How to Manage PMS Mood Swings

• Researched and written by: Dr Archita Rai, PhD (Life Sciences)

• Medical inputs by: Dr Poonguzhali Liston, MBBS, MS OBG, FMAS, DRM, FRM, CIMP

• Medically reviewed by: Dr Yash Bahuguna, MBBS, MS, DNB, ISGE Certified Practitioner for PCOS

TL;DR

• Mood swings are sudden or intense emotional shifts that occur as a symptom of premenstrual syndrome (PMS) or during periods. You experience these as hormonal changes before periods affect how your brain regulates your mood.[1,2]

• Adopting lifestyle habits such as good sleep, regular balanced meals, movement, and stress management can reduce how intense mood swings feel over time.[3]

• These strategies work gradually rather than instantly. They are effective when practised consistently across multiple cycles.

• For immediate relief, simple steps like deep breathing exercises, heat therapy, gentle movement, fresh air, journaling, or talking to someone you trust can help in the moment.[1,3]

• See a doctor if symptoms are severe, persistent for three or more cycles, or affect daily life. Seek urgent help if you have thoughts of harming yourself, feel unable to keep yourself safe, or feel emotionally overwhelmed.[1,3]
  
  

Understanding common symptoms of PMS mood swings

Mood swings are fluctuations in emotions that many women experience around a week before their period. It is one of the most common PMS symptoms. PMS includes a range of physical and emotional symptoms that appear in the days leading up to a period and usually ease once bleeding starts.[1,2]

Premenstrual mood swings can feel sudden or intense, sometimes without a clear trigger. Your emotions may feel stronger than usual, shift quickly, or feel harder to manage at certain points in your cycle. You may experience irritability, sudden sadness, tearfulness, anxiety, or feel emotionally sensitive. You may also move quickly between feeling fine and feeling low. For many women, this can feel like an emotional roller coaster and make everyday situations harder to handle.[1,3]

What causes mood swings during PMS?

Estrogen and progesterone levels fluctuate in the luteal phase of the menstrual cycle, a few days before your period. Estrogen influences the levels of brain chemicals called neurotransmitters, such as serotonin and dopamine. These brain chemicals help regulate mood, motivation, and emotional balance.[1,2] When your hormone levels shift, these brain chemicals can change too. These fluctuations make emotions feel less stable or harder to manage.[3]

Lifestyle Habits to Manage PMS Mood Swings

While you cannot control your hormonal shifts, there are ways to reduce how strongly they affect you. The approaches below focus on habits that help support emotional balance during PMS.

Prioritise consistent sleep

Getting enough sleep plays a key role in how well you manage your emotions. When your sleep is poor or irregular, irritability, low mood, and stress can feel worse. That’s because disrupted sleep affects the levels of serotonin and dopamine. Doctors consistently emphasize on regular, good-quality sleep as a core part of managing PMS.[4,5] 

• Aim for 7-9 hours of sleep each night.[6,7]

• Go to bed and wake up at roughly the same time every day, including weekends. Have a consistent bedtime routine.[8,9] 

• Avoid screens, caffeine, and heavy meals for at least 1-2 hours before sleep.[10,11]

• Keep your bedroom dark, quiet, and cool. Practice mindful meditation for 10-20 minutes before bed.[9]

• If you experience difficulty falling or staying asleep, prioritise rest. Keep a regular sleep routine, even if you sleep a little less than usual.
  
  

Tip: Prepare a simple checklist of the tips to follow every night to help build discipline.

Eat balanced, regular meals

You may feel more irritable, tired, or low in mood when your blood sugar rises and falls sharply. Eating regular, balanced meals can help smooth out these swings and support more stable energy and emotions.[3] Build balanced meals that combine:

• Complex carbohydrates: Whole grains, oats, brown rice, and millets, which provide steady energy. A diet including complex carbohydrates helps reduce physical symptoms of PMS such as cravings, bloating and gas, and stabilizes blood sugar. It also supplies vitamin B6 that supports neurotransmitter production.[12] 

• Protein sources: Eggs, lentils, beans, dairy, tofu, fish, and lean meats, which help balance brain chemicals and emotional balance. Proteins help in stabilizing blood sugar levels and managing inflammation, which supports mood regulation.

• Healthy fats: Nuts, seeds, olive oil, and fatty fish, which provide omega-3 fatty acids linked to better mood regulation during PMS. Balancing meals with healthy fats help stabilize blood sugar levels.

• Fruits and vegetables: Especially leafy greens and legumes, which supply fibre, magnesium, and other micronutrients that may help reduce irritability and support nervous system function.
  
  

A few additional food habits can help support steadier energy and mood.

