why is anxiety worse before my cycle?

One day you feel calm, sane and focused only to find the next day you’re feeling overwhelmed, stretched and fatigued. While your period is due in a week, you don’t have the patience or time to feel like this.  What changed from one day to the next? In a word…  hormones. And while it’s tempting to demonize the internal shift that takes place from one week to the next as we navigate our monthly cycles, this shift can be a time of deep clarity and perspective on what needs to shift in our lives. Also, understanding that an uptick in anxiety is a reflection of a complex interplay of both physical and emotional factors allows us to approach it with compassion and curiosity. Instead of viewing anxiety [or any symptom of PMS] as a monthly burden, allow the following insights to catalyze more ease and grace those final few days before your period. 

Why Anxiety Upticks During PMS

Anxiety the week before your period is not random; it's a multifaceted issue influenced by hormonal fluctuations, neurotransmitter changes, and individual stress responses. Let’s look deeper:

1. Hormonal fluctuations: In the luteal phase of the menstrual cycle, estrogen and progesterone levels drop precipitously, leading to a cascade of neurotransmitter effects on the brain. Progesterone, in particular, has a calming effect on the brain and helps regulate serotonin, a neurotransmitter that influences mood. As progesterone levels rapidly drop to initiate your cycle, so do serotonin levels, which can lead to increased feelings of anxiety and irritability. But there are 7 other neurotransmitters that drop too. You aren’t crazy! Your brain is changing rapidly the week before your period. 

2. Neurotransmitter changes: Besides serotonin, other neurotransmitters like GABA (gamma-aminobutyric acid) also play a role. GABA is known for its calming effects, and fluctuations in hormone levels can affect GABA activity, leading to heightened anxiety and restlessness as well.

3. Blood sugar imbalances: Hormonal changes can also impact blood sugar levels. Progesterone can cause insulin resistance, leading to blood sugar swings. When blood sugar levels fluctuate, reflecting the fluctuation of progesterone before the cycle, this too can trigger anxiety [alongside an uptick in hunger!] It is important to nourish this response instead of suppress it, which could increase anxiety and exacerbate symptoms.

4. Magnesium deficiency: Magnesium, known as nature's relaxant, is used more quickly by the adrenal glands the week before your cycle. This mineral is crucial for maintaining nerve function and regulating mood. Lower levels of magnesium can contribute to increased anxiety and muscle tension.

5. Individual stress responses: Chronic stress and lifestyle factors can exacerbate PMS symptoms. If you are already dealing with high levels of stress, the hormonal fluctuations of PMS can amplify your body's stress response, making anxiety more pronounced.

Listening to Your Body

Our bodies communicate with us through symptoms, guiding us toward what needs attention. By tuning into these signals, we can make informed choices about our health. Tracking your menstrual cycle and noting how you feel at different times can reveal patterns and insights, empowering you to take proactive steps in managing PMS.

Foundational tools for anxiety the week before your period:: 

• Breath: Practicing deep and mindful breathing exercises upon waking and again before bed. This technique activates the parasympathetic nervous system, which is critical for regulating stress responses as your hormones drop to initiate your cycle.  

• Walk: Regular physical activity, such as walking, increases endorphin levels and improves circulation, which can help alleviate anxiety and improve mood. If you walk slowly and scan the horizon [not your phone], you’re telling your body you are safe and not running from danger. 

• Consume ≥ 25 g protein with every meal to regulate blood sugar: Consuming protein with each meal helps stabilize blood sugar levels, preventing mood swings and anxiety that can result from blood sugar fluctuations.

• Prioritize carbs from roots + fruits + legumes: Choosing complex carbohydrates from roots, fruits, and legumes provides grounding energy and supports serotonin production, which can help manage anxiety and enhance mood stability before the period.

Supplemental tools for anxiety the week before your period: 

• Fish Oil [2 g per day]: Rich in omega-3 fatty acids, fish oil helps reduce inflammation and supports brain health, which can alleviate mood swings and anxiety associated with hormonal fluctuations.

• Magnesium Citrate or Glycinate [300 mg per day, doubled the week of cycle]: Magnesium is crucial for muscle relaxation and neurotransmitter function, which can help mitigate anxiety and irritability before your period.

• Vitamin B6 [50 mg per day as part of a B-complex supplement]: Vitamin B6 supports neurotransmitter production and hormonal regulation, which can help stabilize mood and reduce anxiety symptoms before the period.

Want more? 

Tune into THIS A to Z toolkit for PMS. There you will learn how to navigate: 

• excessive hunger

• water retention

• pre-menstrual headaches

• anxiety + depression

• acne 

• cramping

Cuciureanu MD, Vink R. Magnesium and stress. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. https://www.ncbi.nlm.nih.gov/books/NBK507250/ 

De Bondt, T., De Belder, F., Vanhevel, F., Jacquemyn, Y., & Parizel, P. M. (2015). Prefrontal GABA concentration changes in women—Influence of menstrual cycle phase, hormonal contraceptive use, and correlation with premenstrual symptoms. Brain research, 1597, 129-138. https://doi.org/10.1016/j.brainres.2014.11.051

Huang, Y. M., Chien, W. C., Cheng, C. G., Chang, Y. H., Chung, C. H., & Cheng, C. A. (2022). Females with diabetes mellitus increased the incidence of premenstrual syndrome. Life, 12(6), 777. https://doi.org/10.3390/life12060777