PMS Mood Swings: Symptoms and Causes Explained

Disclaimer: Cranberry.Fit aims to empower women with health information and actionable guidance rooted in evidence. Our Berry Wiki articles are for educational purposes only and are not a substitute for professional medical advice. For diagnosis, treatment, or before trying anything new, please consult a qualified healthcare provider.

• 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 emotional fluctuations that many women experience before and during periods. They usually settle once bleeding begins.

• Changes in hormone levels affect certain mood-regulating brain chemicals that may cause mood swings. 

• Mood swings may feel worse when they occur with physical symptoms, stress, sleep problems, or underlying health conditions. 

• If mood swings interfere with daily life, seeking medical advice can be helpful.

What Are PMS Mood Swings?

Mood swings are fluctuations in emotions that many women experience before and during periods. You may notice more emotional ups and downs, with feelings changing easily, stronger reactions, and a greater effort needed to stay emotionally balanced during periods. Often, you may not be able to pinpoint an exact reason and these swings seem unpredictable and hard to control.

In medical terms, doctors commonly describe this pattern as an emotional symptom of PMS. A majority of women who menstruate experience one or more PMS symptoms. These emotional changes often occur alongside other period-related changes such as tiredness, pain, or disrupted sleep.[1]

Mood swings related to periods usually appear in the days leading up to menstruation and often peak in the last two to three days before bleeding begins. For most women, these emotional changes ease once the period starts or shortly afterward.

A quick note on premenstrual dysphoric disorder (PMDD) 

A smaller number of women experience a more severe form of PMS known as premenstrual dysphoric disorder (PMDD). It is a much more intense form of premenstrual symptoms, affecting about 5% of women of reproductive age. Women with PMDD experience stronger emotional swings that interfere with daily life, work, or relationships.[2]

Symptoms of PMS Mood Swings

Mood swings are one of the emotional symptoms of PMS, which also involves mental and physical changes. Some women notice only emotional shifts, while others experience a mix of symptoms. Not all women experience every PMS symptom.[3]

You may experience one or more of the following emotional changes, often shifting from one to another.

• Rapid or unpredictable changes in mood

• Stronger emotional reactions to minor or everyday situations

• Increased anxiety, tension, or inner restlessness

• Difficulty concentrating or feeling mentally “foggy”

• Feeling emotionally overwhelmed or withdrawing socially
  
  

Certain other symptoms are not mood swings themselves, but they commonly occur as part of PMS and can intensify emotional fluctuations. These include fatigue or low energy, sleep disturbances including difficulty falling or staying asleep. Some women also experience headaches, back pain, and/or breast tenderness. They may also notice abdominal discomforts such as bloating or fluid retention, changes in appetite or food cravings, and digestive changes, such as constipation or diarrhea.

FYI: Your mood swings are medically recognised and considered normal as long as they are manageable or subside after periods. You may find it hard to cope when these changes occur alongside cramps, fatigue, and the discomfort of bleeding. Together, these symptoms make the days around a period emotionally demanding, and the strain can show up as noticeable mood swings while you try to carry on with daily life.

What Causes Mood Swings During PMS?

The exact causes of period-related mood swings are not fully understood, but changes in reproductive hormones are known to influence brain chemistry and the regulation of emotions. These hormonal shifts are a normal part of the menstrual cycle and can temporarily alter how the brain processes emotions, stress, and reactions to everyday situations.

Your mood is regulated by chemical messengers in the brain called neurotransmitters, which help your nerve cells communicate with one another. Key neurotransmitters involved in emotional balance include serotonin, which supports mood stability and gives you a sense of wellbeing. Another brain chemical called gamma-aminobutyric acid (GABA) has a calming effect and helps regulate your anxiety and tension.[4,5]

Your neurotransmitters may not always have the same levels and activity. They respond to several factors, including sleep, physical activity, stress, nutrition, and hormonal changes. As the levels of these neurotransmitters change, your emotional responses may become stronger, mood may fluctuate more easily, and coping with stress may feel harder.

In the luteal phase of the menstrual cycle, aka the days between ovulation and the start of a period, your estrogen and progesterone levels first rise and then fall sharply. These rapid hormonal changes can influence the brain pathways that regulate the mood.

Falling estrogen levels are associated with changes in serotonin activity, which may contribute to low mood, irritability, or emotional sensitivity before periods. This link is supported by the fact that certain antidepressants that act on serotonin pathways can help reduce PMS symptoms in some women. A sudden drop in progesterone can affect GABA, the calming neurotransmitter, which may increase feelings of anxiety, restlessness, or tension.[6]

While these hormonal shifts occur in all menstruating women, studies suggest that your mood swings may not depend solely on changes in hormone levels. Instead, receptors in the brains of some women respond more sensitively to these hormonal changes. A progesterone-related hormone can interfere with the brain’s natural calming system, making emotional regulation more difficult. This may explain why mood changes during periods can feel more intense or less predictable.[7,8]

Together, these normal hormonal changes and the brain’s sensitivity to them can alter neurotransmitter activity and make your emotional responses feel stronger before and during periods. While these changes can affect behaviour and mood, they reflect a natural interaction between your hormones and the brain.

