Mood swings and emotion regulation: what the research says

How do women with PMDD process emotions differently in their brains?

Women with PMDD show increased activity in emotion-processing brain networks, especially during the luteal phase, and this baseline difference even appears in the follicular phase and relates to symptom severity.

Do women with PMS handle emotions differently at different times of the cycle?

Yes. Women with PMS tend to use emotion coping strategies that make symptoms worse (like dwelling on negative thoughts) and fewer strategies that help (like accepting difficult thoughts). These patterns change across the menstrual cycle.

Do people with PMDD and severe PMS have difficulties with emotion regulation?

People with PMDD and severe PMS may have difficulties identifying emotions and choosing how to handle them, particularly using rumination (replaying upset thoughts) in the late-luteal phase. Evidence remains limited.

Does teaching adolescent girls about their menstrual cycle and health help reduce period pain and PMS?

Yes. A systematic review of five good-quality studies shows that psychoeducation (structured teaching) significantly reduced period pain and PMS symptoms and improved emotional wellbeing in adolescent girls.

Does paroxetine work better if taken daily or just during your luteal phase for PMDD?

Daily paroxetine had an 85% response rate and was most effective overall, while luteal-phase-only paroxetine worked equally well for irritability and mood swings but was weaker for depression and physical symptoms. This well-designed study provides reliable results.

How many different ways do researchers measure PMS in clinical trials?

Researchers use many different measurement tools across studies. 65 different questionnaires were found in 350 trials of PMS drugs, making it hard to compare whether treatments actually work.

What coping strategies help women manage PMS symptoms?

Many strategies help manage PMS: psychological and behavioral changes, lifestyle modifications, and complementary methods like yoga and meditation. Programs combining counseling, education, and lifestyle changes work best and have few side effects.

Do how you think about your period and how you manage emotions affect PMS and PMDD?

Yes. How you view your period and whether you reframe difficult thoughts (cognitive reappraisal) matter. Women who reframe thoughts had less distress, while those who suppress feelings and deny menstrual impact had more.

Does acceptance and commitment therapy help women with PMS manage emotions and unhelpful thoughts?

Yes. Eight weeks of acceptance and commitment therapy improved emotional regulation and reduced unhelpful thought patterns in women with PMS, with benefits lasting at least 2 months after treatment.

How do beliefs about control and ways of handling emotions affect distress before your period?

Women who believed their premenstrual period was uncontrollable experienced stronger increases in distress before their period. Their general ways of handling emotions were linked to overall distress throughout the cycle rather than specifically to increases before the period.

Is emotional dysregulation linked to premenstrual symptoms?

Yes, emotional dysregulation is significantly linked to premenstrual symptoms. Women with poor emotional regulation are more likely to experience severe premenstrual symptoms.

Do women with PMS have difficulty managing emotions across their whole cycle or only before their period?

Women with PMS reported more difficulty managing emotions overall, but when tested at different cycle phases, these difficulties were not actually found. Whether emotion problems cause PMS or untreated PMS makes women feel like they have emotion problems remains unclear.

Do estrogen and progesterone each trigger PMDD symptoms differently?

Yes, likely. Both hormones triggered mood symptoms in women with PMDD when reintroduced after suppression, but progesterone appeared more closely linked to irritability and mood swings than estrogen.

Can group therapy help adolescent girls with PMS manage emotions and reduce binge eating?

Yes. Adolescent girls who received group supportive psychotherapy showed significant improvement in anger control, mood, anxiety, and positive emotions, and a significant reduction in binge eating compared to girls who did not receive treatment.

Can a smartphone app help diagnose and monitor PMS?

Yes. A Telegram chatbot achieved 80% active participation and tracked PMS symptoms effectively, showing promise as a tool for diagnosis and monitoring.

How does PMS affect the brain's response to positive emotions?

Women with PMS show reduced brain activity when viewing positive emotional images, especially during the luteal phase, and have lower mood scores throughout their cycle. This suggests emotional changes in PMS happen even when women don't notice symptoms.

How do relationship difficulties and emotional control affect the link between PMS and poor sleep?

Both relationship difficulties and how people manage emotions affect the link between PMS and sleep problems. When women suppress emotions more, PMS affects sleep differently.

Do women with PMDD who experienced childhood trauma have more trouble recognizing emotions?

Yes. Women with PMDD who experienced childhood trauma, especially physical or sexual abuse, had significant difficulty recognizing emotions compared to women with PMDD who were not traumatized.

