Periodic tension: The cause and suggestions for alleviation
**Managing Anxiety Before a Period: Understanding PMS and PMDD**
For many individuals who menstruate, the premenstrual phase can bring about feelings of anxiety and mood swings. This phenomenon, often linked to premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), is primarily caused by hormonal fluctuations during the menstrual cycle, particularly in the luteal phase.
The luteal phase, which begins after ovulation and typically lasts for about two weeks, sees peak levels of estradiol and progesterone. These hormonal changes can affect neurotransmitters in the brain, including serotonin, which regulates mood. As a result, symptoms such as anxiety, mood swings, irritability, and depression may occur [1][3][4][5].
Women with PMDD, a more severe form of PMS, have an extreme sensitivity to these hormonal changes, causing more intense emotional symptoms, including debilitating anxiety, feelings of hopelessness, and severe mood swings [3][4].
**Managing Anxiety Related to PMS and PMDD**
1. **Lifestyle modifications:** - Regular exercise, ensuring adequate sleep, and practicing stress management techniques can significantly alleviate mild to moderate PMS symptoms, including anxiety [1][2][3][5]. - A healthful diet, avoiding alcohol and smoking, are also recommended [2].
2. **Supplements and non-prescription remedies:** - Some women find relief from supplements such as calcium, magnesium, vitamin B6, and herbal remedies, though specific recommendations depend on individual cases and should be discussed with a healthcare provider [1][2].
3. **Medications for more severe symptoms or PMDD:** - Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed and effective for reducing anxiety and mood symptoms associated with PMDD [3][4]. - Hormonal treatments such as oral contraceptives may stabilize hormone fluctuations and reduce symptoms. - In severe cases, other psychiatric medications or therapy may be necessary.
4. **Therapeutic interventions:** - Cognitive-behavioral therapy (CBT) and counselling can help women cope with anxiety and mood symptoms related to PMS and PMDD [3][4]. - Monitoring symptoms carefully to differentiate PMS anxiety from more serious mental health issues is important, as PMDD can cause incapacitating emotional states requiring specialized care.
If anxiety includes severe depression, suicidal thoughts, or uncontrollable anger before menstruation, prompt consultation with a healthcare provider is critical as these may indicate PMDD [5].
Researchers do not fully understand why some people develop PMDD and others do not, but fluctuations in hormone levels may play a role. Relaxation techniques such as yoga, massage, meditation, and breathing exercises can help reduce PMS symptoms. Aiming for 7-9 hours of sleep per night may also help manage PMS symptoms.
In addition to the treatments mentioned above, hormonal birth control, SSRIs, and antianxiety medications are common treatments for PMDD. Light therapy, benzodiazepine alprazolam (Xanax), and hormone intervention using gonadotropin-releasing hormone agonists may also be recommended for PMDD treatment. Creating a regular sleep schedule and improving the quality of a person's sleep environment can further help manage PMS symptoms.
[1] Mayo Clinic. (2021). Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Retrieved from https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20351663
[2] NHS. (2021). Premenstrual syndrome (PMS). Retrieved from https://www.nhs.uk/conditions/premenstrual-syndrome-pms/
[3] Office on Women's Health. (2021). Premenstrual dysphoric disorder (PMDD). Retrieved from https://www.womenshealth.gov/a-z-topics/premenstrual-dysphoric-disorder
[4] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
[5] American College of Obstetricians and Gynecologists. (2021). Premenstrual dysphoric disorder. Retrieved from https://www.acog.org/womens-health/faqs/premenstrual-dysphoric-disorder-pmdd
- Multiple health conditions could be aggravated by PMS or PMDD: - Some individuals might experience exacerbation of existing health issues, such as Crohn's disease, atopic dermatitis, migraine, breast cancer, and macular degeneration, due to hormonal fluctuations during the menstrual cycle [1][2]. - Degenerative diseases like type 2 diabetes and ulcerative colitis might be influenced by the onset of PMS symptoms, although evidence is inconsistent [2].
- Predictive science and health-and-wellness apps could help track PMS: - Wearable technology and health-and-wellness apps can help individuals track menstrual cycles, symptoms, and patterns, allowing them to anticipate and manage PMS or PMDD more effectively [1][2].
- Menstrual health keyboard emoji - Integration of a menstruation-related keyboard emoji into digital platforms can help destigmatize menstruation, promote mental health, and encourage discourse around women's health issues [6].
- Mental health and PMS: - Mood disorders, such as anxiety and depression related to PMS, could potentially make it challenging to adhere to healthcare recommendations, impacting overall mental health [3].
- Women's health and mental healthcare: - Low recognition of PMDD and limited mental healthcare resources for women can lead to delayed diagnosis and inadequate treatment, negatively affecting mental health and quality of life [3][5].
- Women with chronic illnesses and PMS: - Women with chronic health conditions like HIV disease could find that PMS and PMDD exacerbate existing symptoms or complicate disease management [1]. - Healthcare providers should consider the broader impact of PMS and PMDD on both the physical and mental health of women with chronic illnesses.
- Sclerosis, cancer, and PMS: - Some studies have suggested a connection between PMS and autoimmune diseases like Multiple Sclerosis, as well as between PMS, PMDD, and certain types of breast cancer, though further research is needed to establish these links conclusively [1].
- Research and progress in the field of PMS and PMDD: - Continued support for research on PMS and PMDD can lead to improved diagnostic tools, novel treatments, and a better understanding of the underlying mechanisms, ultimately benefiting women's health andmental health.
