Learn Staying Sober During PMS: 4 St...

Staying Sober During PMS: 4 Strategies to Protect Your Recovery

Staying Sober During PMS: 4 Strategies to Protect Your Recovery
By
Nikki Seay
Nikki Seay
Author
Updated December 18, 2025

Premenstrual syndrome, or PMS, has served as a punch line for thousands of jokes, one-liners, and Saturday Night Live skits. The problem is there’s nothing funny about this once-a-month “gift.” Aside from being a real pain – and an emotional roller coaster ride – PMS can also become a threat to sobriety.

Why PMS Symptoms Intensify in Recovery

When a normal person drinks alcohol, the brain’s endorphin receptors are flooded with serotonin and dopamine. The result is a flood of happiness and euphoria. For long-term alcoholics and binge drinkers, constant exposure to alcohol causes the brain’s neurotransmitter levels to become depleted. That means that any and all relief becomes totally dependent on the next drink.

Interestingly enough, many experts also believe that, for women in recovery, the brain becomes highly sensitive to PMS symptoms. And it’s that increased level of sensitivity that can ultimately lead some women to relapse.

PMS is actually a blanket term that describes a myriad of symptoms brought on by a woman’s monthly menstrual cycle. These symptoms can vary in intensity and duration, but the American College of Obstetricians and Gynecologists estimates 85 percent of menstruating women experience at least one physical, mental and cognitive symptom.1

Why PMS Increases Relapse Risk for Women in Recovery

Experts believe that PMS symptoms can create a hormonal imbalance within a woman’s brain. Just before ovulation, progesterone and estrogen hormone levels spike. If there is no fertilization (pregnancy), those levels quickly drop. This rise and fall of hormones is believed to lower levels of neurotransmitters like serotonin and GABA, which leads to feelings of depression and anxiety. Unfortunately, thousands of women reach for alcohol in an attempt to regulate these feelings.

PMS can make each and every emotion feel as if it has been painfully amplified. For some, combination of mood swings and physical pain culminates in the belief that they simply cannot cope. In the blink of an eye, weeks and months of sobriety can go up in flames.

PMS can make each and every emotion feel as if it has been painfully amplified. For some, combination of mood swings and physical pain culminates in the belief that they simply cannot cope.

4 Ways to Cope With PMS Without Reaching for a Drink

Fortunately, there are a number of coping skills that can help women overcome the PMS symptoms that threaten to derail sobriety. Instead of reaching for the bottle, try the following:

  1. Tell yourself this is only temporary; it’s just your hormone levels fluctuating. Approaching it from a calm and rational angle can help to slow your racing mind.
  2. Reach out to your AA sponsor or a trusted girlfriend. One study on PMS pointed out that many women cope with PMS by isolating themselves.2 Instead of locking yourself in a room, far away from your friends and family members, do the exact opposite. Opening up to someone about how you feel can often talk you off the ledge.
  3. Craving chocolate? Go for it; just make sure it’s dark chocolate. That’s because this form of chocolate contains more serotonin-boosting cocoa than any other.
  4. Exercise can be a great way to boost mood naturally. For PMS, low intensity activities like walking and yoga are recommended over high intensity workouts.3 Regular exercise can also increase sleep quality and relieve insomnia, another troublesome side effect of PMS.4

Learn more about available recovery programs specifically for women.


FAQs

A: Hormone shifts during the premenstrual phase can affect brain systems involved in mood and reward, which may make cravings feel stronger than usual. Research suggests these changes can increase emotional sensitivity and stress, both of which can raise vulnerability to cravings for people in recovery.5

A: Studies show that people with substance use disorders who experience PMS or premenstrual dysphoric disorder (PMDD) often report stronger alcohol cravings during this phase of the cycle. These symptoms do not cause relapse on their own, but they can make coping feel harder if you are not prepared with extra support.5

A: During PMS, increases in negative mood, irritability, or anxiety are common and have been linked to higher craving levels in people with alcohol use disorder.6 When you're no longer using substances to regulate emotions, these mood shifts can feel sharper, especially during early or ongoing recovery.

A: Yes. Research on smoking cessation shows that people often experience stronger withdrawal symptoms and cravings during certain menstrual phases, particularly the luteal phase.7 This suggests that hormonal changes can influence recovery efforts across different substances, not just alcohol.

A: PMS commonly includes symptoms like irritability, mood swings, anxiety, fatigue, and changes in appetite or sleep. Research shows these symptoms can interfere with emotional regulation and daily functioning, which may overlap with known relapse risk factors if you are not supported.

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