
• Changes in appetite or food cravings
• Insomnia or sleep disturbances
• Feeling out of control or overwhelmed
• Decreased interest in activities usually enjoyed
• A sense of being overwhelmed or out of control

Physical Symptoms

• Breast tenderness or swelling
• Bloating and water retention
• Headaches or migraines
• Muscle aches and joint pain
• Changes in appetite or food cravings
• Digestive issues, such as constipation or diarrhea

With PMDD, it is expected that those symptoms are persistently problematic, i.e. that they:

• Are present for most menstrual cycles in the past year
• Significantly interfere with work, school, social relationships, or other vital areas of life

It can be challenging to tell the difference between PMS and PMDD when you’re feeling all your feelings. It might help to track your symptoms, thoughts, and emotions. However, if you suspect you may have PMDD or a major depressive disorder, we strongly recommend you consult a healthcare provider who can assess your symptoms, provide an accurate diagnosis, and discuss appropriate treatment options. 

Treatment for PMDD may include lifestyle modifications, psychological interventions, and sometimes medication, such as selective serotonin reuptake inhibitors, to help manage the symptoms effectively.

PMS Anxiety Versus Generalized Anxiety Disorder (GAD): How to Tell the Difference?

Distinguishing between PMS-related anxiety and mental disorders such as generalized anxiety disorder can sometimes be challenging, as they can share similar symptoms. In addition, some people may have "premenstrual exacerbation" of anxiety disorders. However, some key factors can help differentiate premenstrual symptoms and GAD:

1. Timing of Symptoms:

• PMS anxiety: Symptoms of anxiety associated with PMS occur in the luteal phase of the menstrual cycle, typically in the week or 2 before menstruation, and tend to resolve with the onset of menstruation.
• Generalized anxiety disorder: Symptoms of GAD persist consistently for at least 6 months and are not limited to any specific phase of the menstrual cycle.

2. Symptom Patterns

• PMS anxiety: Anxiety symptoms related to PMS are typically cyclical, meaning they occur predictably before each menstrual period and may be accompanied by other PMS symptoms such as mood swings, breast tenderness, or bloating.
• Generalized anxiety disorder: GAD is characterized by chronic and excessive worry or anxiety not specifically linked to the menstrual cycle. The anxiety experienced is typically persistent and not tied to specific events or triggers.

3. Severity and Impact

• PMS anxiety: While premenstrual anxiety can be distressing, it tends to be more temporary and tied to the menstrual cycle. The symptoms may affect daily functioning but usually subside once menstruation begins.
• Generalized anxiety disorder: GAD is a chronic condition characterized by persistent and excessive anxiety that can significantly impair various areas of life, including work, relationships, and overall well-being.

It's important to note that GAD and PMS anxiety can coexist. And some individuals with GAD may find their anxiety is more exacerbated during the premenstrual phase. 

As mentioned in the PMDD section, it can be challenging to reflect neutrally on your emotional well-being, especially while you are experiencing it "live," so to speak. As such, always seek support if you are worried or if your symptoms significantly impact your daily life. Your doctor or mental health professional can provide a proper diagnosis and recommend appropriate treatment options.

Frequently Asked Questions

Why Do I Get Anxiety During My Period?

Experiencing anxiety during your period can be due to several factors, including hormonal fluctuations, physical discomfort, and emotional changes:

• Hormonal changes: The menstrual cycle involves significant hormonal fluctuations, primarily in estrogen and progesterone levels. These hormonal changes can affect neurotransmitters in the brain, which affect mood regulation. Variations in hormone levels can lead to increased anxiety in some individuals.
• Premenstrual syndrome: PMS is a common condition that includes physical and emotional symptoms, such as mood swings, irritability, and anxiety. The week leading up to your period, known as the late luteal phase, is when PMS symptoms are most pronounced.
• Physical discomfort: Menstruation often comes with physical pain, such as cramps, bloating, and headaches. These physical symptoms can be distressing and contribute to anxiety.
• Pain and discomfort: Pain associated with conditions like dysmenorrhea (painful periods) can trigger or worsen anxiety. The anticipation of pain or discomfort can also lead to stress.
• Emotional sensitivity: Some women become more emotionally sensitive or irritable during their menstrual period, making them more prone to experiencing anxiety or stress.
• Negative thought patterns: Negative associations with periods due to past experiences or cultural influences can contribute to anxiety during this time.
• Premenstrual dysphoric disorder: PMDD is a severe form of PMS characterized by intense mood disturbances, including severe anxiety, irritability, and mood swings. It can significantly impact daily functioning.
• Lifestyle factors: Lifestyle factors such as poor sleep, high-stress levels, and an unhealthy diet can exacerbate anxiety during your period. These factors can interact with hormonal changes to intensify symptoms.

