The Scientist: Sara Gottfried, M.D., OB/GYN, a gynecologist and author of “The Hormone Cure

The Answer: Between 60 and 80 percent of women experience PMS, and it’s perfectly common for their particular cocktail of symptoms to vary from month to month and to get worse as they approach menopause (after which, they’ll stop completely). PMS is closely tied to the hormone progesterone, which declines as you age, especially between 35 and 45 years old, as you start to run out of good eggs. The period before menopause, called perimenopause, is a particularly rocky time for many women. Think rage, headaches, cysts, miserable periods and sleep disorders.

Progesterone stimulates the GABA receptors in your brain, which have sedative qualities. Progesterone is your friend; it calms you down when you get enraged, helps you sleep and makes you feel more calm, cool and collected. So when there’s less of it—and as your body builds resistance so that you need more of it to have the same effect—well, you can turn into a cranky mess.

Hormone imbalance is at the heart of a lot of menstrual woe, but other factors play into it as well. Diet is a big one, which you can control. Caffeine, low calcium and excessive sugar consumption trigger PMS symptoms. Not getting enough magnesium can make bloating worse—and too much sugar can cause magnesium loss. Taking vitamin B6 with magnesium can reduce PMS-related anxiety. Chronic stress lowers your level of progesterone, so stress management (guided breathing, meditation, yoga) is especially important for women with bad PMS. If you’re on birth control and have nasty symptoms, you can talk to your doctor about finding a pill that does a better job balancing your hormones.

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Stress and Your Cycle