The ESK blog
Why do I get angry before my period?
19 August 2024
Dr Anne Thomson
Why do I get angry before my period?
It's very common to feel a bit more irritable or angry before your period. This might be due to premenstrual syndrome (PMS) or its more severe (and thankfully less common) form, known as PMDD or premenstrual dysphoric disorder. PMDD is a hormonal brain condition experienced by between 5-8% of women. The major symptoms of which include anger, irritability, and internal tension just before the period. We’re talking severe enough to majorly interfere with normal life - relationships, work, the whole shebang. To be diagnosed with PMDD we need to rule out other conditions like depression or even substance abuse, but usually it’s pretty clear cut. After your period you’re fine! But just before it, your mood takes a nosedive and the anger really ramps up.
Other symptoms of PMDD include:
Severe anger or rage
Irritability
Depression or feelings of hopelessness
Moods that swing wildly
Lethargy
Might be breast tenderness, headaches, general aches and pains, bloating and even weight gain
Let’s dive into what’s happening and how you can manage it.
Hormonal Changes
Before your period, your body undergoes significant hormonal shifts. The two key hormones involved are:
Oestrogen: Levels drop off after ovulation and again just before your period.
Progesterone: This hormone rises after ovulation but then falls if you don’t become pregnant. There is a theory that both PMS and PMDD symptoms develop because of falling progesterone levels before the period that causes changes in the levels of a relaxing neurotransmitter called gamma-aminobutyric acid (GABA) in the brain.
These hormonal fluctuations can affect other neurotransmitters in your brain too. But while the changes in oestrogen and progesterone levels are consistent, our responses to them aren’t.
For example glutamate is an excitatory neurotransmitter, so it makes you feel happier and brighter. Its levels fall before and during the menstrual cycle for all women. But women with PMDD seem to have an increased sensitivity to these cyclical changes.
Why is this happening?
So why are some women more sensitive to the menstrual cycle hormone fluctuations that all women experience? We’re learning more about this all the time, but here are some interesting facts you might not have heard before:
- Previous trauma. There’s a strong link between PMDD and a history of trauma. We still don’t know why, but assume that trauma changes the neurocircuitry of the brain, making you more susceptible to hormonal shifts.
- Smokers are TWICE as likely as non smokers to suffer from PMDD. As if there weren’t enough reasons not to smoke already!!
- Overweight and obesity significantly up your risk of PMDD. The higher your BMI, the higher the risk of PMDD.
- Diet matters. People who have lots of fast food, soft drink, processed meats, red meat and dairy have a higher risk of PMDD while having more fruit and veggies, nuts, legumes and fish lower the risk!
- People with PMDD are worse sleepers. Women with PMDD have lower melatonin secretion from the brain, especially before the period. Most women with PMDD do have insomnia and more interrupted sleep than women with PMDD.
So, if you’re struggling with rage before your period, here’s some advice that might help:
Lifestyle Changes:
Exercise: Regular physical activity can boost your mood and reduce anxiety.
Diet: Eating less junk food and opting instead for a balanced diet, rich in whole grains, fruits, vegetables, and lean proteins - especially fish, can help stabilize your mood. Reducing alcohol can also be beneficial. Given the clear link between weight and PMDD, it’s worth striving for a healthy weight.
Sleep: Ensure you’re getting enough rest. Aim for 7-9 hours per night.
Stress Management: Techniques such as yoga, meditation, or deep breathing exercises can help manage stress. Giving up smoking can be stressful, but would be a great win for your premenstrual anger and your overall health.
Medical Treatment:
Antidepressants: SSRIs (selective serotonin reuptake inhibitors) can be effective in treating PMDD in as little as one day. They work for around 60% of PMDD sufferers.
Hormonal Treatments: Birth control pills or hormone therapy can help regulate the hormonal fluctuations that contribute to PMDD symptoms. The ones that are recommended are pills containing drospirenone as the progestin. They take around a month to start working and help between 48 and 61% of people (less than antidepressants). Other pills are less effective and might not work at all.
Supplements: There is a bit of evidence for calcium and vitamin B6 supplements as well as magnesium. Other herbs that have been tried include evening primrose oil, ginkgo biloba, St John’s wort. There’s not much evidence that they help. But if you’re finding them helpful, chat to your pharmacist or GP about possibly continuing.
Other medications with less effectiveness and more side effects can be tried. Chat to your GP for more info.
Therapy:
Cognitive Behavioural Therapy (CBT): This type of therapy can help you manage your symptoms by changing negative thought patterns and behaviours. It has been shown to be beneficial for PMDD.
Practical Tips
Track Your Cycle: Knowing when your symptoms typically occur can help you prepare and manage them more effectively.
Communication: Talk to your friends, family, or partner about what you’re experiencing. Their understanding and support can make a big difference.
Self-care: Take time for yourself. Whether it’s a relaxing bath, reading a book, or engaging in a hobby, self-care can help mitigate stress and irritability.
Conclusion
Experiencing anger and irritability before your period is common and can be a sign of PMDD, especially if these feelings are intense and disrupt your life. There are various ways to manage these symptoms, including lifestyle changes, medical treatments, and therapy. Don’t hesitate to reach out to a healthcare professional for support and guidance tailored to your needs.