What May Worsen Your Mood Swings?

Hormonal changes before a period do not occur in isolation. Your mental and physical health conditions, gynecological issues, medications, and lifestyle factors can interact with normal hormonal shifts and intensify mood changes, even when hormone levels are normal.

Mental health conditions

Women with depression or anxiety may feel stronger mood swings. These conditions can cause symptoms throughout the month, but they often feel noticeably worse in the days leading up to a period. If you have a personal or family history of bipolar disorder, you may experience more pronounced mood shifts in response to hormonal changes.[9]

Physical health conditions

If you suffer from asthma, allergies, migraines, and irritable bowel syndrome- the symptoms tend to flare before a period. Your mood can get affected by the physical discomfort associated with such flares. Some women with chronic fatigue syndrome also report that symptoms worsen during periods.[10,11]

Gynecological conditions

Conditions like PCOS, endometriosis, fibroids, ovarian cysts, and pelvic adhesions (also known as scar tissue) can add to the physical discomfort, heavy bleeding, or hormonal imbalance. Anemia is known to affect emotional behavior, although large scale studies on whether anemia in menstruating women causes mood swings are awaited. Certain symptoms of anemia, such as fatigue and frequent headaches, may overlap with mood swings during periods. Having menstrual migraines and B12 deficiency has also been linked to mood swings.[12,13]

Deficiencies

While deficiencies of certain vitamins and minerals do not alter hormone levels, these can make the brain more sensitive to normal hormonal shifts. Iron deficiency, even without anemia, may contribute to fatigue, irritability, poor concentration, and low mood, particularly in women with heavy periods. Low levels of vitamin B12 or folate are linked to mood changes and mental fog, as these nutrients support neurotransmitter function. Deficiencies in magnesium, calcium, and vitamin D have also been associated with increased PMS symptoms, including anxiety, mood instability, and depressive symptoms.[3,14,15]

Warning: Correcting an underlying deficiency may ease symptoms, but supplements should be used under medical guidance.

Medications

Some medicines can affect mood by influencing hormone levels or brain chemistry. Combined birth control pills and other hormone therapies may improve mood stability in some women but worsen mood swings in others, particularly those rich in progesterone. Steroid medications are known to affect emotional regulation and can cause irritability or mood changes. Drugs used for mental health conditions, such as selective serotonin reuptake inhibitors, may also interact with menstrual hormone shifts, making mood changes more noticeable at certain points in the cycle.

Lifestyle factors

Your stress may not directly cause mood swings, but it can make your emotional symptoms feel more intense or harder to manage. Sleep plays a crucial role in mood swings. If your sleep is disrupted or you have insomnia, it can affect your brain function and emotional regulation and worsen your mood fluctuations. Excessive alcohol use and other substances have also been linked to hormonal imbalance and changes in neurotransmitters that influence mood.[16,17]

Periods

The physical and practical discomforts of menstruation, such as constant dampness, frequent bathroom trips to change pads or tampons, cramps, fear of leakage, and disrupted sleep, can add to stress and fatigue. Managing these challenges alongside work and daily responsibilities can make irritability and mood swings more noticeable during periods.

When to Seek Help for PMS Mood Swings?

While mood swings during the days leading up to your period and during periods are common, they should not feel overwhelming. It’s important to seek medical advice if:

• The frequency of your mood swings increases substantially

• Your emotions feel intense enough to disrupt your daily functioning

• You often feel out of control or experience frequent emotional breakdowns

• Your symptoms interfere with your ability to attend school or work

• Your personal relationships are affected
  

• You experience episodes of uncontrolled anger

• Your emotional responses feel disproportionate to the situation

• Your mood swings persist even after your period ends
  
  

Important: You should seek immediate help if you experience severe symptoms along with suicidal thoughts, or feelings of harming yourself or others.

How to Manage Mood Swings During Periods?

You may notice some relief from lifestyle and diet adjustments in case your mood swings are mild to moderate. Regular physical activity, better sleep habits, stress-management techniques, and a balanced diet can all help ease both emotional and physical symptoms. You should try reducing caffeine, alcohol, and smoking to see how you feel before and during your period.

You may consider taking supplements, particularly calcium and magnesium. However, you should speak with a doctor before starting any of these.

When  your symptoms are more severe or interfere with daily life, you may need medicines. Based on thorough assessment and individual needs, a doctor may prescribe hormonal birth control to regulate cycles, pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs), or antidepressants.

Berry’s Insights: Premenstrual Syndrome vs Mental Health Symptoms

PMS mood swings can look similar to symptoms of anxiety or depression, which can make them hard to tell apart. Rather than focusing on the specific emotion, doctors look at the overall pattern across the menstrual cycle. Period-related mood swings tend to follow a predictable cycle, emerging in the days before a period and easing once bleeding begins, with clear symptom-free intervals in between.

