Outsmart Your Hormones All Month Long (Plus 9 Surprising Things Making Your PMS Worse)
Because your cycle shouldn’t rule your life.
Can't sleep? Having memory lapses? Your hormones may be to blame. They can wreak havoc on how you feel, think, and function at different times in your menstrual cycle. Luckily, these period brain fog and other mental changes are predictable. “By anticipating your hormonal ebbs and flows, you can head off ailments such as cramps and headaches,” says Scott Isaacs, M.D., an endocrinologist at Emory University School of Medicine in Atlanta and author of Hormonal Balance.
Experts explain how to make the most of these fluctuations so you'll have more energy, brainpower and self-confidence all month long. Keep reading for the details, plus nine things that can make PMS symptoms worse (and how to avoid them for less period brain fog, fewer cramps, and more).
During Your Period: Days 1-7
The first day of your period is the start of your monthly cycle. Estrogen and progesterone are at their lowest levels. In addition, prostaglandins, hormone-like substances that cause uterine contractions, are triggering cramps and fatigue. Your immunity may be lowered, since autoimmune-related conditions like rheumatoid arthritis, psoriasis, and eczema seem to flare up at this point, says Luis J. Rodriguez, M.D., a clinical associate professor of endocrinology at the University of Texas Medical School in Houston. You may also be more susceptible to motion sickness right before your period due to bloating, which can cause fluid buildup in the middle ear.
“Get plenty of rest, reduce stress, and stick to a healthy diet," advises Dr. Rodriguez. Try eating foods rich in vitamin C (citrus fruits, broccoli, tomatoes) and zinc (oysters, red meat, wheat germ). Studies have shown these nutrients may boost immunity. To prevent cramps, start taking ibuprofen or naproxen a day or two before your period to inhibit the production of prostaglandins. If you‘re prone to motion sickness, try to put off long car trips, flights or cruises; if necessary, take Dramamine, which minimizes the effects of motion on the body, or ginger, which calms stomach nerves.
Studies show that low estrogen levels during this week may cause bouts of forgetfulness or period brain fog. Be diligent about keeping a to-do list and setting reminders in your daily planner. Creating word associations or mental pictures of things you don't want to forget may also help combat period brain fog. To recall the address 1225 Turner Street, for instance, you might say to yourself, "I turned my life around on Christmas (12/25)."
You can also eat your way to less period brain fog: Skipping breakfast has been linked to a decrease in cognitive performance and an increase in period brain fog. For the biggest benefits, add egg yolks or oatmeal to the menu, as they're both excellent sources of choline, a B vitamin that helps maintain memory. (Related: Try Adaptogen Elixirs For More Energy and Less Stress)
Post-Period: Days 8-14
Your energy is at its monthly high, thanks to rising levels of estrogen and low levels of progesterone (a hormone that has a calming effect). Your athletic ability may also be at its peak. Researchers at the University of British Columbia in Vancouver found that aerobic capacity is greatest during the first half of the cycle. (You're also looking your slimmest: Premenstrual water weight is gone.) With that in mind, this is the perfect time to put your athletic advantage to use by taking on a physical challenge like mountain biking or trying that boot camp class. You're also most likely to conceive during the second half of the week, so if you want to get pregnant, this is a good time to start trying—your fertility window continues until day 15. (Related: Anna Victoria Gained Weight During Fertility Treatment—Here’s She’s A-OK With That)
Memory, concentration, articulation, and verbal fluency improve when estrogen is elevated, studies have found. In one, young women scored best in a test requiring them to recall a series of numbers and letters when their estrogen levels were high. Use this time to tackle difficult projects at work. If you have to give a presentation or speech, try to schedule it during this week.
In terms of your mood, research shows that women are less likely to experience depression (there’s actually four kinds of the condition) or withdrawal symptoms at this point in the cycle. That's because as estrogen rises, your mood and outlook become more positive. If you rely on an unhealthy or not-so-healthy habit like smoking or nail biting to relieve stress, try dropping it during this week.
Mid-Cycle: Days 15-20
Some research suggests that women burn more calories during this week. "This may be due to the elevated body temperature associated with ovulation," says Michelle P. Warren, M.D., a professor of obstetrics, gynecology and women's health at Columbia University College of Physicians and Surgeons in New York City. You may have minor cramps and/or spotting for one or two days when the egg ruptures out of its shell, says Neil Goodman, M.D., a reproductive endocrinologist at the University of Miami School of Medicine in Florida and chair of the reproductive medicine committee for the American Association of Clinical Endocrinologists.
