what causes anxiety before period

12 Ways to Reduce Anxiety Before your Period

Dr. Jolene BrightenPublished: Last Reviewed: Menstrual Cycle Leave a Comment

Having anxiety before periods show up? It might surprise you to learn that this is a common time for anxiety to peak for women due to changes in their hormones. 

Anxiety — it’s the body’s normal response to stressful events. Getting a little bit nervous before speaking in public or a big job interview? That’s completely normal. 

But for millions of women, their lives are completely disrupted by anxiety. 

It’s hard to define the symptoms because they can feel different for everyone, but sometimes women describe anxiety as:

  • Racing thoughts
  • Rapid heartbeat
  • A disconnect between body
  • Inexplicable fears
  • Unfounded worries
  • Desire to completely avoid social situations
  • Feeling shaky 

Anxiety may also include panic attacks, nightmares, rapid breathing, nervous energy, diarrhea, and insomnia.

If your symptoms are severe, it could be a sign of Premenstrual Dysphoric Disorder or PMDD.

It’s not the most commonly discussed PMS symptom, but hormonal fluctuations during the menstrual cycle can often be the cause of anxiety for tons of women. One of the most common reasons women experience anxiety before their period is due to low progesterone.

And probably even less well-known is the relationship between PCOS, menopause, thyroid function, and anxiety. We're going to talk about all of this and more in this article!

Understanding how our hormones affect anxiety levels can be the first step in finding relief and taking our lives back from this crippling disorder.

What Causes Anxiety Before Periods?

If you’re experiencing anxiety before your period only then it is most likely due to the shifts in hormones that occur during the luteal phase of your cycle. Before the onset of you period, progesterone levels (along with estrogen) drop, which can trigger anxiety in some women. For others, stress hormones like cortisol, epinephrine, and norepinephrine can contribute to anxiety and a sense of overwhelm. 

What Hormones Cause Anxiety?

As we'll explore in this article, several hormones can contribute to anxiety, including:

  • Estrogen
  • Progesterone
  • Thyroid hormone
  • Cortisol
  • DHEA
  • Epinephrine
  • Norepinephrine
  • Prolactin

Can Low Progesterone Cause Anxiety?

The second half of the menstrual cycle is called the luteal phase. This is usually day 15-28 in a woman’s cycle, after ovulation. (Remember, these days are an approximation because not all women have 28 day cycles). This is when we typically see anxiety levels rise.

Once you’ve ovulated, progesterone rises and it stimulates the gamma-aminobutyric acid (GABA) receptor in your brain. GABA is the neurotransmitter that can reduce anxiety and stress levels. When stress hormones try to trigger a “freak-out,” GABA steps in and calms everything down.

However, if you are struggling with low progesterone or if you don't ovulate, progesterone levels don’t rise, and therefore GABA can’t do its extremely important job.

This is when anxiety sets in. 

Can Adrenal Issues Cause Anxiety?

Ultimately, our adrenal health can determine our anxiety levels.

The adrenal glands are located right above the kidneys, and they are responsible for producing many of the hormones we need to function — including cortisol, epinephrine, and norepinephrine. I call these the last two the ‘freak-out’ hormones because when they hit your brain your body will go into panic mode. 

While these stress hormones are critical to protecting us from danger, in modern times, we are often not really in danger on a regular basis.

Instead, vitamin deficiencies, over-exercising, under-eating, lack of social interaction and stress of any sort get demand a response from our adrenals. Maybe stress even tells your body to shut down ovulation or stop making progesterone in favor of producing cortisol and boom — anxiety and panic attacks set in. There’s no GABA there to mitigate the panic fest.  

If you’ve been feeling tired but unable to go to sleep at night, having difficulty waking up in the morning, and are completely relying on caffeine to make it through the day — I would recommend checking out your cortisol levels and my Optimal Adrenal Kit.

And keep reading because I've got a whole lot more tips to ward of anxiety before your period.

DHEA + DHEA-S Levels and Anxiety

Dehydroepiandrosterone (DHEA) and its sulfated form, dehydroepiandrosterone-sulfate (DHEA-S) are also produced by the adrenal glands. 

DHEA is a precursor to testosterone and estrogen, so it’s a critical piece of the hormone puzzle. Studies have shown that in postmenopausal women, higher levels of androgen hormones indicate higher levels of anxiety and other mood disorders. And in this study, a correlation between DHEA-S levels and the severity of anxiety was noted.

While we don’t know for sure why exactly DHEA correlates to anxiety, we do know that women with polycystic ovarian syndrome (PCOS) have DHEA levels that are high. They’re also significantly more likely to experience anxiety and depression.

