From the Research
Irritability in Premenstrual Syndrome (PMS) is primarily caused by hormonal fluctuations, specifically the changes in estrogen and progesterone levels that occur during the luteal phase of the menstrual cycle, which affect neurotransmitters in the brain, particularly serotonin, as evidenced by a recent study published in 2024 1. These hormonal shifts affect neurotransmitters in the brain, particularly serotonin, which regulates mood, sleep, and appetite. When serotonin levels decrease, irritability, mood swings, and emotional sensitivity often increase. Some key points to consider:
- Changes in brain chemicals like GABA (gamma-aminobutyric acid) can reduce the brain's ability to manage stress and regulate emotions.
- Other contributing factors include fluid retention, which can cause physical discomfort and bloating, and blood sugar fluctuations that may trigger mood changes.
- Some women may also experience sleep disturbances during the premenstrual period, and the resulting fatigue can worsen irritability. For those experiencing significant PMS-related irritability, treatment options include:
- Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, which has been shown to be effective in reducing premenstrual symptoms, including irritability, as demonstrated in a study published in 1992 2.
- Lifestyle modifications such as regular exercise and stress management techniques.
- Dietary changes including reducing caffeine, salt, and sugar intake while increasing complex carbohydrates and calcium-rich foods. It's worth noting that the most recent and highest quality study on this topic, published in 2024 1, found that SSRIs are probably effective in reducing premenstrual symptoms, including irritability, and are probably more effective when taken continuously compared to luteal phase administration.