Does cognitive-behavioral hypnotherapy reduce period pain and PMS symptoms?

Yes. Hypnotherapy significantly reduced period pain, PMS symptoms, and improved women's emotional regulation.

Does experiencing stressful life events change how your mood varies during your menstrual cycle?

Yes. Women who experienced more stressful or traumatic life events show bigger mood and mental health changes during the premenstrual phase, particularly increases in suicidal thoughts.

Does emotion regulation change during your menstrual cycle or with birth control?

Yes, but it depends on whether you use birth control. Women with natural cycles showed less brain response to negative emotions in the second half of their cycle compared to the first half, while women using birth control pills or IUDs showed sustained responses.

Does emotion-focused therapy help PMDD symptoms?

Yes. Emotion-focused therapy significantly reduced PMDD symptoms, emotion regulation difficulties, and depression and stress over 16 weeks compared to a waiting list control.

Does the menstrual cycle affect daily changes in suicidal thoughts?

Yes, for women with suicidal ideation. They had worse suicidal thoughts and planning during certain menstrual cycle phases, particularly around menstruation, driven mainly by depression and hopelessness.

Are calorie tracking and eating disorders linked to menstrual problems in female athletes?

64.6% of resistance-trained athletes tracked calories. Limited connections appeared between body image concerns or eating disorders and menstrual cycle problems. However, there was a clear link between eating disorders and missing periods.

Do Pilates exercises help women with PMS manage emotions and stress?

Yes. Pilates exercises significantly improved emotion regulation and stress tolerance in women with PMS, with benefits lasting at follow-up.

Does the menstrual cycle affect how often women have suicidal thoughts?

Yes. Women with recent suicidal thoughts reported significantly more severe ideation during the perimenstrual phase (around their period) compared to other cycle phases. The cycle explained 25% of the change in suicidal thoughts.

Does alternate-day modified fasting improve PMS symptoms and quality of life in overweight or obese women?

Yes, alternate-day modified fasting improved mood lability, expressed anger, and mental health more than daily calorie restriction. These improvements were statistically significant but dropout was high.

Do emotion regulation strategies help women with PMDD manage mood and stress hormones?

Women with PMDD use less helpful emotion regulation strategies. Using better strategies improves daily mood but does not fully prevent the premenstrual mood drop. Mindfulness may help maintain normal stress hormone levels.

Do women with PMDD have different brain function at different cycle phases?

Yes. Women with PMDD have worse focus and decision-making during the week before their period, and they have more difficulty managing emotions throughout the cycle.

Do hormone pills prevent suicidal thoughts from getting worse around menstruation?

Yes. Giving women estradiol and progesterone during the time when their natural levels drop (around menstruation) significantly reduced suicidal thoughts, depression, and feelings of rejection and burden compared to placebo.

How common are premenstrual symptoms, and do they change with age?

Very common. Food cravings affect 85%, mood swings 64%, and fatigue 57%. Several symptoms got worse with age, but mood symptoms stayed the same across all age groups.

Does a transdiagnostic treatment program help adolescent girls with premenstrual syndrome?

Yes. Girls who received 8 weeks of treatment had significantly greater improvement in PMS symptoms and emotion regulation compared to girls in the control group.

Does the menstrual cycle affect women's ability to train and compete?

Yes. Women who experienced more frequent menstrual symptoms were significantly more likely to miss or change their training, miss competitions, miss work or school, and use pain medication.

Does cognitive-behavioral emotional regulation training help women with PMDD?

Yes. Training significantly improved marital happiness and emotional regulation in women with PMDD. This was a small study with a control group, so the effect is promising but needs confirmation in larger studies.

Does fatigue change across the menstrual cycle, especially in women with anxiety?

Mental fatigue increases during the high-hormone phase in healthy women, rising to levels that women with anxiety disorder experience. Physical fatigue does not change, and hormone levels alone do not explain fatigue.

Does progesterone therapy help premenstrual syndrome in women with PCOS?

Yes, progesterone significantly reduced multiple emotional PMS symptoms in women with PCOS, including depression, anxiety, and mood swings.

Do women with PMDD struggle to control emotions because of different brain activity?

Yes. During the late luteal (premenstrual) phase, women with PMDD had less activity in parts of the brain involved in controlling emotions compared to control women and compared to their own activity during the early cycle phase.

