Why do I cry before my period?

Your emotions can get the better of you before your period

Feeling sad and emotional for a few days for seemingly no reason and then starting your period is a common experience among people who menstruate. This is a symptom of premenstrual syndrome or PMS and can start the week before menstruation.

Period mood swings are notorious for making us sob at the most trivial things, like a cute cat picture, or sometimes make us feel overwhelmed at simple tasks, which then causes an emotional outburst. We’ve all heard “come on yaar, why are you being so moody? Is it shark week?”, or “what’s gotten into you, why are you being so sensitive?”.

Be rest assured that it’s not just in your head; we’re here to help you understand why this happens.

So what really happens the week before your period?

Two hormones (think of them as sisters) that play a role in menstruation are progesterone and estrogen.

• Changes in mood before and during our periods are caused by fluctuations in these hormones. The levels of these hormones rise and fall throughout the menstrual cycle.

• Progesterone and estrogen decrease just before your period starts, towards the end of the luteal phase.

• This fall in estrogen and progesterone levels causes a decrease in other chemicals made by the brain, like serotonin (the “happy hormone”) and dopamine (the “feel-good hormone”).

• Lower serotonin and dopamine are related to the feelings of sadness, anxiety, and irritability that you feel before your period. These feelings often stay until the first 2 days of your period and then go away as hormone levels get higher.

Everyone is different, so hormonal fluctuations can affect you differently from someone else. You may even have worse mood swings during one cycle and feel better the next. This is due to variations in hormonal changes.

For some people though, emotional outbursts and mood swings can be more than just PMS.

Some symptoms of PMDD include:

• Depression and low mood

• Anxiety

• Feeling more irritable than usual

• Increased emotional sensitivity and mood swings

• Sudden lack of energy and motivation

• Having a hard time concentrating

• Increased fatigue and changes in sleep pattern

• Gastrointestinal issues - nausea, constipation, bloating

Some behavioral symptoms of PMDD include:

• Sudden lack of energy and motivation

• Depression, and in some cases, suicidal ideation

• Anxiety

• Feeling more irritable than usual

• Having a hard time concentrating

• Increased fatigue and changes in sleep pattern

PMDD is considered a mood disorder that should be evaluated and treated appropriately by a doctor. If this sounds like you, please speak to a doctor and know that help and treatment are available.

The data

It is estimated that more than 80% of menstruators experience the emotional and physical symptoms of PMS, including mood changes and depression (source). Both PMS and PMDD are still poorly understood and stigmatised; their prevalence is likely under-reported.

A recent study in India found that PMS symptoms were present in 46.1% of participants. In fact, 10.2% of people were eligible for a PMDD diagnosis, and of these individuals, 84.5% experienced emotional symptoms like irritability and sadness (source).

Some people may be more likely to have increased emotions and more intense feelings of sadness due to genetic factors, a history of depression or anxiety, or other lifestyle factors like high stress and low physical activity (source). In fact, a 2010 study found that a history of major depressive disorder or anxiety disorder can make you more likely to develop PMDD (source).

Things you can do to feel better

It can be a good idea to keep track of your mood and energy levels throughout your cycle. This can help you figure out if the times you feel more sad or emotional than usual correspond with the different phases of your cycle. If you have a diary, you can add a little note about how you feel each day, or make notes on your phone. Journalling is also a great way to understand and accept your feelings and be in tune with your mind and body.

On this journey to understanding what your body needs, some lifestyle changes can help you manage the intense emotions that come with PMS.

• Exercise - you don’t have to become a gym buff, but even light exercise like going on walks, dancing, or any kind of physical activity can help you feel lighter and more relaxed.

• Stress-busting - if you can, take a little time out for yourself to relax, take it easy, and do the things you enjoy to make yourself feel a little better. Relaxation techniques like meditation or massage therapy can help you feel mentally and physically relaxed and rejuvenated.

• Food habits - we’re all-too-familiar with the cravings that come right before and during our periods. You may be tempted to eat your feelings in chocolate, but too much sugar can actually make you feel worse by making your blood sugar fluctuate. There’s no need to completely cut sweets out, but try incorporating grains and other foods rich in fibre. This has been shown to regulate blood sugar and make you feel less irritable.

In case your symptoms indicate something that needs more medical attention like PMDD, the above interventions and lifestyle changes can work for you but you may need some extra support. Please reach out to a doctor and work with them to figure out the best course of action.

You may be recommended to take antidepressants either just around your period or everyday to help manage your symptoms. The most common type of antidepressants are selective serotonin reuptake inhibitors (SSRIs), which work by keeping more serotonin around in your brain. This helps by elevating your mood.

So, the next time someone asks why you’re being crabby, tell them about the happy hormones!

- Team Cranberry

Sources:

Bansal, D., Raman, R. and Rao, T.S., 2019. Premenstrual dysphoric disorder: ranking the symptoms and severity in Indian college students. Journal of Psychosexual Health, 1(2), pp.159-163. https://journals.sagepub.com/doi/full/10.1177/2631831819827183 Accessed: June 18, 2023

Dutta, A. and Sharma, A., 2021. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in India: A systematic review and meta-analysis. Health promotion perspectives, 11(2), p.161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233671/ Accessed: July 4, 2023

Jarosz, A.C., Jamnik, J. and El-Sohemy, A., 2017. Hormonal contraceptive use and prevalence of premenstrual symptoms in a multiethnic Canadian population. BMC Women's Health, 17, pp.1-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615478/ Accessed: July 4, 2023

Pinkerton, J.V., Guico-Pabia, C.J. and Taylor, H.S., 2010. Menstrual cycle-related exacerbation of disease. American journal of obstetrics and gynecology, 202(3), pp.221-231. https://pubmed.ncbi.nlm.nih.gov/20207238/ Accessed: June 18, 2023