Anyone who lives with anxiety knows how unpredictable the condition can be. Rather than purely being a mental health concern, anxiety has a ripple effect through the whole body, and for women, this can be especially noticeable before and during menstruation. Plus, as depression and anxiety are recognized symptoms of PMS, it makes sense that someone who already lives with either of these conditions might experience mood changes. I for one dread the anxiety spike I experience right before I bleed.
While there are over-the-counter remedies for cramps and suggested lifestyle changes to help PMS symptoms, when combined with an existing anxiety diagnosis (which I have), the rulebook is no longer valid. I can medicate the pain of menstruation, rest, exercise to help relieve stress and PMS symptoms, but when my anxiety flares, literally nothing helps.
According to Dr. Prudence Hall, a gynecologist and surgeon, low levels of estrogen can create anxiety.
“The time of a period is when estrogen reaches the lowest point in a woman’s cycle," she says. "This results in all the symptoms of PMS, including anxiety. It is not the period that causes anxiety, but low levels of estrogen that occur during a period. Low estrogen causes anxiety, depression, fatigue, body aches and a huge case of the grumpies.”
As a person who has experienced the lows that most women face during and before their periods, it’s reassuring to hear the medical explanation for it. And as a woman who also lives with anxiety, knowing that low estrogen can cause “anxiety, depression, fatigue, body aches,” as Hall puts it, makes it possible to rationalize my feelings and thoughts when my anxiety spikes prior to menstruation.
When it comes to ways to treat the emotional roller coaster, there’s no one-size-fits-all answer.
Dr. Fahimeh Sasan, an OB-GYN at Mount Sinai Hospital in New York, spoke to Women’s Health about how contraception methods such as the pill can help ease PMS symptoms. “If you’re not ovulating, you’re not experiencing a change of hormones, so that should certainly help with PMS,” Sasan explains.
While this recommendation is often made to women as a means of getting unruly periods under control, synthetic hormones don’t work for everybody. Personally, I’ve tried several different pills, but each of them brought its own set of negative side effects. But this is certainly one method for potentially controlling the negative symptoms associated with PMS, including anxiety, for those who want to use hormonal contraception.
Before I was diagnosed with anxiety, the PMS I experienced pre-period often made me feel crazy, like I was losing control of my emotions, giving me a feeling of intense panic that shook my core. But now, knowing that there’s a reason for my heightened sense of anxiety and that it’s part of my body’s natural cycle and will soon pass has helped me cope better with PMS and its side effects. We all have different coping mechanisms — mine are TV and food — so if you’re dealing with the heady combination that is anxiety and PMS at the very same time, you have zero to apologize for. Just remember to self-care like there’s no tomorrow.
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