Can couples therapy help with severe PMS or PMDD more than individual therapy alone?

Yes. Both one-to-one and couple-based CBT reduced premenstrual symptoms and distress compared to a wait-list control, and couple-based CBT added extra benefits for coping skills and relationship quality. This comes from a moderate-sized randomised trial, so results are promising but not definitive.

Do women using hormonal birth control have fewer menstrual symptoms?

Most women have menstrual symptoms regardless of birth control use. Women not using hormonal contraception report slightly more symptoms on average (5.9 versus 5.3 symptoms).

Do hormonal contraceptives reduce PMS symptoms?

Hormonal contraceptives are linked to lower risk of some PMS symptoms, including cramps, fatigue, and depression, but not others like mood swings and bloating.

Do women with PMS have more difficulty controlling their emotions?

Women with PMS tend to suppress emotions rather than rethink situations, and PMS severity is linked to more suppression and less reappraisal. When suppressing emotions, women with PMS show stronger physical stress responses than women without PMS.

Does progesterone reduce PMS symptoms in women with polycystic ovary syndrome?

Yes. Women with PCOS and PMS who took progesterone had significant reductions in depression, anxiety, mood swings, bloating, and several other PMS symptoms compared to placebo.

Does your personality type affect your hormone levels during your menstrual cycle?

Yes. Women with higher activity and endurance and lower emotional reactivity had nearly twice the estrogen levels and more favorable progesterone patterns than women with opposite traits.

Do headaches, irritability, and mood swings get worse or better during the transition to menopause?

Surprisingly, these symptoms improve. Headaches decrease, and irritability and mood swings decline as women approach menopause, though these improvements are linked to hormone shifts and especially to a woman's PMS history and current stress.

Do mood swings happen the same way in people taking birth control pills compared to people not taking them?

In young healthy women, mood worsened before menstruation and improved around ovulation regardless of birth control pill use. The mood patterns were the same in both groups.

Does sexual behavior change across different phases of the menstrual cycle?

Sexual behavior varies across cycle phases. Masturbation is highest during the follicular and ovulatory phases for women without a partner, but not for those with a live-in partner. Sexual activity with a partner peaks in the follicular phase for both groups.

How common are premenstrual symptoms in American women, and what factors affect them?

Premenstrual symptoms are very common in American women, with over 30% experiencing weight gain, headache, mood changes, and other symptoms, though only 2% to 8% found them severe.

Can a yoga program designed for different cycle phases reduce PMS symptoms?

Yes. In an 8-week study, 15 women with PMS who did cycle-specific yoga five times per week showed significant decreases in PMS symptoms and improved quality of life, with no adverse effects.

Does controlling personality traits help emotional regulation in women with PMS?

The study found that controlling neuroticism (a tendency toward negative emotions) was linked to emotional regulation differently in mild versus moderate PMS. The relationship was complex and depended on PMS severity.

Do emotional regulation and resilience change during the menstrual cycle in women with PMDD?

Women with PMDD have much higher depression and anxiety than other women, especially before their period. Their ability to handle emotions and bounce back from stress is significantly lower during that time.

What causes PMDD?

PMDD happens when the brain is too sensitive to hormonal changes during the menstrual cycle. Many brain systems are involved, but most of the mechanisms still need direct testing.

What do we know about PMDD in autistic people and those with ADHD?

Very little research exists on PMDD specifically in autistic people and those with ADHD. Early evidence suggests they may experience more severe symptoms and face barriers to diagnosis, but we cannot yet say for certain.

Does estradiol level affect mood and how we relate to others during the menstrual cycle?

Yes. Higher estradiol in the late follicular phase improved mood and self-esteem, while lower estradiol in the early follicular phase increased irritability. This small study of 23 women provides initial evidence, but more research is needed.

What patterns of mood changes and food cravings occur during the menstrual cycle in college students?

Nearly 60% reported food cravings during menstruation, with dairy products most common. Mood swings were most prominent in the premenstrual phase and linked to poor sleep quality.

Are the most bothersome premenstrual symptoms physical or emotional?

Emotional symptoms like stress, anxiety, and depression are reported at much higher levels than physical symptoms. Married women experience significantly more emotional distress than unmarried women.

Can changing your diet help with period and PMS symptoms like fatigue, mood swings and bloating?

This paper suggests certain foods may help, but it is not a real study on people, it is a write-up of general nutrition advice based on a newspaper health article, so it does not prove anything.

