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Ever feel a little (or a lot) irritable, sad, or anxious in the days leading up to your period? Many of us link it to premenstrual syndrome, but the latest research shows that we shouldn’t be so quick to blame. There are actually a significant number of factors that can influence those times when you are feeling more down than usual, ranging from environmental and hormonal factors to pre-existing conditions such as anxiety and depression.

Your Mood Depends on Much More Than PMS

Many of us expect to feel moody around the same time every month thanks to PMS. But recent research reveals that PMS might not be the sole factor in how edgy you feel right before your period.

In her TEDx talk, Dr. Robyn Stein DeLuca cautions that, while it is true many women experience mood changes and other negative symptoms before their period, she doesn’t believe that women should be labeled as having a disorder (PMS) when they experience these symptoms. DeLuca believes that a blanket PMS label (of which the type and severity of symptoms are inconclusive) fails to account for other factors that can influence our moods.

In fact, a study reported by Time Magazine found that 85 percent of the women who participated in the study did not experience typical PMS symptoms (mood swings, feeling sad or hopeless, feeling anxious, etc.). Only about half (53 percent) of the participants experienced a link between their period and mood. The report concludes that “while the new review suggests that most women don’t have a predictable pattern of low moods preceding their periods, it doesn’t exonerate reproductive hormones from having any role in how people feel.” So the next time you feel emotional in the days leading up to your period, think twice before you blame PMS. It might play a role, but it isn’t the only factor.

Stress Is More Likely to Affect Your Mood Than PMS

Managing stress is key to boosting your mood whether you are on your period or not. Research has found that stress is more likely to affect your mood than PMS.

study in the Journal of Women’s Health found that women who reported experiencing stress in the beginning of their menstrual cycle were more likely to experience mood swings right before their period. Another research study cited by Brown University found that cortisol levels (a stress hormone) were higher during the menstrual phase of the participants’ cycles, suggesting that the stress response in women who experience PMS symptoms are higher than in women who do not.

Stress can happen at any time in your cycle. The Mayo Clinic notes that it can impact your physical and mental health in many ways ranging from headaches, sleep problems, and muscle tension to anxiety, irritability, and depression. So keep stress at bay by incorporating easy practices like taking breaks, being creative, and by avoiding these stress-inducing habits.

Though Rare, Premenstrual Dysphoric Disorder Might Be the Culprit

While some, like Dr. Robyn Stein DeLuca, question the validity of PMS as a diagnosable disorder, Premenstrual Dysphoric Disorder is recognized as a specific disorder that affects about 3 to 8 percent of women. PMDD symptoms include experiencing clinical levels of depression and/or anxiety during the week or two before your period starts and other PMS-like symptoms such as bloating, breast tenderness, and headaches. These changes in mood begin right before a woman’s period and resolve immediately after.

While the cause of PMDD is uncertain, Massachusetts General Hospital reports that women diagnosed with PMDD may be more sensitive to normal hormonal changes, not that there is a hormonal imbalance. If you think you might have PMDD, keep a chart to track any mood changes you experience for three cycles. Then discuss your symptoms with your doctor. Depending on your needs, treatment options range from natural techniques such as herbal supplements to talk therapy and prescription medication.

It May Just Be Sensitivity to Pre-Existing Symptoms

Some research shows that women who experience depression and anxiety notice a worsening of their symptoms in the days leading up to their period. In a Cambridge University study, 64 percent of women reported an increase in Major Depressive Disorder symptoms five to ten days before their period. Another study found that even women taking medication for these conditions were more likely to experience these symptoms during their periods despite taking medication.

In my practice as a psychotherapist, several of my clients have reported experiencing a spike in their anxiety symptoms prior to their period. If you are coping with anxiety or depression, talk to a therapist or psychiatrist about ways to manage your symptoms when they worsen. Verily writer Maria Walley shared great suggestions for managing anxiety to get you started.

Hormonal Changes, Not Just Imbalances, Affect Your Mood

Our moods are very complex. While we can’t pinpoint the exact reason why we feel particularly grumpy on a certain day, hormone changes do play a role in how we feel. Way to make things more complicated, right? Some women might be more sensitive to changing hormone levels, such as those diagnosed with PMDD, while others are not as sensitive. They do not experience as severe of symptoms before their period. In fact, this Time Magazine study reports that higher progesterone levels have been shown to reduce anxiety, while lower levels accompany symptoms of depression. Similarly, higher estrogen levels can help mitigate the effects of an emotional disturbance while lower levels can increase sensitivity to trauma, a research study by Harvard University and Emory University found. Another study found that women who experience PMS symptoms resolved emotional conflict more slowly than women who did not experience PMS symptoms. Some researchers even believe that estrogen levels play a role in the reason why women are twice as likely as men to develop an anxiety disorder or depression.

The reasons for your mood changes aren’t as simple as being at a certain point in your cycle. Before we point the finger at PMS for our less than sunny dispositions, consider that there could be any number of factors at play. Changes in hormone levels throughout your cycle do play a role in your susceptibility to being irritable, edgy, sad, or anxious. But, there is also evidence that stress, pre-existing anxiety or depression, and other life events influence our moods. Knowing what factors might be at play empowers you to use the most effective tools to take charge of your mood.

Photo Credit: Evgenia Kohan