Just like with cortisol, DHEA production increases in response to stress. So, if your adrenals are constantly firing off cortisol and DHEA, your body thinks it’s in danger — and here comes that anxiety again. 

When DHEA levels go the other way, and they’re too low, like in Addison’s disease, anxiety can increase too. Just like with other hormones, it’s critical to find that balance of the proper levels for you.

Can Estrogen Cause Anxiety in Women?

Estrogen is so important for so many things — without it, we wouldn’t have our female curves…but it’s so critical to have just the right amount of estrogen: not too much, not too little.

Estrogen levels can affect both anxiety and depression. 

If you have estrogen dominance, for example, you can have symptoms of irritability. High estrogen + low progesterone = irritability AND anxiety. Fun times.

If that’s you, it’s a sign that something is imbalanced. It's not a sign that you're broken, or crazy, or any of that negative stuff that gets passed around society. It’s a sign and a symptom, and an opportunity to heal your hormones and heal your body. 

Check out my popular Balance Women’s Hormone Support formula if you’re struggling with estrogen dominance. And be sure to scoop up a copy of my free hormone balancing diet too. Paired together, these tools can help you effortlessly find that perfect amount of estrogen for you.

Can Thyroid Problems Cause Anxiety?

Hormone-related mood changes and anxiety can also occur when there is a thyroid disorder. Both hypothyroidism and hyperthyroidism can cause anxiety and depression. Even subclinical thyroid issues can mean a person’s more likely to be depressed.  

Women with thyroid disorders can experience anxiety and:

  • Increased heart rate
  • Palpitations
  • Shakiness
  • Increased sweating
  • Fatigue
  • Insomnia

Often, new mothers can develop postpartum thyroid disease — which affects 10-17% of moms. The symptoms of thyroid disease coupled with anxiety and the pressures and sleep deprivation that accompany motherhood can be downright debilitating for these women.     

The good news is, improving thyroid function seems to improve levels of anxiety and depression, even for those who don’t respond to traditional medications.

Anxiety Before Irregular Periods

The hormone prolactin, produced by the pituitary gland in the brain, can also cause problems with anxiety if levels are out of balance.

Usually, we associate prolactin with breastfeeding, but it also plays a crucial role in stress response and emotional regulation. Elevations in prolactin can make your period irregular or can lead to amenorrhea, a missing period.

Prolactin levels can become elevated by hypothyroidism, or in rare cases, benign tumors of the pituitary gland called prolactinoma. When prolactin levels are high, menstrual irregularities and anxiety are often reported by women.

Levels of prolactin can also be affected by the same exact things that elevate adrenal hormones, things like:

  • Stress
  • High-intensity workouts
  • Vitamin deficiencies (especially b vitamins)

If you’re experiencing anxiety and any of the following symptoms, it might be wise to have your doc check out your prolactin levels:

  • Loss of libido
  • Acne
  • Vaginal dryness
  • Loss of period
  • Infertility
  • Milky discharge from nipples
  • Excess body hair 

Can PCOS Affect Moods?

As I mentioned earlier, women with PCOS are statistically more likely to battle issues with anxiety and depression. 

They are at high risk for developing major depression, binge-eating disorder, and generalized anxiety disorder.

While we can’t say for sure exactly why this is, some research indicates it’s due to the insulin resistance that’s characteristic of PCOS. Whether this is exactly why or not, incorporating dietary changes that support balanced blood sugar and inflammation are key to getting PCOS in check. 

If you are experiencing anxiety and a cluster of the following symptoms, you may want to talk to your doctor about PCOS:

  • Acne
  • Irregular periods
  • Excessive hair growth (especially on the face)
  • Weight gain
  • Infertility
  • Hair loss
  • Heavy menstrual bleeding

Since one of the hallmark traits of PCOS is anovulatory (lack of ovulation) cycles, women can often find themselves low in progesterone and high in testosterone. As I’ve explained, both imbalances in progesterone and testosterone can contribute to anxiety.

I would encourage you to check out my PCOS Kit that is designed to support women’s natural hormone function to help clear up acne, lose weight, and even get their period back.

I also have a ton of great information on my website specifically to help you ladies struggling with PCOS.

Anxiety with Perimenopause Cycles

As we enter into perimenopause we stop ovulating as frequently and low progesterone coupled with estrogen dominance is common. Once in menopause, we no longer have the circulating levels of progesterone that we once did. 

Along with the other changes menopause brings, anxiety can be another unwelcome symptom. By some estimates, 3 out of 10 women experience anxiety, lethargy, and irritability during menopause. Researchers have also reported that up to 51% of women aged 40-55 complain of occasional nervousness or tension. 

Even women who do not have a history of anxiety may be at increased risk for developing it during the menopausal years.