How common is premenstrual tension and does it affect university students' studies?

65.2% had premenstrual symptoms and 8.1% met PMDD criteria. Those with symptoms had more difficulty concentrating, worse exam performance, and less participation in activities.

How common is PMS in female undergraduate medical students?

PMS was very common, affecting 73.6% of students. Abdominal pain and cramping were the most common symptoms, followed by mood swings and irritability. Weight was not linked to PMS in this group.

Is premenstrual syndrome more common in women with higher body weight?

PMS was most common in normal weight women (33%) and overweight women (30%), not clearly linked to obesity (22%). The study cannot explain why.

Does an Ayurvedic treatment called Brahmi Shirodhara reduce PMS mood swings?

The treatment showed a 25.3% improvement in overall PMS symptoms. However, this was a very small pilot study with no control group, so we cannot be confident this will work for everyone.

Do college students know that exercise helps PMS and do they actually exercise?

Two-thirds of students knew that aerobic exercise can help PMS and 75% thought exercise was good. But only 34% actually exercised regularly, showing a big gap between knowing and doing.

What types and amounts of exercise help or harm PMS?

Regular moderate aerobic exercise and yoga reduce PMS symptoms like pain, fatigue, anxiety, and low mood. However, very high-intensity training combined with insufficient food can worsen menstrual health.

Is there a link between how severe PMS is and mood swings?

Yes. The worse the PMS, the worse the mood tends to be. There was a statistically significant but weak to moderate link between PMS severity and mood.

Do emotional traits and emotion regulation affect PMS and PMDD?

Yes. Women with negative personality traits and difficulty accepting emotions were more likely to have PMS or PMDD. These emotional factors appear to play a role in these conditions.

Does your personality type affect how much emotional PMS symptoms you have?

Yes. Your temperament or personality type is a strong predictor of emotional PMS symptoms like irritability and mood swings.

Does eating fewer calories affect sleep during the menstrual cycle?

Yes. Eating 55% fewer calories disrupts sleep in healthy young women, especially in the late luteal phase when hormone levels are higher.

Does difficulty managing emotions make menstrual mood symptoms worse?

Yes. Women who struggled to manage their emotions had higher anxiety and sadness during the days right before and at the start of their period, and experienced stronger urges to smoke when they felt sadder during this time.

Does autogenic relaxation help manage mood swings in PMS?

Autogenic relaxation (focused breathing and attention techniques) improved mood in adolescent girls with PMS, with most shifting from negative to positive mood. The study lacked a control group, so we cannot be certain the improvement was due to the technique alone.

Does anxiety and emotion regulation change across the menstrual cycle in women with PMS and PMDD?

Yes, women with PMS and PMDD showed higher anxiety sensitivity and worse emotion regulation during the luteal phase compared to those without these conditions.

Does PMS affect how women control emotions and feel socially connected?

Women with more PMS symptoms had poorer emotional regulation and felt more socially isolated. This is a small single-location study showing an association.

How common is PMS among female medical students, and how severe are the symptoms?

PMS is very common in female medical students (71.1%), with most having both emotional and physical symptoms of moderate severity.

Do personality traits and emotion control affect PMS?

Women with lower self-directedness and cooperativeness, and higher harm avoidance, tend to have PMS. Difficulty controlling emotions partly explains this link.

How do mood and emotion regulation differ between women with PMS and PMDD?

Women with PMS had reduced activity in the brain region controlling emotional responses, while women with PMDD did not show this difference. Both groups had different mood patterns across phases of the menstrual cycle.

Do sports activities reduce PMS symptoms and improve mood in young women?

Mood swings were significantly better in sports students (more positive) than non-sports students, but PMS symptoms showed no significant difference between the groups. This is low-strength evidence from a small observational study.

Can PMDD cause psychosis that returns with each menstrual cycle?

Yes. A woman experienced psychotic symptoms starting 5 days before her period and ending when her period began, and this pattern repeated every month for 5 years. Treatment with medications reduced the severity but did not completely stop the symptoms.

How is PMDD diagnosed and treated in teenagers?

One 19-year-old girl with severe cyclical mood symptoms was diagnosed with PMDD by tracking symptoms for two menstrual cycles and improved markedly after starting an SSRI and birth control pills.

What PMS symptoms do nursing students experience?