• Eat regular meals every 3-4 hours to help keep blood sugar steady and reduce irritability or energy crashes.[12]

• Limit the intake of highly processed foods, added sugars, alcohol, and excess caffeine when possible. These have been linked to irritability, low mood, and energy fluctuations.[3]
  
  

Engage in regular exercise

Exercise can help regulate mood by increasing endorphins and reducing stress hormones. It also supports better sleep and steadier energy levels, both of which influence emotional balance during PMS. Even gentle, consistent movement, such as a daily walk, can make a noticeable difference over time.[13,14]

• Aim for at least 150 minutes of physical activity per week. This can be broken into 20-30 minutes on most days.

• Engage in low-impact workouts during your period. 

• Helpful options include walking, light cardio, light strength training, yoga or stretching, or cycling.
  
  

Practice relaxation techniques

Stress can intensify hormone-related mood changes by keeping the nervous system more activated than usual. Calming techniques help reduce this activation and support better emotional control.[15]

• Try slow, guided breathing techniques, such as the 4-7-8 breathing. In this, you inhale for 4 seconds, hold your breath for 7 seconds, and exhale slowly for 8 seconds. Try repeating this sequence for 5-10 minutes. Breathing exercises help lower stress hormones, activate the body’s relaxation response, and can ease anxiety, irritability, and emotional overwhelm during PMS.

• Mindfulness and short meditation can help improve awareness of emotional changes without immediately reacting to them. Practising for even 5-10 minutes a day, especially in the evening or before bed, has been shown to reduce stress and improve emotional regulation. If you are new to this technique, you can try guided meditation or breathing tools to help you.[1,10]

• Breath-focused movement practices such as pranayama, pilates with controlled breathing, or gentle yoga combine physical release with nervous system calming. Guided relaxation techniques, including progressive muscle relaxation, may further reduce physical tension and mental stress.[16]
  
  

Tip: You do not need to use all of these approaches. Choose one or two and practise them regularly. These can make mood changes feel more manageable over time.

Build self-awareness

Along with physical habits, paying attention to your emotional patterns can help you feel more in control during mood changes. 

Tracking your symptoms is one of the most effective ways to build self-awareness around mood swings. Keep a record for two to three menstrual cycles about when your symptoms appear and what may make them better or worse.[1,2]

You can use a period-tracking app or a notebook to note your mood. Add notes on your energy levels, sleep quality, stress, and physical symptoms (such as cramps or bloating). Over time, this helps you identify patterns and triggers, anticipate more sensitive days, and plan ahead.

Manage physical discomfort

Physical symptoms such as lower abdominal cramps, lower back pain, muscle tension, bloating, and general body aches during PMS can add to emotional distress. Easing these may also help mood changes feel more manageable.

Heat therapy is one of the simplest and most commonly used approaches. You can apply a heating pad or hot water bottle to the lower abdomen or lower back, or take a warm bath or shower for 15-20 minutes. This can help relax muscles, improve blood flow, and reduce pain and tension. Heat therapy combined with other supportive measures mentioned previously can help reduce physical strain and support overall comfort.[17]

TENS (Transcutaneous Electrical Nerve Stimulation) is another option that may help ease physical discomfort during PMS. It uses gentle electrical pulses on the lower abdomen or lower back to interrupt pain signals and relax muscles. Research shows that high-frequency TENS can meaningfully reduce cramps and lower the need for painkillers, making it a safe, non-drug support tool. You can use TENS through a small portable device with adhesive pads by placing it where you feel pain.

Note: These strategies work best when practised consistently over time and may not provide immediate relief, but they can make mood swings more manageable across cycles.

Berry’s Tips: Immediate help for PMS mood swings

If you are looking for quick relief tips to manage PMS mood swings, consider the following doctor-backed guide: 

• Pause and breathe: Take slow, deep breaths for 2-5 minutes, breathing out slightly longer than you breathe in. Practice the 4-7-8 breathing technique mentioned earlier.[21]

• Step outside: Get some fresh air or natural light, even for a few minutes.[22]

• Use warmth: Apply a heating pad or take a warm shower to relax your body.[17]

• Move gently: Try light stretching, a short walk, or gentle movement.[23]

• Have a calming drink: Sip warm tea such as chamomile, ginger, or peppermint.[24,25,26,27]

• Express it: Write a few lines in a journal to release what you’re feeling.

• Reach out: Talk to a friend or someone you trust for emotional support.

• Reduce stimulation: Lower noise, step away from screens briefly, and give yourself a pause.

• Art therapy: Engage in structured weekly art-therapy sessions to reduce stress and anxiety. These help in active expression of emotions and help regulate thoughts.[3,28]
  
  

Note: These are meant to help you get through difficult moments and work best when combined with longer-term habits over time.

When to see a doctor

Most mood changes around your period can be managed with self-care and lifestyle support. However, you should consider seeing a doctor if your symptoms feel overwhelming, persistent, or begin to affect your daily life.[1,2]

It may be time to seek medical advice if:

• Your mood changes are severe, feel out of proportion, difficult to control, or are worsening over time.

• Your symptoms interfere with work, studies, relationships, or daily functioning.

• Your symptoms do not improve after three cycles of consistent lifestyle and strategies mentioned above.