If you're trying to lose weight, make the most of this time by eating just a bit less and exercising slightly more. (Here are 10 ways to find time to sneak in a workout, even if your schedule is crazy-busy.) Be sure to stretch and incorporate exercises that strengthen major muscle groups and make joints less prone to injury, such as squats, lunges, and leg extensions. Studies show that serious knee injuries are more likely to occur now, since high estrogen levels can make joints loose.
And prepare for your fierce (or fiercer!) side to come out. Assertiveness, competitiveness and ambition are strong, courtesy of high amounts of testosterone. This male hormone, always present in your blood at low levels, surges slightly right after ovulation.
As testosterone drops and progesterone levels start to climb (peaking around day 21), you should start to feel more serene No period brain fog here! So devote some time to yourself. Take solitary walks in the woods, write in your journal, or enroll in a meditation class. (Related: The Best Meditation Apps for Beginners)
Pre-Period: Days 21-28
Progesterone and estrogen levels plummet right before menstruation, triggering physical changes and a myriad of maladies including headaches, insomnia, fluid retention and acne flare-ups. Your tresses, on the other hand, are radiant. (And just get even better when you nosh on these 16 superfoods for skin and hair.) The initially high progesterone levels stimulate the sebaceous glands to produce more oil, promoting shiny hair, says Audrey Kunin, M.D., a dermatologist in Kansas City, Missouri and founder of DERMAdoctor. An alert for asthma sufferers: One study found that women are more likely to experience serious asthma attacks right before their periods due to low progesterone, which plays a role in enabling bronchial muscles to relax and combatting cell inflammation.
This week, aim to cut back on caffeine (see how much coffee is too much), since it disrupts sleep and aggravates PMS symptoms, and go to bed at the same time every night (this will help ward off insomnia). To help banish bloating, avoid carbonated drinks and salty foods. For clearer skin, cleanse your face with a gentle exfoliating wash to get rid of bacteria and open up pores, Dr. Kunin recommends. If you have severe headaches, ask your doctor about wearing an estrogen patch for a few days before your period: It’s been shown to ease them. Asthma sufferers should wash bed linens to get rid of triggers like dust mites and pet dander.
Your concentration may be poor and your attention span short due to hormone swings. Some studies have found that women with PMS have trouble learning new material or completing mental tasks due to pre-period brain fog.
The pros’ Rx: Hit the gym or take a brisk walk around the block. Research shows that exercise improves concentration, creativity and cognitive skills by pumping more oxygenated blood to the brain. And eat foods rich in vitamin B6: It plays a crucial role in mental functioning, from neurotransmitters to brain-cell activity. Good sources of the vitamin include bananas, baked potatoes and salmon. (Related: The Amazing Ways Exercise Boosts Brain Power)
The hormonal roller coaster may also bring on irritability, weepiness, and mood swings. Plus, the brain chemical serotonin is in short supply, making you crave sweets and starches. To curb your urge for sugary or high-calorie foods, increase your intake of whole grains, fruits, and vegetables. Eat small, frequent meals to keep blood-sugar levels even; this will ward off overeating. If you still crave chocolate, make it dark: It has the most concentrated forms of chemicals that have been shown to boost mood, Dr. Isaacs says. Those feel-good hormones will be on the upswing again soon, as you start the cycle all over again.
9 Things That Can Make PMS Worse
Now that you have a week-by-week breakdown of hormonal fluctuations, let’s talk about something the vast majority of women already know: PMS sucks. During the luteal phase of the menstrual cycle (that's the second half, between ovulation and your period), 75 percent of women experience physical issues—cramping, bloating, backaches, headaches, weight gain, breast tenderness, sleeping issues, digestive issues—as well as emotional problems, like anxiety, sadness, irritability, mood swings, low self-esteem, period brain fog, and general exhaustion. (And that's just your run-of-the-mill PMS. Some women experience an extreme version, otherwise known as PMDD.)
But here’s something you might now know about PMS: It turns out you may be unintentionally making yourself feel even shittier. There are a handful of circumstances and choices that, when they coincide with that post-ovulation period, can make the monthly pains way, way worse. Luckily, they're all somewhat controllable.
