Does anxiety get worse before your period during perimenopause?

Many women notice that anxiety intensifies in the days leading up to their period during perimenopause. This premenstrual flare is driven by the sharper hormonal drops that characterize perimenopause cycles compared to regular menstrual cycles.

During perimenopause, your body often produces higher peaks of estrogen followed by steeper drops. The luteal phase (the 10 to 14 days before your period) is when progesterone should be dominant, but erratic ovulation during perimenopause means progesterone levels may be lower than normal. This imbalance makes premenstrual symptoms, including anxiety, more pronounced.

What you can do: Track anxiety severity alongside your cycle days. If you see a clear premenstrual pattern, you can proactively adjust your routine in the days leading up to your period. This might mean reducing caffeine, prioritizing sleep, choosing lower-intensity workouts, and increasing anti-inflammatory foods during that window.

If premenstrual anxiety is severely disruptive, your healthcare provider can discuss targeted interventions for the luteal phase specifically.