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Strong Women
“Why do I always feel so anxious in the week before my period?” A doctor and a therapist give their verdict
By Alex Sims
7 months ago
4 min read
Ever wondered why you feel your anxiety levels spike in the days leading up to your period? We asked health experts to explain the science behind the misunderstood PMS symptom.
Welcome back to Just Curious, Strong Women’s weekly series exploring all the random health and fitness questions you’ve always wondered about but never got the answers to.
This week, we’re looking into why we can feel anxiety in the week before our period and how to cope.
At best, getting your period can be an inconvenience. At worst, it can be completely debilitating. And while menstruation is completely natural and nothing to be embarrassed about, the symptoms of PMS, whether it’s piercing cramps or niggling cravings can be a lot to navigate.
One of the lesser talked about symptoms of PMS is a spike in anxiety in the days leading up to a period. It’s estimated that around 75% of menstruating women will experience premenstrual anxiety, including excessive worrying, heightened sadness and feelings of being overwhelmed.
But what causes these periods of anxiety and what are the best ways to manage them month after month? We asked the experts.
What causes anxiety during the menstrual cycle?
The luteal phase of the menstrual cycle – the phase after ovulation and before a period – is when our “hormones go through quite a roller coaster”, explains Dr Naomi Newman-Beinart, a health researcher and nutritionist.
In anticipation of a potential pregnancy, the body boosts progesterone and oestrogen. Progesterone is a hormone that helps to keep the brain calm and thickens the uterus lining, while oestrogen is a chemical that helps with serotonin regulation and production, which contributes to wellbeing and happiness. “These shoot up and we think: Great, I feel regulated, stable and calm,” says Joshua Fletcher, an anxiety counsellor and the author of And How Does That Make You Feel?
However, as soon as the body recognises there is no pregnancy, these levels plummet. “This causes a big shift in the body and puts a lot of stress on it,” says Fletcher. In reaction to this stress, the body also starts to produce more cortisol – one of the main chemicals associated with fear and the flight or fight response – to try and combat it. “Plummeting progesterone, plummeting oestrogen, rising cortisol – it’s a lot for the body to deal with,” says Fletcher.
Cortisol not only makes us feel anxious, it also has a litany of physical symptoms, like increased heart rate, insomnia, hot flushes and digestion issues.
Credit: Getty
Is it normal to feel anxious in the run-up to your period?
These hormonal changes are completely normal and are “part of the body’s natural cycle controlled by the endocrine systems, which involves the hypothalamus, pituitary gland, and ovaries”, says Dr Newman-Beinart.
Around 75% of menstruating women will experience premenstrual anxiety as part of premenstrual syndrome (PMS); however, the impact this has can differ a lot from one woman to another.
“Some women are just more sensitive to these changes and might feel more anxious or experience other PMS symptoms more intensely,” says Dr Newman-Beinart. “Genetics, overall health, stress levels and lifestyle all play a role in how these hormonal fluctuations affect you.”
It’s a lot for the body to deal with
What can we do to manage these periods of hormonal fluctuation during our menstrual cycle?
There are lots of ways to prepare your body to cope with stress, anxiety and PMS symptoms. This includes staying active by doing mood-boosting forms of exercise, eating a balanced diet and trying to get enough sleep.
Dr Newman-Beinart also suggests monitoring the body’s magnesium levels. “Magnesium is really important for how your body handles stress,” says Newman-Beinart. “It helps regulate neurotransmitters that affect your mood, like serotonin. It also works on GABA receptors in the brain, which help calm you down. Studies show that low magnesium can increase anxiety and stress.”
You can maintain magnesium levels by loading up on magnesium-rich foods like leafy greens, nuts, seeds, whole grains and legumes, or by taking a magnesium supplement.
Credit: Getty
How do people who are already prone to anxiety manage their symptoms during the luteal phase of their cycle?
If you already suffer from anxiety or have an anxiety disorder, simply being able to understand the biological processes behind why these feelings might increase before your period is a good way of managing them. “When you can make sense of why something is happening, it takes away a layer of fear,” says Fletcher. “If you know what’s happening inside you, you can contend with the discomfort of anxiety better.”
PMS-induced anxiety can be particularly challenging for those who suffer from stress already, due to something called ‘anticipatory anxiety’. This is where a person’s anxiety levels spike by thinking about an event or situation that could cause them anxiety in the future. As PMS-induced stress occurs consistently at the same time every month, it can feed into this ‘anticipatory anxiety’.
“I practice something called ‘willful tolerance’,” says Fletcher. “Realising that you‘re going to have these periods of anxiety but that you can cope with them helps your self-esteem. If you have heightened sensitivity around the luteal phase of your menstrual cycle you know it’s coming, so you can ask What am I going to do about it? rather than resisting. Suddenly, you start to fear it less.”
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