• You are facing fatigue, anemia symptoms, headaches, or any of your recent blood reports show hemoglobin below 12 mg/dL.

• Your sleep is getting affected.
  
  

Get urgent medical or mental health support if you experience:

• Thoughts of harming yourself or not wanting to live.

• A feeling of being unable to keep yourself safe.

• Severe emotional distress that feels overwhelming or out of control.

• Sudden or extreme changes in behaviour that feel alarming.
  
  

When you visit a doctor, they will ask about the timing and pattern of your symptoms across the menstrual cycle, review your medical history, and discuss any medications or supplements. They may recommend basic tests to rule out other causes, such as thyroid problems or anemia, and guide on the next steps.

Treatment options for PMS mood swings 

Medical and psychological treatments are available for when your mood swings are severe or continue despite lifestyle changes. These options are chosen based on symptom severity, how much daily life is affected, and your overall health.[18]

Psychotherapy

Cognitive behavioural therapy is a structured form of talk therapy that helps you recognise unhelpful thought patterns and develop healthier ways to respond to emotional stress. It has been shown to reduce PMS-related mood symptoms and improve coping.[18]

Medications

Doctors often combine medical treatment with lifestyle strategies depending on the underlying issues. Therefore, you should start any therapy or medication only in consultation with your doctor.[18]

When emotional symptoms are moderate to severe, doctors may recommend antidepressants like selective serotonin reuptake inhibitors (SSRIs). These help regulate serotonin levels and can reduce irritability, low mood, and anxiety.

Some women may also benefit from hormonal birth control pills, which work by reducing hormonal fluctuations that trigger symptoms. Certain formulations are more effective for mood-related symptoms than others, and suitability depends on your health history.

Supplements

Dietary supplements are meant to support your diet and help meet daily nutrient needs. In addition to lifestyle measures and medical treatments, some supplements have been mentioned for PMS symptom relief, particularly when dietary intake may be insufficient.[19]

• Vitamin B6 supports neurotransmitter production and may help reduce mood-related PMS symptoms in some people.

• Calcium plays a role in nerve and muscle function and has been linked to improvement in both emotional and physical PMS symptoms. 

• Magnesium supports nervous system function and muscle relaxation and may help ease irritability, fatigue, and bloating.[20]
  
  

The Bottom Line

Mood swings in the days leading up to your period are common and reflect normal hormonal changes that affect emotional balance. For many women, they become easier to manage with consistent lifestyle habits, awareness, and simple coping strategies practised over time. You should consult a doctor if your mood changes are persistent over three or more cycles, severe, or start to interfere with daily life. Effective medical and psychological support is available that can help manage mood swings.

FAQs

How do I know if your mood swings are hormonal or related to mental health?

If your symptoms follow a clear menstrual pattern and improve after your period starts, they are more likely hormone-related.

Why do mood symptoms feel worse before menstruation even without stress?

Falling estrogen levels affect brain chemicals like serotonin, which can intensify emotional responses.

Can lifestyle changes really help with severity of PMS mood swings, or is medication always needed?

Many women notice improvement with lifestyle and stress-management strategies, while medication is considered when symptoms are severe or persistent.

How long should I track symptoms before seeing a doctor?

Tracking symptoms for at least three menstrual cycles helps identify patterns and supports accurate evaluation.

Why do mood swings often improve once my period begins?

Hormone levels stabilise after bleeding starts, which can quickly ease emotional symptoms.

References

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2. National Health Service. PMS (premenstrual syndrome). Accessed January 11, 2026. 

3. Office on Women’s Health. Premenstrual syndrome (PMS). Accessed January 11, 2026.

4. Mighani S, Taghizadeh Shivyari F, Razzaghi A, Amerzadeh M, Ranjbaran M, Samavat M, et al. Association between sleep quality and premenstrual syndrome in young women in a cross-sectional study. Scientific Reports. 2025 Feb 20;15:6260.

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15. Bentley TGK, D’Andrea-Penna G, Rakic M, Arce N, LaFaille M, Berman R, et al. Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sci. 2023 Nov 21;13(12):1612.

16. National Center for Complementary and Integrative Health. Relaxation Techniques: What You Need To Know. Accessed January 11, 2026.

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18. American Academy of Family Physicians. Premenstrual Syndrome and Premenstrual Dysphoric Disorder. Accessed January 11, 2026.

19. Masoumi SZ, Ataollahi M, Oshvandi K. Effect of Combined Use of Calcium and Vitamin B6 on Premenstrual Syndrome Symptoms: a Randomized Clinical Trial. J Caring Sci. 2016 Mar 1;5(1):67–73.

20. Allen MJ, Sharma S. Magnesium. StatPearls. Accessed January 11, 2026.

21. Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023 Jan 10;4(1):100895.

22. Twohig-Bennett C, Jones A. The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research. 2018 Oct;166:628–37.

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24. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med. 2012 July 10;12:92.

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