Most nursing students experience PMS symptoms. The most common were lower abdominal pain in 55.6%, mood swings in 64.9%, and fatigue in 39.8%.

How much does PMS affect female students' grades, mood, and social life?

Significantly. PMS was linked to mood swings, irritability, delayed homework, and social withdrawal. The study was observational, so it shows associations but not proof of cause.

Does attachment style affect how severe premenstrual symptoms are?

For women not on hormonal birth control, yes. Women with anxious attachment (being very worried in relationships) had more severe premenstrual symptoms through difficulty controlling emotions. Women on hormonal contraception did not show this pattern.

Does low energy availability or eating problems affect how well young female soccer players perform?

No. Low energy availability and eating problems were not significantly linked to physical performance. However, most players perceived their menstrual cycle affected their game, and they rarely discussed this with coaches.

Does matching your running training to your menstrual cycle phase improve performance, recovery and wellbeing?

This pilot study was designed to test that question, but the text available here stops before the results section, so no answer can be given yet.

What does research show about PMDD neurochemistry?

The provided text does not include results from a PMDD neurochemistry study. It discusses unrelated research on other topics.

Can neurofeedback targeting emotion brain regions help people with PMDD?

Neurofeedback targeting the amygdala (a brain region that processes emotions) significantly reduced anger and other emotional symptoms compared to control neurofeedback. Improvement was stronger in people who learned more from the training.

Does exercise affect how the brain responds to sadness in women with PMS?

In women with severe PMS, exercise slowed down the brain's response to sad faces, suggesting it may affect emotion regulation areas. However, this is based on a small study measuring brain activity changes, not actual symptom relief.

Can Spiritual Emotional Freedom Technique help with premenstrual mood swings?

Unable to answer based on this abstract. The abstract describes the study methods but does not report the results or whether SEFT therapy helped.

Does psychological capital and marital satisfaction help women with PMS manage their emotions better?

Yes. Women with stronger psychological capital (more hope and confidence) managed their emotions better, and this connection worked both directly and through marital satisfaction.

Does sertraline help women with severe premenstrual dysphoric disorder?

In this case, a 44-year-old woman with severe PMDD symptoms showed complete recovery after taking sertraline for two menstrual cycles, and was able to continue taking it just during the week before menstruation.

What factors make PMS mood swings worse?

Stress, gynecological conditions like endometriosis and PCOS, and family history of bipolar disorder can worsen PMS. About two-thirds of women (67.4%) reported PMS and a quarter (25.6%) had PMDD.

Do brain wave patterns differ across the menstrual cycle in women with PMS?

Yes, women with high PMS show a specific brain wave pattern (higher delta/beta power ratio) during the late luteal phase compared to the follicular phase. Women with low PMS do not show this pattern.

How does competitive swimming affect menstrual cycles and PMS symptoms?

31% of competitive swimmers experienced menstrual cycle stoppage for over 3 months. More intense swimming predicted worse cycle problems, but maintaining a healthy body weight protected against disruptions. Swimming did alleviate some PMS symptoms.

What are the most common PMS symptoms in young women?

Psychological symptoms were most common at 95.8%, with mood swings in 88%, acne in 85.9%, and fatigue in 65.5%. This small study of students at one university may not apply broadly.

Does a history of childhood trauma make premenstrual symptoms worse?

Yes, women who reported more childhood trauma also reported more severe premenstrual symptoms, and this link seemed to be fully explained by difficulties managing emotions.

Does how women control disgust change during the menstrual cycle?

In the follicular phase, suppressing disgust worked better than rethinking it. In the luteal phase, both strategies produced similar results.

Do past trauma and emotions predict PMS severity?

Yes. How women cope emotionally, particularly catastrophizing (assuming the worst), predicted about one-third of PMS severity. Past trauma involving life threat also predicted about one-third of PMS severity.

Do sleep and emotion regulation explain why depression is linked to worse premenstrual symptoms?

Yes, both poor sleep and difficulty regulating emotions partly explain why women with depression also experience more severe premenstrual symptoms. These factors appear to mediate the connection between mood problems and menstrual cycle symptoms.

Are PMS symptoms linked to how women feel about their health and stress?

Yes. Women who reported feeling unhealthy or stressed had much more severe PMS symptoms. How a woman perceives her own health was the strongest factor linked to PMS symptom severity.

Does stress from studying medicine make PMS worse?