In contrast, primary mental health conditions usually cause symptoms that persist beyond your periods, even if they worsen around periods. When emotional symptoms do not improve after menstruation or continue throughout the month, further evaluation for an underlying mental health condition is needed.[18]

Tip: Doctors often recommend tracking your symptoms, such as maintaining a daily mood diary over two to three cycles. These can help in accurately diagnosing your condition.

The Bottom Line

Mood swings before and during your periods are linked to temporary changes in brain chemistry in response to your changing levels of hormones. Mild to moderate symptoms are manageable through lifestyle and diet interventions. However, it is a good idea to see a doctor if your mood swings regularly interfere with daily activities, work, or relationships. A range of evidence-based treatments are available to reduce symptoms and improve overall wellbeing.

FAQs

Are PMS mood swings normal?

Yes. Mood swings are recognised by doctors as common symptoms during periods. However, you should speak to a doctor if your mood swings interfere with daily life.

Can mood swings cause depression?

Mood swings do not cause clinical depression, but can worsen existing depression or anxiety. PMDD is a more severe condition linked to significant mood disorders and requires treatment.

Why do I cry more before my period?

The drop in estrogen during the luteal phase can affect serotonin and lower stress tolerance, making emotions feel stronger and tearfulness more likely.

Can lifestyle habits affect mood swings?

Yes. Stress, poor sleep, lack of exercise, and unhealthy eating habits can all make mood swings more noticeable.

Do mood swings stop after periods?

Usually, yes. Symptoms tend to ease once bleeding starts and hormone levels begin to stabilise.

References

At Cranberry.Fit, we prioritize medical accuracy and evidence-based information. All our Berry Wiki articles are grounded in clinical practice guidelines, peer-reviewed research, clinical trials, and guidance from leading medical journals and associations.

1. American College of Obstetricians and Gynecologists. Premenstual Syndrome. Accessed December 24, 2025.

2. American College of Obstetricians and Gynecologists. What I Wish Everyone Knew About Premenstrual Dysphoric Disorder. Accessed December 24, 2025.

3. Office on Women’s Health US. Premenstrual syndrome. Accessed December 24, 2025.

4. Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Front Neurosci. 2015 Feb 20;9.

5. Bendis PC, Zimmerman S, Onisiforou A, Zanos P, Georgiou P. The impact of estradiol on serotonin, glutamate, and dopamine systems. Front Neurosci. 2024 Mar 22;18.

6. Jespersen C, Lauritsen MP, Frokjaer VG, Schroll JB. Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder. Cochrane Library. 2024 Aug 14.
   

7. Modzelewski S, Oracz A, Żukow X, Iłendo K, Śledzikowka Z, Waszkiewicz N. Premenstrual syndrome: new insights into etiology and review of treatment methods. Front Psychiatry. 2024 Apr 22;15.

8. Hantsoo L, Epperson CN. Allopregnanolone in premenstrual dysphoric disorder (PMDD): Evidence for dysregulated sensitivity to GABA-A receptor modulating neuroactive steroids across the menstrual cycle. Neurobiology of Stress. 2020 May;12:100213.

9. Hsiao MC, Hsiao CC, Liu CY. Premenstrual symptoms and premenstrual exacerbation in patients with psychiatric disorders. Psychiatry and Clinical Neurosciences. 2004 Mar 03;58(2):186–90.

10. Vrieze A, Postma DS, Kerstjens HAM. Perimenstrual asthma: A syndrome without known cause or cure. Journal of Allergy and Clinical Immunology. 2003 Aug;112(2):271–82.

11. Pati GK, Kar C, Narayan J, Uthansingh K, Behera M, Sahu MK, et al. Irritable Bowel Syndrome and the Menstrual Cycle. Cureus. 2021 Jan 14;13.

12. Fernandez-Jimenez MC, Moreno G, Wright I, Shih PC, Vaquero MP, Remacha AF. Iron Deficiency in Menstruating Adult Women: Much More than Anemia. Women’s Health Reports. 2020 Dec 1;1(1):26–35.

13. Zeitoun T, Dehghan Noudeh N, Garcia-Bailo B, El-Sohemy A. Genetics of Iron Metabolism and Premenstrual Symptoms: A Mendelian Randomization Study. The Journal of Nutrition. 2021 July 1;151(7):1747–54.

14. Siminiuc R, Ţurcanu D. Impact of nutritional diet therapy on premenstrual syndrome. Front Nutr. 2023 Jan 31;10.

15. Ghanbari Z, Haghollahi F, Shariat M, Foroshani AR, Ashrafi M. Effects of Calcium Supplement Therapy in Women with Premenstrual Syndrome. Taiwanese Journal of Obstetrics and Gynecology. 2009 June;48(2):124–9.

16. Yi SJ, Kim M, Park I. Investigating influencing factors on premenstrual syndrome (PMS) among female college students. BMC Women’s Health. 2023 Nov 10;23(1):592.

17. Emanuele MA, Wezeman F, Emanuele NV. Alcohol’s Effects on Female Reproductive Function. Alcohol Res Health. 2002;26(4):274–81.

18. BJOG: An International Journal of Obstetrics & Gynaecology. Management of Premenstrual Syndrome. Accessed December 24, 2025.