Period Mood Swings: Causes, Contributors, and Relief Strategies

Premenstrual mood swings affect up to 90% of menstruating individuals. They stem from hormonal fluctuations interacting with neurotransmitter systems.

Hormonal Basis

• Late luteal phase: Estrogen and progesterone drop sharply.
• Serotonin decreases with estrogen decline → low mood, irritability.
• GABAergic changes (progesterone metabolite allopregnanolone) affect anxiety.

Contributing Factors

• Nutrient deficiencies: Magnesium, B6, calcium, omega-3s.
• Stress: Amplifies HPA-HPO crosstalk.
• Sleep deprivation: Worsens emotional regulation.
• Sedentary lifestyle: Exercise boosts endorphins, serotonin.

Evidence-Based Interventions

• Lifestyle: Aerobic exercise 150 min/week, sleep hygiene, stress management.
• Supplements (moderate evidence): Calcium 1200 mg, Mg 250–360 mg, B6 50–100 mg, Vitex agnus-castus.
• Pharmacologic: SSRIs (continuous or luteal-only), combined OCP (drospirenone/EE), GnRH agonists (severe).
• CBT: Effective for PMDD.

When to Seek Help

If symptoms impair work, relationships, or daily function → may be PMDD (3–8% prevalence). Consult clinician for diagnosis and treatment.