Medical students had higher PMS scores than non-medical students (93.791 vs 88.473), suggesting stress may worsen PMS. Both groups scored above the PMS threshold. Without a control group, we cannot be certain stress is the cause.

How common is premenstrual syndrome among medical students?

About 3 out of 4 medical students in this study had PMS. Mood swings and anxiety were most common.

Do difficulties handling emotions affect premenstrual symptom severity?

Yes. Women who act impulsively when upset had worse premenstrual symptoms. Women who ruminate (think repetitively about problems) had symptoms that increased faster before their period and improved more slowly afterward.

Does estrogen affect anxiety and mood problems in PMDD, and does a woman's genes play a role?

In women with PMDD, higher estrogen before the period was linked to lower anxiety and stress, but only in women carrying a specific genetic variant. This shows correlation in this subset and cannot confirm cause and effect.

Do Asian and Caucasian women experience different PMS symptoms?

Yes. Asian women reported significantly higher rates of mood swings, depression, food cravings, digestive problems, and menstrual cramps, and had shorter menstrual periods.

Can diet help with PMS symptoms?

Diet may affect PMS. High intake of tea, coffee, cola, alcohol, chocolate, and sugary snacks is linked to worse symptoms, while adequate milk and certain minerals may help.

Can women in the midluteal phase suppress their response to negative emotions as well as men?

No. Women in the midluteal phase showed greater difficulty suppressing brain responses to negative emotions compared to men, and also reported more distress and effort when trying to suppress their responses.

Do women with PMDD have more difficulty controlling their emotions?

Yes. Women with PMDD reported significantly more trouble controlling emotions and more impulsive behavior than healthy women. Cognitive and behavioral strategies might help, but this finding is based on a small study.

Do women with PMDD have more difficulty regulating their emotions?

Yes. Women with PMDD and PMS had significantly more difficulty with emotional regulation compared to controls, especially those with psychological symptoms.

Does difficulty controlling emotions affect how PMS and anxiety change during your cycle?

Partially. Emotion regulation affected how much anxiety control changed between cycle phases, but did not clearly affect physical PMS symptoms.

Does how women smokers react to stress change during their menstrual cycle?

Yes. Women smokers react to stress differently depending on where they are in their cycle.

Does the menstrual cycle affect how well women can regulate their emotions?

Yes. Women had more trouble controlling sadness and other emotions during their period. They had to work harder but were less successful.

Does the menstrual cycle change how the brain responds to stress?

Yes. In the late luteal phase (before your period), stress affected brain emotion regions differently than in other cycle phases, with unexpected lower response in the late luteal phase. Women with higher natural hormone changes showed smaller brain responses to stress.

Do women prone to anxiety have different brain chemistry changes during the menstrual cycle?

This rat study suggests anxious individuals have different patterns of mood-related brain chemicals throughout their cycle compared to calm individuals. This is an animal model and cannot prove the same happens in women.

Are PMS symptoms the same from cycle to cycle?

Yes. Mood symptoms like anxiety and irritability are the most stable. These mood symptoms, not physical symptoms, cause most of the impact on daily life.

Are certain personality traits linked to PMS?

Women with PMS have higher scores on harm avoidance and novelty seeking compared to the general population. These traits are modestly linked to specific symptom patterns.

Are zinc and copper levels different between different phases of the menstrual cycle in women with PMS?

Women with PMS had lower zinc levels during the luteal phase (after ovulation) compared to the follicular phase (before ovulation). During the luteal phase, women with PMS also had lower zinc and higher copper compared to women without PMS.

Could progesterone antagonists help treat premenstrual syndrome?

Progesterone antagonists like RU-486 are theoretically promising for treating PMS because high progesterone levels may contribute to symptoms, but the medication has not been adequately tested in PMS and political controversy limits its availability for research.

Can progesterone tablets help PMS?

Oral micronized progesterone appears suitable for treating PMS, with no reported side effects on heart health factors tested. However, this is a review, not a clinical trial proving it works.

Are premenstrual and menstrual symptoms separate problems or part of one larger problem?

They appear to be part of one larger problem. Although some symptoms are worse before your period and others during it, the symptoms largely overlap.

Could hormone-driven changes in brain chemicals explain premenstrual mood swings?

This 1971 review suggests that shifting levels of ovarian hormones (estrogen, progesterone, aldosterone) during the cycle may affect mood by altering brain chemicals called monoamines, but this is a theory built from combining older human and animal studies, not a new trial in women with PMS.