Many individuals who menstruate experience mood shifts, including irritability, sadness, or heightened anxiety, particularly in the week leading up to their period. Over 64% report premenstrual mood swings or anxiety.
The Hormonal Rollercoaster
Cyclical fluctuations of hormones, particularly estrogen and progesterone, drive these mood shifts. These hormones regulate the reproductive system and influence the brain, with levels naturally rising and falling across the follicular and luteal phases.
During the follicular phase, estrogen levels gradually increase. After ovulation, in the luteal phase, both estrogen and progesterone levels rise. If pregnancy does not occur, a sharp decline in both hormone levels just before menstruation triggers the changes experienced premenstrually.
Brain’s Response to Hormones
Fluctuations in estrogen and progesterone influence brain chemistry through neurotransmitter systems. Neurotransmitters are chemical messengers that transmit signals throughout the brain, impacting mood, sleep, and appetite.
Estrogen affects serotonin, a neurotransmitter associated with well-being. Estrogen enhances serotonin production and receptor sensitivity, increasing active serotonin levels.
When estrogen levels decline sharply before menstruation, serotonin activity reduces. This decrease is linked to sadness, irritability, and anxiety. Progesterone plays a role, with its metabolite interacting with gamma-aminobutyric acid (GABA) receptors. GABA is the brain’s main inhibitory neurotransmitter, promoting a calming effect. While this interaction often contributes to relaxation, some individuals may experience a paradoxical response, leading to heightened anxiety or negative mood.
Understanding Severity
Premenstrual mood changes exist on a spectrum. Many individuals experience mild symptoms in the days before their period.
Premenstrual Syndrome (PMS) is a more pronounced set of cyclical symptoms occurring in the luteal phase, causing some daily interference.
More severe is Premenstrual Dysphoric Disorder (PMDD), affecting approximately 3% to 8% of women of reproductive age.
PMDD symptoms are intense and debilitating, disrupting daily life. Diagnostic criteria include marked mood swings, irritability, depressed mood, or anxiety, with at least five symptoms present in the week before menstruation and resolving within a few days of its onset. Diagnosis requires tracking symptoms across at least two cycles to confirm their cyclical pattern.
Beyond Hormones: Other Influences
While hormonal fluctuations are a primary cause of premenstrual mood changes, other factors can influence their intensity.
Lifestyle factors like chronic stress exacerbate mood swings, as stress hormones interfere with neurotransmitter balance. Poor sleep quality also contributes, potentially worsening emotional regulation.
Dietary habits play a role; consuming sugar, unhealthy fats, and excessive salt negatively impacts mood and worsens symptoms. Conversely, a diet rich in complex carbohydrates, calcium, and vitamin D can mitigate symptoms.
Regular physical activity improves mood and reduces premenstrual symptom severity. Genetic predispositions influence sensitivity to hormonal changes, affecting the experience of mood shifts.