Here are nine ways you may be making your PMS worse than it needs to be-and what you can do to find relief:
1. An Undiagnosed STI
A study in Evolution, Medicine, and Public Health found that before women were diagnosed with a sexually transmitted infection (STI) like chlamydia, herpes, or HPV, they were twice as likely to report headaches, cramps, and emotional sensitivity in the two weeks leading up to their period. Sounds crazy, but it's actually thanks to your body's natural immune response and the inflammatory cascade from the infection that increases pain and heightens your emotions, ob-gyn Natasha Chinn, M.D., told us. (Read more on all that here: Apparently, an Undiagnosed STI Could Be to Blame for Your Terrible PMS)
2. Skimping On Sleep
Not getting enough shuteye-or enough quality sleep, thanks to things like stress and anxiety-can worsen PMS, including period brain fog, says Atlanta, Georgia-based ob-gyn Tami Prince, M.D. "If we don't sleep, we can't produce certain hormones responsible for stabilizing our health and well-being," she explains. On top of this, you also score the baseline traits of a bad night's sleep—irritability, fatigue, period brain fog—which just pile on the premenstrual symptoms we all know and loathe. And unfortunately, worse symptoms from a few sleepless nights become a catch-22: Women with worse PMS symptoms or menstrual cramps score poorer quality sleep, according to research published in Sleep Medicine Clinics. (Related: Why Sleep Is the No. 1 Most Important Thing for a Better Body)
3. Rosé All Day
"Excessive alcohol use can increase levels of estrogen-disrupting hormones, which lead to dehydration, bloating, and water retention, making PMS symptoms intolerable," explains Sherry Ross, M.D., an ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica, California. And while you probably have a different opinion of "excessive alcohol," she says pretty much anything beyond the healthy one drink per day for women will hurt—but only when repeated multiple nights in a row.
4. Being Stressed AF
A 2018 study in Saudi Medical Journal found female college students who were super stressed were nearly three times as likely to experience worse PMS symptoms in the luteal phase, and twice as likely to have painful cramps during their period. "Stress exacerbates depression, anxiety, weight loss or weight gain, and period brain fog. PMS, along with common stress symptoms, can make the one to two weeks prior to your period debilitating," Ross says. What's more, people tend to perceive pain differently when they're under stress, Dr. Prince points out, which means both physical and emotional aches might bother you more. Go-to stress relievers like exercise and meditation can help relieve PMS, she says. (Related: How One Woman Regained Control Over My Body After Years of Debilitating PMS)
5. Low Vitamin D Levels
Some studies, including a large one published in the Journal of the Academy of Nutrition and Dietetics, have found women with low vitamin D levels were more likely to experience certain exacerbated symptoms—namely cramps, fatigue, anxiety, and confusion, tied to their cycle. While there are also studies finding no link between the vitamin and symptoms, some research has shown supplementing vitamin D can help alleviate PMS-related pains, emotionality, and painful cramps, and it's a relatively harmless fix to try. "Vitamin D is needed so that calcium can be absorbed, which in turn allows for our muscles, including the heart, to contract properly," Dr. Prince explains. Without proper contraction, your organs and tissue have limited blood flow, which increases fatigue, muscle fatigue, and cramping, she says.
6. Eating All the Food
"In the week or two before your period, hormonal changes cause bloating, diarrhea, and constipation," Dr. Ross says. Eating foods that are already tied to bloating on a good day will just exacerbate the problem. Plus, for many women, water retention, weight gain, and bloating are all tied to mood, potentially exacerbating the emotional parts of PMS, she adds. (Related: Exactly What to Do When You Overeat, According to Nutritionists)
One study found that among high school students, PMS symptoms were worse when they ate fried foods, sugary drinks, and fast food-but, surprisingly, also fruit. In the two weeks before your period, Ross recommends steering clear of dairy, high-sodium foods (read: takeout), and red meat, but also cruciferous vegetables, beans, even apples, peaches, and pears, all of which will make bloating, constipation, and diarrhea worse.
7. Mad Anxiety
If you have a history of depression or anxiety, your imbalanced hormones can make your PMS routinely worse-the extreme of which is known as PMDD. But even without chronic concerns, if the stars align against you and throw an anxiety-inducing situation in your lap right before your period, you're more likely to feel depression, anxiety, and general, uncontrollably emotional feelings that are already wrapped up in PMS-but worse, Dr. Ross says. "If you feel more emotionally fragile, you may not handle the one to two weeks leading up to your period as well as you would during less stressful times." (Related: Try This Guided Meditation the Next Time You Feel Overwhelmed with Anxiety)
8. Too Much Caffeine
"Caffeine is considered a vasoconstrictor which decreases blood flow to organs," Dr. Prince says. Two main ways this manifests: constricted blood vessels in the GI tract make you bloated and not enough blood to the heart will skyrocket your heart rate and induce anxiety. Stick to your usual shot count to avoid unpleasant side effects. (Psst...these 11 foods help fight stress and anxiety.)
9. Sneaking In a Cigarette
Cigarettes affect your hormone levels, which can exacerbate PMS symptoms, says Dr. Prince. And you don't have to be a chain-smoker to feel the effects; even just one or two slip-up smokes to relieve stress or when you're out drinking count, too.