The sensation of feeling shaky, tremulous, or jittery in the days leading up to a menstrual period is a common physical symptom of premenstrual syndrome (PMS). This physical change occurs predictably during the luteal phase as the body prepares for menstruation. Understanding the underlying physiological shifts, particularly those related to metabolism and the nervous system, helps explain why this feeling of internal tremor is frequent.
Hormonal Fluctuations and Blood Sugar Regulation
The primary drivers of premenstrual physical symptoms are the shifts in reproductive hormones, namely estrogen and progesterone. During the luteal phase, progesterone levels are high, and this hormone temporarily affects glucose metabolism. Progesterone promotes a state of temporary insulin resistance in the body’s cells.
Insulin resistance means the body’s cells do not respond efficiently to insulin, which moves glucose from the bloodstream into the cells for energy. This resistance causes blood sugar levels to become less stable and more prone to fluctuations. This instability can lead to “reactive hypoglycemia,” where blood sugar dips sharply after eating.
The physical symptoms of low blood sugar, or hypoglycemia, closely mirror the feeling of premenstrual shakiness. These symptoms include anxiety, sweating, dizziness, and the distinct physical tremor or jitteriness. The hormonal environment of the late luteal phase makes sensitive individuals more susceptible to these energy-related dips. This physiological effect is why many people report intense cravings for simple carbohydrates and sugar, as the body seeks a quick fuel source to stabilize fluctuating glucose levels.
Heightened Nervous System Response and Anxiety
Premenstrual shakiness is also linked to the impact of hormonal shifts on the central nervous system and mood-regulating chemicals. Fluctuations in estrogen and progesterone directly influence neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA), which are essential for mood and calmness. A drop in serotonin, common in the late luteal phase, contributes to feelings of anxiety and irritability.
Increased anxiety and tension are recognized symptoms of PMS, triggering the body’s fight-or-flight response. This involves the release of stress hormones, primarily adrenaline and cortisol, from the adrenal glands. Adrenaline prepares the body for immediate action, increasing heart rate and causing internal tremor in the muscles.
The physical manifestation of this heightened nervous system excitability is the shaky feeling. For some, this sensation is general jitteriness; for others, it can escalate to feelings that resemble a panic attack, complete with heart palpitations and intense anxiety. This neurological component combines with blood sugar instability, creating a compound effect where a minor dip in glucose triggers a disproportionately strong adrenaline response.
When to Seek Medical Guidance and Management Strategies
Immediate management of premenstrual shakiness focuses on stabilizing blood sugar and calming the nervous system. Eating smaller, more frequent meals that combine complex carbohydrates with protein and healthy fats helps slow glucose absorption and prevent sharp peaks and crashes. Incorporating nutrient-dense foods and staying well-hydrated supports overall metabolic stability.
Specific nutrients can be helpful; for instance, magnesium supplementation assists in nerve and muscle relaxation and reduces many PMS symptoms, including anxiety. Engaging in regular, moderate exercise, like walking or yoga, boosts mood-lifting endorphins and reduces stress. Prioritizing seven to eight hours of quality sleep nightly is important, as poor sleep can exacerbate stress hormone production and worsen symptoms.
It is important to consult a healthcare provider if the shakiness is severe, significantly interferes with daily life, or is accompanied by other concerning symptoms. Medical consultation is warranted if symptoms occur outside the premenstrual window, or if they are coupled with severe mood changes, extreme weight loss, or persistent heart palpitations. A doctor can rule out other potential causes, such as thyroid dysfunction, and may discuss treatment options for severe cases, including hormonal contraceptives or specific medications that regulate serotonin levels. Keeping a detailed symptom diary for at least two menstrual cycles helps a professional accurately diagnose the condition.