Every woman experiences her menstrual cycle and PMS differently. A lucky few hardly notice their periods and experience little discomfort during the days leading up to them, while others can barely function. Most women will fall somewhere in between these two extremes, but one thing is certain—the hormones that regulate our menstrual cycles affect more than just the body. Besides producing cramps and bloating, they can also produce or exacerbate mood-related symptoms like anxiety.
Because of differences in brain chemistry and the impact of hormones such as estrogen and progesterone, women are already more likely than men to suffer from anxiety disorders and even panic attacks. And these can definitely be more pronounced right before and during their periods. Women who don’t normally feel anxious may find themselves feeling stressed or fearful around the time of their period. Read on for some solutions I’ve used in my practice to help patients mitigate PMS- or period-related anxiety without prescription drugs.
PMS and period symptoms are diverse and different for everyone.
Let’s consider a few case studies. The first is the story of Katie, a friend’s daughter who came to me because she would become extremely anxious during two weeks of her monthly cycle. During those weeks she was constantly breaking out in rashes and suffering from debilitating headaches and stomach pains. Sometimes, Katie even felt so fearful that her teeth would chatter, and she would remain confined in her room.
And then there is my own experience with PMS, which evolved over the years. At 18, I remember losing it after losing a Monopoly game with my sisters. I was dumbfounded by this outburst, which seemed to come out of nowhere, and then an hour later, my period began. Looking back through the lens of my training and experience as a gynecologist, this was powerful proof that PMS and its hormonal drops can alter brain chemistry. In my thirties, my PMS took on a different flavor. I began to develop obsessive-compulsive behaviors the week before my period.
Hormones rule your body—including your mental health.
Hormones don’t just determine how our body functions, but also how we feel and respond to internal and external stimuli. They are a part of the intricate human “software” that is also built on enzymes, healthy food, positive thoughts and balanced body chemistry. Due to hormonal fluctuations, PMS interrupts and upsets that balance, often triggering symptoms like increased anxiety. After many years of working with patients in my clinic—and of course through my own experience—I’ve come to recognize that low estrogen is a major culprit in anxiety and other PMS symptoms.
In Katie’s case, coming off the Pill was a big part of the battle. She was also given natural supplements and bioidentical estrogen cream. (In my own case, my symptoms disappeared once I began treating myself with bioidentical estrogen cream during my PMS time.) And to further help Katie regain her carefree, radiant outlook on life, I suggested she take meditation and attend some mindfulness workshops. With this integrated approach, she was virtually free of her anxiety after six months.
In summary, here’s my non-prescription “prescription” for ways to dial down your anxiety level before or during your period, or in fact any time of the month:
1. Consider coming off the pill.
Consider coming off hormonal birth control if you are using it (the pill makes the body think and act like it is in menopause, which comes with its own set of symptoms). Ask your doctor about an alternative to the pill that would work best for you.
2. Ask about bioidentical estrogen and other supplements.Ask your doctor about bioidentical estrogen, as well as natural dietary supplements that combat anxiety and help promote sleep and proper digestion
3. Check your diet and lifestyle.
Eat a well-balanced, anti-inflammatory diet that’s rich in fruits and vegetables and low in dairy and meat. Avoid alcohol and caffeine and get enough sleep every night.
4. Don't forget about mindfulness and movement!
Walking, running, cycling, swimming, and other aerobic activities are all-natural stress-busters. I would also recommend using breathing exercises or meditation—there are plenty of online programs to help beginners get started.