If you find that anxiety during your period significantly impacts your quality of life or if it's associated with severe mood swings, it's essential to consult a healthcare professional. They can help determine whether you might have PMDD or whether there are other underlying factors contributing to your anxiety. Treatment options may include lifestyle changes, therapy, medication, or hormonal interventions, depending on the diagnosis and severity of your symptoms.

How Can I Calm My Period Anxiety?

Coping with period-related anxiety can be challenging, but several strategies may help you manage and reduce these feelings:

• Exercise: Regular physical activity can help alleviate anxiety and improve mood. Engaging in activities like walking, jogging, or yoga during your period can be beneficial.
• Diet and nutrition: Maintain a balanced diet rich in fruits, vegetables, and whole grains while reducing caffeine and sugar intake. Some people relieve anxiety by reducing their caffeine intake, which can exacerbate symptoms.
• Stress management: Practice stress-reduction techniques, such as deep breathing, meditation, or progressive muscle relaxation, to help manage anxiety. These techniques can be instrumental during your period.
• Pain relief: Over-the-counter pain relievers like ibuprofen can help alleviate physical discomfort associated with your period, which may indirectly reduce anxiety.
• Warm compresses: Applying a warm compress to your lower abdomen can ease menstrual cramps and promote relaxation.
• Hydration: Stay well-hydrated during your period, as dehydration can exacerbate anxiety and physical symptoms.
• Aromatherapy: Some people find relief through aromatherapy, using essential oils like lavender or chamomile, which can have calming effects.
• Counseling or therapy: If period-related anxiety is severe or significantly affects your daily life, consider therapy or counseling. Cognitive-behavioral therapy (CBT) can help you address and manage anxiety symptoms.
• Prescription medications: In cases of severe premenstrual symptoms, a healthcare provider might recommend medications such as hormonal birth control, antidepressants, or anti-anxiety medications.
• Track your symptoms: Keeping a menstrual cycle diary can help identify patterns and triggers, which can help manage anxiety.
• Self-care: Prioritize self-care during your period. This includes getting adequate rest, relaxing, and doing activities you enjoy.
• Talk to a healthcare provider: If anxiety during your period is persistent and disruptive, consult a healthcare provider. They can help determine the underlying causes and recommend appropriate treatments.

Remember that what works for one person may not work for another, so finding the strategies that best suit your needs is essential. Consulting with a healthcare provider can provide personalized guidance and treatment options for managing period-related anxiety.

What Are 5 Coping Skills for Anxiety?

Coping skills for anxiety can be valuable in managing and reducing symptoms. Here are 5 practical coping skills:

1. Deep breathing: Practice deep, diaphragmatic breathing to calm your nervous system. Inhale slowly through your nose, hold for a few seconds and exhale slowly through your mouth. Repeat this process to reduce anxiety and promote relaxation.
2. Mindfulness meditation: Mindfulness techniques, such as meditation and mindfulness-based stress reduction (MBSR), help you stay present and focused, reducing worry and rumination.
3. Progressive muscle relaxation: This technique involves tensing and relaxing different muscle groups to release physical tension and promote relaxation. It can help reduce anxiety-related muscle tension.
4. Cognitive-behavioral techniques: Challenge and reframe negative thought patterns contributing to anxiety. Identify and replace irrational or anxious thoughts with more realistic and positive ones.
5. Social support: Talk to a trusted friend or family member about your anxiety. Social support can provide comfort, understanding, and a different perspective on your concerns.

These techniques are just a starting point. It's essential to find coping strategies that work best for you, and in some cases, seeking professional help from a therapist or counselor may be necessary to address anxiety effectively.

When Is Anxiety Highest During Menstrual Cycle?

Anxiety levels during the menstrual cycle can vary from person to person. Still, for many individuals, anxiety tends to peak during 2 specific phases, according to a study published in the journal Clinical Psychology Review:

1. Premenstrual phase: Anxiety often reaches its highest point in the days leading up to menstruation as progesterone declines. This phase typically occurs during the late luteal phase of the menstrual cycle, which is the 2 weeks before your period begins. Premenstrual anxiety is a common experience and can be attributed to hormonal fluctuations, physical discomfort, and emotional sensitivity during this time.
2. Menstrual phase: Some individuals may also experience heightened anxiety during their menstrual period following a decline in progesterone.

