When my period comes around, I transform into a nervous, jittery version of myself. I worry I'm not working hard enough, I suck at writing, or I said something off-putting or offensive to my friends and family members. I'm not alone. While most people equate PMS with food cravings and cramps, evidence suggests 64% of those who menstruate feel extra anxious during That Time Of The Month. (As if bleeding for a week straight wasn't frustrating enough.)
Joshua Klein, MD, FACOG, a reproductive endocrinologist and cofounder of Extend Fertility in New York City, tells SELF that this anxiety spike is a very common biological response to a whole host of physiological changes going down in your body, including the free fall of various sex hormones and neurotransmitters, research shows. "You're not crazy, it's a real thing," he says. We asked three health experts for the best ways to cope with brutal anxiety spells before and during your period. Here's what they said.
The reason you feel so edgy as your flow nears? Plunging hormones, Dr. Klein says. "A week before your period arrives, progesterone and estrogen are falling, and that's what provokes most premenstrual symptoms," he notes. Basically, your brain has a ton of hormone receptors, and as hormone levels fluctuate during your cycle, they can affect the production of GABA, serotonin, and dopamine (a.k.a. the neurotransmitters responsible for keeping you relatively calm and stress-free).
One way to ensure your progesterone and estrogen don't ebb and flow so drastically is to take a combination oral contraceptive (like drospirenone and ethinyl estradiol, YAZ is a common type), says Dr. Klein, meaning it contains both estrogen and progestin. Pairing these two hormones together in a pill helps prevent ovulation, thereby stabilizing hormone levels and mood swings, research shows.
Other hormonal birth control methods like the patch and the ring can also suppress ovulation by regulating both hormones that may be making you anxious. Nonhormonal birth control methods like the copper IUD, however, don't have the same effect. Of course, some people find that their mood plummets because of the pill. Dr. Klein's rec? Talk to your doctor to see which route might be most ideal, as most pills require a trial-and-error period to find the right type. Though it's not birth control, you could bring up taking a serotonin reuptake inhibitor (SSRI) with a health pro too, as antidepressants are often first-line treatments for mood-related menstrual issues.
Alice Domar, PhD, a health psychologist, tells SELF that having a recurring relaxation practice has been linked to fewer symptoms of PMS -- particularly psychological ones. She notes that it can help make you feel less irritable and reactive when you actually get your period. Of course, it's important to land on a habit that specifically calms *you* down. If movement feels good, yoga, walking, and progressive muscle relaxation -- which involves tensing, and then relaxing, various muscles -- are solid places to start. If you need to completely turn off your brain to feel zen, meditation might be a good idea. (Here are seven simple mindfulness exercises you can easily fit into your day.)