PMS is really messing with my emotions!

Dear Alice,

Once a month I get PMS-y. I can deal with the bloating and cramps, (usually), but, honestly, I go crazy, loony, wacky. My emotions are completely out of control, from extremely happy to totally miserable and crying, with lots of grumpy behavior in between. I actually don't usually realize when I'm behaving irrationally, so when my boyfriend tries to point out that maybe my bouts of anger and tears are caused by hormones I attack him for telling me I'm just an irrational woman. Basically, is there any way to help these mood swings? I'm on birth control pills, which is supposed to help, but it doesn't really seem to do anything.


Dear Nuts,

Premenstrual syndrome (commonly called PMS) — no matter how you experience it — can be a pill. It may be helpful to know that you're not alone, as most individuals with a uterus experience PMS at some point in their lives and that experience is different for everyone. While the exact causes of premenstrual symptoms aren't exactly known, there are a few factors that may contribute to it, such as the cyclic influx of hormones that occur during menstruation. Another factor that has been linked to premenstrual symptoms are the fluctuations of serotonin, which is a specific neurotransmitter that impacts a person's mood, that occur in the brain. To help stabilize your mood, you may find selective-serotonin reuptake inhibitors (SSRIs) to be useful. Birth control may help with some symptoms, but it's often less helpful for emotional symptoms. 

While everyone tends to have a different experience with PMS, some of the common symptoms include:

  • Depression
  • Angry outbursts
  • Being irritable
  • Crying spells
  • Anxiety
  • Confusion
  • Social withdrawal
  • Poor concentration
  • Sleep disturbance
  • Thirst and appetite changes (food cravings)
  • Tender breasts
  • Bloating and weight gain
  • Headache
  • Swelling of the hands or feet
  • Aches and pains

Moreover, those with a uterus who experience these symptoms may be diagnosed with PMS if these symptoms are present five days before and end four days after their period starts. They also would have to interfere with some of their normal activities.

In terms of treatment, there are a couple of different treatment options you can discuss with your health care provider. As you mentioned, birth control pills have been used for PMS, particularly the physical symptoms associated with PMS. However, they typically don't relieve any of the emotional and behavioral symptoms. Additionally, a health care provider could also suggest taking antidepressants, especially selective-serotonin reuptake inhibitors (SSRIs), as they can be helpful with reducing some of the symptoms that impact a person's mood. Furthermore, dietary supplements, such as calcium or vitamin B6, have also be used to help relieve some of the symptoms associated with PMS. There are also some home remedies that individuals can try to relieve their symptoms. For example, in the days leading up to their period, some individuals find it helpful to eat more fruits, vegetables, and whole grains, reduce their intake of fat, salt, and sugar, and avoid caffeine and alcohol. Moreover, utilizing relaxing activities such as yoga, massage, or tai-chi may also help relieve some of the symptoms associated with PMS. In addition, some find that engaging in aerobic activity, such as walking, swimming, or cycling, can help relieve some of the fatigue and depression that's often associated with PMS. Further, some menstruating individuals may experience intense PMS symptoms that can be disabling. This is typically known as premenstrual dysphoric disorder (PMDD) which, according to Mayo Clinic, affects about ten percent of individuals who experience PMS symptoms.

Overall, if you feel that PMS is affecting your life, there are a number of home remedies that people can use to help alleviate their symptoms. If your symptoms associated with PMS become more debilitating, it may be worth it to see a health care provider who can help you diagnose the cause of your symptoms and suggest an appropriate treatment.  

Good luck in finding what works for you!

Last updated Aug 19, 2022
Originally published Jan 19, 1995

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