Premenstrual Syndrome (PMS) affects up to 75% of menstruating women, with symptoms ranging from mild irritability and fatigue to more severe mood swings, anxiety, and physical discomfort. While PMS can feel overwhelming, understanding how it affects both the body and mind—and how to manage it—can make a huge difference in improving quality of life.

As a psychiatrist in Newport Beach, I often work with patients who struggle with PMS and its emotional impact. Here’s a comprehensive guide on how to approach PMS from a psychological perspective, incorporating practical advice and strategies that can help alleviate its symptoms. Please call us today so we can help you (949) 222-9922 or email: info@superiorpsychiatric.com

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What Is PMS?

PMS refers to a group of physical, emotional, and behavioral symptoms that occur in the second half of the menstrual cycle, typically after ovulation and before the start of a period. These symptoms can include:

• Mood swings (irritability, anxiety, depression)
• Physical discomfort (bloating, cramps, fatigue)
• Sleep disturbances
• Food cravings

The exact cause of PMS is unclear, but it’s thought to be related to fluctuations in estrogen and progesterone levels, which influence neurotransmitters like serotonin and dopamine in the brain.

For many, PMS symptoms can be managed with lifestyle adjustments, psychological strategies, and, if necessary, medical treatments. Below are some psychiatrist-recommended strategies to help manage and reduce the impact of PMS.

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1. Understand the Psychological Impact

While PMS is often thought of as a physical condition, its emotional toll can be just as significant. Many women experience:

• Mood swings ranging from irritability to sadness.
• Increased anxiety or feelings of being overwhelmed.
• Depression-like symptoms, such as a lack of motivation, difficulty concentrating, or feeling hopeless.

These emotional fluctuations are not “just in your head”—they are a real part of PMS, often triggered by hormonal changes in the body.

Here is what is often suggested:

• Track your symptoms: Start by keeping a journal to track your symptoms, especially mood changes, anxiety, and irritability. Recognizing these patterns will not only help you anticipate the challenges of PMS but also empower you to take steps to manage them.
• Cognitive Behavioral Therapy (CBT): CBT is highly effective in managing mood symptoms associated with PMS. It helps you identify and challenge negative thought patterns, like catastrophizing or self-criticism, and replace them with more realistic and balanced perspectives.
• Mindfulness & Relaxation Techniques: Mindfulness practices, such as deep breathing, progressive muscle relaxation, and meditation, can help you stay grounded during emotionally turbulent times. Spending just 10 minutes a day practicing mindfulness can reduce stress and improve emotional well-being.

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2. Lifestyle Changes to Balance Hormones

Hormonal fluctuations during the luteal phase (the two weeks before your period) can cause a drop in serotonin levels, leading to mood changes.

Here is what is often suggested:

• Nutrition Matters: Foods rich in complex carbohydrates, lean proteins, and healthy fats help stabilize blood sugar levels, which can improve mood. For example, try eating more whole grains, nuts, seeds, and leafy greens.
• Magnesium and Calcium: Studies have shown that magnesium (found in foods like leafy greens, nuts, and seeds) and calcium (from dairy or fortified non-dairy milks) can help alleviate PMS symptoms, such as irritability and fatigue. A balanced intake of these minerals might also reduce physical symptoms like cramps.
• Limit Caffeine and Alcohol: Caffeine and alcohol can exacerbate anxiety, irritability, and sleep disturbances, so it’s a good idea to limit or eliminate them, particularly in the two weeks leading up to your period.

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3. Exercise: The Natural Mood Booster

Exercise isn’t just for the body—it’s crucial for mental well-being, too. Physical activity boosts the release of endorphins, the brain’s “feel-good” chemicals, and improves sleep, reducing symptoms of depression and anxiety.

Here is what is often suggested:

• Regular Exercise: Aim for 30 minutes of moderate exercise most days of the week. Aerobic exercises, like walking, jogging, swimming, or cycling, can significantly improve mood and energy levels. Exercise can also reduce physical PMS symptoms like bloating and fatigue.
• Yoga & Pilates: Gentle movements, like those found in yoga or Pilates, combine physical exercise with mindfulness, helping to reduce stress, alleviate muscle tension, and improve flexibility.

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4. Sleep: Don’t Underestimate Its Power

Getting enough restorative sleep is essential when it comes to managing PMS. Poor sleep can exacerbate irritability, anxiety, and fatigue, all of which are common PMS symptoms. During the luteal phase, sleep disturbances—whether from physical discomfort, hormonal changes, or anxiety—can be more pronounced.

Here is what is often suggested:

• Sleep Hygiene: To improve sleep quality, aim for a consistent bedtime and wake-up time. Create a relaxing pre-sleep routine by avoiding screens (phones, laptops, TV) at least an hour before bed. Relaxation techniques, like deep breathing or reading a calming book, can help prepare your body for sleep.
• Relaxation Before Bed: Incorporating techniques such as guided imagery or progressive muscle relaxation can help ease your body into a deeper, more restful sleep, which in turn can reduce mood swings and irritability.

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5. Medical Support: When to Seek Help

For some women, lifestyle changes and self-care strategies aren’t enough to manage PMS symptoms. If your symptoms are severely impacting your daily life, you might be experiencing Premenstrual Dysphoric Disorder (PMDD)—a more severe form of PMS that requires targeted medical treatment.

Here is what is often suggested:

• Medication: If mood symptoms are significantly disruptive, antidepressants (SSRIs/SNRIs) may be prescribed to stabilize serotonin levels and help with anxiety or depression. These are particularly effective for those with PMDD or severe PMS.
• Hormonal Treatments: Some women benefit from hormonal treatments like birth control (oral contraceptives, IUDs) to regulate hormonal fluctuations and reduce emotional symptoms. Continuous use of birth control (skipping the placebo week) can sometimes alleviate mood swings by preventing hormone levels from dipping.
• Consider Therapy: If PMS symptoms are affecting your quality of life, therapy such as Cognitive Behavioral Therapy (CBT) or interpersonal therapy can help with managing emotional reactions, improving coping mechanisms, and addressing any underlying mental health concerns.

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Call Us Today

PMS doesn’t have to control your life. With the right strategies, such as tracking your symptoms, improving your diet, exercising regularly, and practicing mindfulness, you can significantly reduce its impact. If symptoms are severe or interfere with daily life, it’s important to seek professional help. A psychiatrist can provide the support you need, whether through therapy, medication, or a combination of both, to make PMS more manageable.

Remember, you’re not alone in this. Understanding your body, being proactive about self-care, and seeking help when needed can go a long way in helping you feel better during your menstrual cycle.

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Have you found any particular strategies that help with your PMS symptoms? Or maybe there’s a part of PMS management you’re struggling with? Let me know in the comments!

Dr. Alexis Meshi and Superior Psychiatric Services in Newport Beach welcome you to call or email today to get help.

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