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“Honey, is it that time of the month?” my husband unwittingly asked during a heated argument during our early years of marriage. “Excuse me?!” I shot back, “This problem is real! My hormones are just emphasizing it.” My response was inspired by a Verily piece on How to Talk to Your Man about Your Hormones. He never made that mistake twice.

In my early twenties, I was fortunate to be surrounded by fellow women who took periods seriously. We were tired of the same old cheap jabs constantly thrown at PMS. If we couldn’t take our own cycles seriously, we wondered how we could expect others to do the same. At Verily, our periods have never been something to hate on. Sure, the symptoms are annoying: carb cravings, cramps, headaches, bloating, and more. But we can see the menstrual cycle for the health marker, hormone process, and possible pregnancy prep it is.

Even the severity of PMS, or premenstrual syndrome, can tell us if something is wrong inside our bodies. For all the good our periods do us, it’s important to learn how to distinguish when PMS symptoms are normal and when they are not. We’re pleased to report that it’s totally normal to find yourself on a rollercoaster of emotions as your period is about to start.

What is normal

The U.S. Office On Women’s Health (OWH) reports that over 90 percent of women say they experience some premenstrual symptoms like moodiness, including irritability, tension, sadness and, yes, crying. Researchers believe that big hormone changes throughout our menstrual cycle are the primary cause of PMS.

As the body prepares to ovulate (release an egg), estrogen hormone levels rise, thickening the uterine lining in case implantation (i.e., pregnancy) occurs. After ovulation, estrogen drops sharply and progesterone hormone levels rise, keeping the uterine lining stable and healthy. If pregnancy doesn’t occur, these hormone levels drop and the uterine lining sheds. According to an article on the site Healthline, estrogen and progesterone shifts influence levels of serotonin, “a neurotransmitter that helps regulate your mood, sleep cycle, and appetite.” And according to the article, “Low levels of serotonin are linked to feelings of sadness and irritability, in addition to trouble sleeping and unusual food cravings—all common PMS symptoms.”

When to worry

OWH notes that if you suffer from anxiety and depression, you may feel worse before or during your period. But if your mood swings are so debilitating that they interfere with daily life, it may be another more serious condition called Premenstrual Dysmorphic Disorder (PMDD).

PMDD affects anywhere from 3 to 8 percent of women with “symptoms usually emerging during a woman’s twenties,” reports the Massachusetts General Hospital Center for Women’s Mental Health (MGH). If you or your family have a personal history of mood or anxiety disorder, stress, and are in your late twenties and thirties, you are at higher risk for PMDD. The psychological symptoms include:

  • Anxiety
  • Feeling overwhelmed or out of control
  • Increased depressed mood
  • Irritability
  • Mood swings
  • Sense of feeling overwhelmed
  • Sensitivity to rejection
  • Social withdrawal
  • Sudden sadness or tearfulness

MGH states that these “mood disturbances” can appear one to two weeks before your period and be noticeably disruptive at work or in social situations, “with its most prominent effects in interpersonal functioning.” The best way to distinguish between a mood disorder and PMDD is by “daily charting of symptoms,” MGH adds. If these emotions are worse before and during your period but are largely absent between the end of your period and the next time you ovulate, it’s most likely PMDD.

How you can make it better

If monthly mood charting leads you to believe that you have PMDD, you can speak with your doctor about options like taking progesterone or an antidepressant. However, MGH recommends all women try lifestyle changes—consuming less caffeine, salt, sugar, and alcohol, getting enough sleep and regular aerobic exercise—as treatment before taking medication. “These modifications have no associated risks and may provide significant benefits,” notes MGH.

“Additionally, all women should be advised to continue daily charting of their premenstrual symptoms after diagnosis,” which can help determine whether the treatments are effective. It can also give you some control over your symptoms by helping you anticipate and work around them—just one more of many reasons why it’s wise to start charting your cycle today