It's important to note that not everyone will experience heightened anxiety during these phases, and the severity of anxiety can vary from person to person. Some individuals may not experience any significant increase in stress related to their menstrual cycle. However, for those who do, understanding the pattern and potential triggers can help manage and cope with premenstrual and menstrual anxiety. If anxiety during your menstrual cycle is severe and interferes with your daily life, it's advisable to consult a healthcare provider for guidance and potential treatment options.

Can Magnesium Help Reduce Anxiety?

Magnesium may help reduce anxiety in some individuals. Magnesium is essential in various bodily functions, including nerve function and muscle relaxation. It is believed to have a calming effect on the nervous system, making it potentially beneficial for anxiety management. Here's how magnesium can be helpful:

• Stress reduction: Magnesium can help regulate the body's stress response by influencing the release of stress hormones like cortisol. It may help to mitigate the physiological reactions to stress and anxiety.
• Neurotransmitter regulation: Magnesium regulates neurotransmitters in the brain, including gamma-aminobutyric acid (GABA), which has a calming effect. Adequate magnesium levels may support GABA function and reduce anxiety.
• Muscle relaxation: Magnesium can help relax muscles, especially when anxiety is accompanied by physical tension and muscle tightness.
• Improved sleep: Magnesium may promote better sleep quality, and sleep disturbances are closely related to anxiety. Adequate sleep can help reduce anxiety symptoms.
• Cardiovascular health: Magnesium supports healthy heart function, which is essential for overall well-being. Anxiety can sometimes be related to heart palpitations or increased heart rate, and magnesium may help.

It's important to note that the effectiveness of magnesium in reducing anxiety can vary from person to person. While some individuals may find relief by increasing their magnesium intake, others may not experience the same benefits.

If you are considering magnesium supplements for anxiety, consult a healthcare provider to determine the appropriate dosage and any underlying medical conditions that might contribute to your stress.

Magnesium can be obtained through dietary sources, such as leafy greens, nuts, seeds, and whole grains, so adjusting your diet may also be an option to increase your magnesium intake.

Can Your Period Cause Panic Attacks?

According to a study published in the journal Clinical Psychology Review, "Women with premenstrual symptoms or PMDD experience panic attacks more frequently in response to an external stressor as compared to women without premenstrual symptoms."

While the exact causes are not fully understood, several factors may contribute to this:

• Hormonal fluctuations: Hormonal changes throughout the menstrual cycle can affect neurotransmitters in the brain, such as serotonin and GABA, which are crucial in regulating mood and anxiety. The fluctuations in estrogen and progesterone levels may impact the vulnerability to panic attacks.
• Premenstrual syndrome: Some individuals experience severe premenstrual syndrome symptoms, including mood swings, irritability, and anxiety. These symptoms may be more likely to lead to panic attacks during the menstrual period.
• Stress and anxiety: Pre-existing stress and anxiety can be exacerbated during menstruation, making individuals more susceptible to panic attacks. The physical discomfort and other symptoms of menstruation can add to the overall stress load.
• Pain and discomfort: Physical discomfort, such as menstrual cramps and bloating, can be distressing and may lead to increased anxiety and panic attacks in susceptible individuals.
• Hormonal disorders: In some cases, underlying hormonal conditions, such as polycystic ovary syndrome (PCOS), can lead to irregular menstrual cycles and hormonal imbalances, contributing to anxiety and panic attacks.

If you experience panic attacks related to your menstrual cycle, seeking help from a healthcare provider is essential. They can evaluate your symptoms, rule out any underlying medical conditions, and discuss treatment options. Treatment may include addressing hormonal imbalances, therapy, medication, or lifestyle changes to help manage anxiety and panic attacks during your period.

What Are the 3 3 3 Rules for Anxiety?

The "333 rule" is an informal grounding technique that can be used to manage anxiety and panic attacks. Here's how it works:

1. Name 3 things you see: Look around and identify 3 items in your immediate environment. This helps you focus on the present moment and can reduce panic or anxiety.
2. Name 3 things you hear: Listen for and acknowledge 3 distinct sounds you can hear. Pay attention to the sounds in your surroundings, whether it's the hum of an appliance, the rustling of leaves, or people talking.
3. Move 3 parts of your body: Move 3 different parts, even if just a slight movement. This can be as simple as wiggling your toes, tapping your fingers, or gently moving your head from side to side. Physical activity can help break the cycle of anxious thoughts.

The 333 rule is a form of grounding and mindfulness, which can help reduce the intensity of anxiety or panic symptoms. By focusing on your immediate sensory experience and the physical sensations of movement, you can regain control and calm during heightened anxiety.

Written by Jane Flanagan — Updated on Oct. 22, 2023.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.