Fluctuating levels of progesterone and estrogen are to blame here —  as we’ve seen, both hormones play a crucial role in the presence of anxiety. 

For some women, menopausal changes that take place in the hypothalamic-pituitary-adrenal (HPA) axis affect their GABA as well — and again, it’s a major player in the development of anxiety.

Can Birth Control Make You Anxious?

Did you know that there’s been a well-documented relationship between hormonal birth control use and anxietyI have a whole article on birth control and mood swings that goes deeper on this topic.

The pill specifically depletes the body of nutrients, notably B vitamins that are required to produce serotonin and GABA, which again is critical for preventing anxiety and panic attacks. It’s one of the reasons experts think that many women on hormonal contraception experience an increase in anxiety and depression.     

In fact, mood disorders are one of the most common unpleasant side effects women cite for discontinuing the use of the pill. 

In addition, birth control can shift the gut microbiome, lead to inflammation, and provides synthetic hormones that don’t appear to offer the same benefits as the ones we make when it comes to brain health. This is an area where we need a lot more research to understand the correlation between birth control and mood symptoms.

In my best selling book, Beyond the Pill, I talk about ways to reverse these side effects and support your body on birth control. I also teach you all about your hormones and how to optimize them so you can live both anxiety and symptom free.

If you're on birth control now, looking to transition off, or have already stopped then grab my free support guide to help you on your journey.

12 Natural Ways to Reduce Anxiety Before Your Period

No matter what the root cause of your anxiety, there are several ways to minimize its effects while you figure out how best to treat it. 

While medications like Xanax are often prescribed and effective in the short term, they can be extremely addictive and difficult to withdraw from should you choose to discontinue use. There's no shame in leveraging medication to get relief. And at the same time, I'd encourage you to investigate why you have anxiety in the first place.

Even if you do choose to go the pharmaceutical route (no judgment — at all) the following natural recommendations can help tremendously as well. And remember, always talk to your doc about your medications before changing or discontinuing them.

1. Optimize Hormones

If hormones are driving your anxiety then focusing on improving your estrogen to progesterone ratio is one way to help reign in those emotions. Having lab testing 5-7 days after you ovulate for both estrogen and progesterone will help you identify if this is your issue. While you wait for labs, begin eating a diet to support your hormones. You can grab my free hormone balancing meal plan here.

You want to aim to include cruciferous vegetables daily to support estrogen metabolism and bring in foods rich in B6 to support both estrogen and progesterone levels. I wrote a whole guide on the benefits of vitamin B6 that you can explore and get ideas for foods to incorporate. 

Vitamin C is a beneficial nutrient for both optimal progesterone levels and adrenal support. You can find it in leafy greens, peppers, and citrus fruits.

In addition to the other recommendations you’ll find here, you may want to begin a supplement aimed at supporting women’s hormones, like my Balance Women’s Hormone Support. Ingredients like Vitex have been shown to be beneficial in supporting progesterone production. And DIM, along with calcium-d-glucarate and broccoli seed extract, can help your liver and gut appropriately metabolize estrogen. 

2. Seek Out Social Connections 

Oxytocin, also known as the love hormone, is a powerful chemical that is released when mother and child bond, sexual attachments are formed, and even when we experience more general social connections. Oxytocin triggers serotonin, which helps makes us feel happy. 

Need a quick oxytocin fix? Pet a dog or get a twenty second bear hug in!

3. Spend Time in Nature 

Studies suggest that spending time in nature can actually decrease a hallmark of anxiety — repetitive negative thoughts. As little as 20 minutes can actually lower stress levels and create a more positive mental outlook.  

4. Reduce Stress 

Ok, this may be easier said than done. However, taking a ruthless inventory of the places you can legitimately cut stress in your life can go a long way towards reducing anxiety. Remember, anything you can do to reduce stress hormone production will reduce anxiety.

5. Leverage L-Theanine

L-theanine is an amino acid found in green tea. While caffeine may not be your friend if you’re experiencing anxiety, you can make the most of this amino acid by consuming decaf green tea or taking it in supplement form. 

L-Theanine has been shown to reduce symptoms of anxiety and physiological signs of stress, like high blood pressure. Aim for 200 milligrams once to twice daily for the most benefit.

6. Move Large Muscle Groups 

Exercise can be terrifically therapeutic for those with anxiety and depression. Since we tend to want to move when we feel anxious, it makes sense to listen to the body. Even short bursts of activity can help alleviate anxious feelings quickly.

7. Meditation  

Meditation has become mainstream, and even scientific studies tout its effectiveness for reducing anxiety. Starting out small is fine —  successful meditation practices can be built one minute at a time. There are several meditation apps that offer guided meditations to get you started too.

8. Eat Regular Meals

Eating regular meals can help ensure you don’t experience the anxious feelings that come on when you find yourself “hangry.” Skipping meals and under-consuming calories only serve to spike those cortisol levels, along with other stress hormones.

Eating a nutrient-dense diet with plenty of vegetables, fruits, fiber, high-quality protein, and fat can go a long way towards helping reduce anxiety. Filling in the gaps with a high-quality multi-vitamin to keep nutrient deficiencies at bay is a good idea, too.

9. Consider Magnesium

Magnesium has been shown in numerous studies to help ease anxiety, including anxiety before periods. Foods that are rich in magnesium include chocolate, avocado, leafy greens, nuts and seeds. Studies have shown that most people do not get enough magnesium from their diet and therefore, supplementation may be necessary.

For my patients, I typically begin with a dose of Magnesium Bisglycinate at 300 mg 1-2 hours before bed to support restful sleep and healthier mood the following day.  

10. Listen to Binaural Beats

You can find these on Spotify and make a playlist to listen to when you’re feeling anxious. These make a great travel playlist if you get anxious on planes or with delays in travel. If you have trouble falling asleep at night, try doing some deep breathing and listen to binaural delta rhythms. This is an incredibly non-invasive way to manage anxiety that many of my patients have had success with. 

11. Make Bedtime a Priority

Speaking of sleep, most of us will experience mood symptoms if we’re skimping on this. At night, cortisol is meant to decline while melatonin rises. As I explain in Beyond the Pill, safeguarding your circadian rhythm is incredibly powerful for creating balanced hormones. 

Some women find that anxiety can get in the way of their sleep. If this is true for you, consider these steps:

  • Avoid electronics one hour before bed
  • Wear blue light blocking glasses at least 2 hours before bed
  • Engage in relaxation practices like meditation, stretching, reading, or deep breathing before bed
  • Get in bed at least 15 minutes before you plan to go to sleep
  • Sleep in a cool, dark room
  • Consider supplements to support your sleep, like Sweet Dreams, which also contains melatonin

12. Try Adaptogenic Herbs

If misfiring of stress hormones from your adrenals is driving your anxiety, adaptogenic herbs can be a gentle way to support your body in establishing its equilibrium. 

Adaptogens are a group of herbs that are known for their ability to reduce stress and enhance adrenal function. I've formulated both Adrenal Support (daytime formula) and Adrenal Calm (night time formula) with adaptogenic herbs to support a healthy cortisol rhythm and adrenal function.

Our adrenal and ovarian function are intimately tied. When your body is experiencing stress, the brain can signal to the glands to produce stress hormones and downregulate progesterone production. This is an adaptive mechanism designed to help you survive, but it can also lead to feelings of anxiety before your period.

Examples of adaptogenic herbs include:

  • Rhodiola
  • Ashwagandha
  • Ginseng
  • Gotu Kola
  • Licorice Root
  • Eleutherococcus
  • Reishi Mushroom
  • Cordyceps
  • Maca

Learn more about how to heal adrenals with adaptogenic herbs here.

Anxiety Before Your Period? Don’t Go It Alone.

As someone who suffered from anxiety, I know first hand how difficult and frustrating it can be.

I also know how challenging it sometimes is to find a doctor who will listen to you and help you find the root cause of your anxiety. Whether it be hormonal fluctuations or something else, there is usually a reason for your suffering that can be addressed.

I encourage you to seek out a mental health professional, as well as a health care provider you can partner with to get to the root of your issue.

Women who are suffering from anxiety can feel extremely lonely. It’s a very isolating condition. If you know someone who is battling anxiety or depression, be patient with them. Offer support in any way you can — sometimes we just need to talk…and that social connection can actually increase oxytocin and help bring anxiety levels down!

Everyone is welcome in my Instagram community, too. You’ll find an incredibly supportive group of women there. Who knows, they may just be the exact social squad you need to help you get that oxytocin boost and banish a bout of anxiety.      

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is one of the leading experts in women’s medicine and is a pioneer in her exploration of the far-reaching impact of hormonal birth control and the little known side effects that impact health in a large way. In her best selling book, Beyond the Pill, she shares her clinical protocols aimed at supporting women struggling with symptoms of hormone imbalance, including Post-Birth Control Pill Syndrome and birth control related side effects. A trained nutritional biochemist and Naturopathic Physician, Dr. Brighten is the founder and Clinic Director at Rubus Health, an integrative women’s medicine clinic. She is a member of the MindBodyGreen Collective and has been featured in prominent media outlets such as Forbes, Cosmopolitan, ABC news, and the New York Post. Read more about me here.